Understand the three levels of autism

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Anyone who meets the criteria for an autism spectrum disorder (ASD) will also be diagnosed with ASD level 1, ASD level 2 or ASD level 3 according to the criteria established in the Diagnostic and Statistical Manual of Disorders Mental, Fifth Edition (DSM) … -5) .

These levels are based on a person's strengths and limitations in terms of their ability to communicate, adapt to new situations, transcend limited interests, and manage daily life. They specifically indicate how much support an autistic person needs, Level 1 indicates that relatively little support is needed, and Level 3 indicates that significant support is needed .

Illustration by Cindy Chang, Get Drug Information

The three levels of autism allow doctors to make a specific diagnosis and also help people caring for an autistic person to have a clear understanding of the person's strengths and weaknesses. The levels described in the DSM-5 reflect a better way to diagnose autism than in the previous DSM.

In the previous version, DSM-IV, autism was divided into five different diagnoses, ranging from Asperger syndrome (often used to describe mild or "high-functioning " autism) to autistic disorder, indicating severe autism . .

Level 1: Support required

Level 1 ASD is the mildest or most functional form of autism. Children with level 1 ASD have difficulty communicating properly with others. For example, they may not say the right things at the right time, or they may not be able to read social cues and body language.

A person with ASD Level 1 can generally speak in complete sentences and communicate, but finds it difficult to have a direct conversation with others. They may try to make friends, but without much success .

They can also be inflexible in certain relationships and have trouble moving from one activity to another. In addition, they may have organizational and planning problems that prevent them from being as independent as expected for their age.

Tier 2: Substantial support required

People with a level 2 ASD will have more obvious problems with verbal and social communication than people with a level 1 diagnosis. They will also find it more difficult to change focus. For example, they can get very upset when they need to switch from one activity to another or leave school at the end of the day.

Level 2 children tend to have very limited interests and repeat the same behavior , which can make their job difficult in certain situations .

A person diagnosed with level 2 ASD tends to speak in simple sentences and also has difficulties with non-verbal forms of communication .

Level 3: Very substantial support is required

Level 3 is the most severe form of autism. Children in this category will exhibit behavior much the same as Level 1 and Level 2 children, but to a more extreme degree.

Difficulty expressing yourself both verbally and nonverbally can make it difficult to function, socially interact, and change focus or location. Repetitive behavior is another symptom of level 3 ASD.

A person with level 3 ASD will have a very limited ability to speak clearly and will rarely initiate interaction. When they start the interaction, they will be embarrassed to do so. Someone with a Level 3 will also only react to very direct social approaches from other people.

RAS level limitations

While ASD levels are helpful in determining the severity of autism and the need for support, these categories are not exhaustive. They can be subjective and nuanced, and DSM-5 offers little specificity regarding the types of support specified or situations in which support is required. For example, some autistic people need support at school but feel good at home, while others may do well at school but struggle in social situations.

Additionally, the level assigned to a person at first diagnosis may change as social skills develop and improve, and as the severity of problems such as anxiety or depression, common among people with autism, fluctuates.

Bottom Line: Assigning one of the three autism levels can be helpful in understanding how highly functional or underdeveloped a person can be and in determining what types of services and supports will best serve them. However, it cannot predict or account for the nuances in their personality and behavior, which means that the support and services they receive must be highly individualized.

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