Introduction
The autism spectrum disorder (ASD) levels grading system is a way for clinicians to describe the amount of support an individual with autism may need in their daily life. This system was introduced in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and it classifies autism into three levels based on severity and the degree of support required.
Level 1: Requiring Support
- Description:
Individuals at this level have noticeable difficulties with social communication and may have restricted, repetitive behaviors. They can speak in full sentences and engage in conversations, but their attempts at social interaction may be unsuccessful. They may struggle to initiate social interactions or respond appropriately. - Support Needs:
These individuals require some support, such as help with planning and organizing or guidance in social situations. - Examples:
Trouble making friends, difficulty switching between activities, mild inflexibility in behavior.
Level 2: Requiring Substantial Support
- Description:
People at this level have more significant deficits in verbal and nonverbal social communication skills. They may speak in simple sentences, have limited interactions, and exhibit more noticeable repetitive behaviors. Social interactions are often limited to narrow interests or specific topics. - Support Needs:
They require substantial support in daily life, such as more frequent assistance with communication, adapting to changes, and managing behaviors. - Examples:
Marked difficulty coping with change, frequent distress or frustration, obvious problems with social interactions.
Level 3: Requiring Very Substantial Support
- Description:
Individuals at this level have severe deficits in verbal and nonverbal communication. They may use few words, have very limited social interactions, and exhibit extreme difficulty coping with change or managing repetitive behaviors. Their behaviors and communication challenges significantly interfere with daily functioning. - Support Needs:
They require very substantial support, which may include one-on-one assistance, intensive behavioral interventions, and help with nearly all aspects of daily living. - Examples:
Minimal or absent speech, extreme difficulty coping with change, frequent distress, and highly restricted, repetitive behaviors.
Why Is the Grading System Used?
The ASD levels grading system helps healthcare providers:
- Communicate the severity of symptoms and support needs
- Plan appropriate interventions and services
- Track progress and changes over time
It’s important to note:
The levels are not fixed labels—they can change as a person’s skills and needs evolve. Every individual with autism is unique, and support should be tailored to their specific strengths and challenges.
If you have questions about autism spectrum disorder levels or need guidance on support options, please reach out to our clinic for more information.