About the DSM-5 Autism Levels

The brain. It all starts with the brain.

The DSM-5 autism support levels are categories that indicate an individuals needed support in order to properly handle their disability needs. Instead of the outdated autism spectrum which left many autistics feeling unheard and unseen the autism support levels is used as a guide for individuals, families, teachers and clinicians to understand how to provide appropriate interventions and support. 

These levels are broken up into 3 severities:

LEVEL 1

Requiring Support

Social Communication without support-

Individuals with level 1 ASD may exhibit difficulties in initiating and sustaining social interactions. These struggles cause noticeable impairments in social settings. They may have difficulty starting conversations and may not be able to engage in back and forth conversations. They may appear to be socially awkward. They often show decreased interest in social interactions and may prefer solitary activities or interacting with a limited number of familiar people.

Restricted, Repetitive Behaviours without support-

They exhibit behaviours that are inflexible and can significantly interfere with their daily life. For instance, they might insist on following specific routines or become upset with minor changes. Difficulty in switching between tasks or activities is common. They may struggle with transitions, such as moving from one task to the other. They may have trouble with organisational skills and planning, which can affect their ability to complete tasks independently.

LEVEL 2

Requiring Substantial Support

Social Communication without support-

Marked deficits in both verbal and non-verbal communication are evident even when support is in place. These deficits make social interactions significantly challenging. Individuals with level 2 ASD often have limited initiation of social interactions. They may have a reduced ability to engage in meaningful back and forth communication and may use atypical responses in social settings. Their responses to social overtures from others may be noticeably abnormal. For example, they might not respond to social cues or may misunderstand social contexts.

Restricted, Repetitive Behaviours without support-

Their behavior is obviously inflexible and interferes with functioning in multiple settings. They may engage in repetitive behaviors that are noticeable to others. Changes in routine or unexpected events can cause significant distress or difficulty. They experience considerable difficulty in changing focus or transitioning between activities, which can impact their ability to function in daily life.

LEVEL 3

Requiring Very Substantial Support

Social Communication without support-

Severe deficits in communication skills, both verbal and nonverbal, cause major impairments in functioning. These individuals have very limited initiation of social interactions. They may rarely engage in back-and-forth communication and have minimal response to others. They may not respond to social overtures or may only respond in a very limited or atypical manner.

Restricted, Repetitive Behaviours without support-

Their behaviors are highly inflexible and interfere with functioning across all areas of life. These behaviors are obvious and extreme. They experience extreme distress with any change in routine or environment. They have great difficulty in changing focus or action, and this rigidity significantly impairs their ability to engage in everyday activities.

References:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

• Volkmar, F. R., & McPartland, J. C. (2014). From Kanner to DSM-5: Autism as an Evolving Diagnostic Concept. Annual Review of Clinical Psychology, 10, 193-212.