Three Levels of Autism By Dr Nadeem Ghayas

October 8, 2024

Autism influences an individual’s behavior, perception of the world, and self-expression. Although there are common traits among autistic individuals, each person presents their autism in a unique way. The three levels of autism assist healthcare providers in recognizing an individual’s specific needs and recommending suitable therapies. These therapies aim to help autistic individuals maximize their strengths and enhance their social, communication, and work-related skills.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) , differentiates autism spectrum disorder (ASD) into three levels . The distinct levels of support that people may require are reflected in these levels. This categorization emphasizes the variety within the autism spectrum as well as the particular requirements of every person on it.          

Level 1: Requires Support
Individuals at Level 1 have low support needs but may struggle with communication and social cues. They often find it challenging to transition between activities and may need help organizing their lives. While they can mask their autism, this can hinder access to necessary support, and some may receive a late diagnosis.

Level 2: Requires Substantial Support
Those diagnosed at Level 2 face greater difficulties in social interactions and communication compared to Level 1. They often have specific interests and may engage in noticeable repetitive behaviors, such as pacing or repeating phrases. These behaviors, known as stimming, help them manage sensory sensitivities. They have a greater need for self-regulation support.

Level 3: Requires Very Substantial Support
Individuals with a Level 3 diagnosis require the most assistance. They struggle to mask their autism and face significant challenges in communication and daily living tasks. These individuals may benefit from augmentative communication devices and are at higher risk for neglect and abuse. Social interactions are often limited, and they may prefer parallel play over direct engagement.