Levels of Autism – Understanding Autism Spectrum Disorder : Dr Nadeem Ghayas
November 7, 2025
Autism Spectrum Disorder (ASD) is a developmental condition that affects how a person thinks, learns, communicates, and behaves. It is called a “spectrum” because every person with autism is different. Some children may need only a little support, while others may need help throughout their lives. Understanding the levels of autism helps parents, teachers, and professionals provide the right kind of support for each child.
According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), autism is divided into three main levels. These levels show how much help or support a person needs in daily life. They do not measure intelligence or worth — they only describe the amount of assistance needed.
Level 1 – Requiring Support
This is the mildest level of autism. A person at Level 1 can usually talk, learn, and manage many things on their own, but they may still struggle with social situations. They might find it hard to make friends, understand jokes, or join group activities. Changes in daily routine can cause stress or frustration. With guidance, therapy, and patience, they can do well in school and daily life.
For example, a student who speaks well but prefers to be alone and becomes upset if plans suddenly change may be Level 1. With proper support, they can learn to handle new situations and build confidence.
Level 2 – Requiring Substantial Support
At Level 2, people need more help to communicate and manage everyday activities. They may use short sentences, take time to respond, or repeat certain words or actions. They often depend on fixed routines and may find change very upsetting. Focus on one interest for long periods is also common.
These children and adults benefit from regular therapy, special education programs, and consistent care at home and school. With strong family and community support, their communication and behavior can improve over time.
Level 3 – Requiring Very Substantial Support
This is the most severe level of autism. A person at Level 3 has great difficulty communicating and understanding others. Some may not speak at all and instead use gestures, pictures, or devices to express themselves. They may become extremely upset by even small changes in their surroundings. Repetitive behaviors and strong reactions are common.
Children at this level usually need constant help in their daily routines, therapy sessions, and close supervision. With early intervention and continuous support, they can still make progress and learn new skills at their own pace.
Autism in Pakistan and the Need for Support
In Pakistan, awareness about autism is growing, but many families still struggle to find the right services. Understanding these three levels helps parents and educators know how to plan therapy and education according to the child’s individual needs. Organizations such as the Association for Persons with Exceptional Needs (APEN) in Karachi are working to provide better opportunities, training, and awareness for children with autism and other special needs.
Every child with autism has their own strengths, talents, and challenges. With early diagnosis, family involvement, and professional guidance, many children can lead happy and productive lives. What matters most is continuous love, patience, and acceptance.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: APA.
Autism Speaks. (n.d.). Levels of Autism: Understanding the 3 Levels of ASD. Retrieved from https://www.autismspeaks.org/levels-of-autism
Medical News Today. (2024). What are the levels of autism? Retrieved from https://www.medicalnewstoday.com/articles/325106