Understanding Autism Levels: A Complete Guide to Level 1, 2, and 3 Autism
Learn about the three levels of autism spectrum disorder, what they mean, and how support needs vary at each level.
When the American Psychiatric Association updated the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013, they introduced a new classification system for autism spectrum disorder (ASD).
Instead of separate diagnoses like Asperger's syndrome or PDD-NOS, autism is now categorized into three levels based on the amount of support an individual needs.
Clinical Director's Insight
"I often remind families that autism levels describe support needs at a particular point in time – not a fixed limitation. In my 20+ years of experience, I've worked with children at all levels who have made remarkable progress with appropriate intervention.
What matters most isn't the level assigned but finding the right support that meets your child where they are and helps them grow."
– Jennifer Harbour, M.S., BCBA
What Are the Three Levels of Autism?
According to the Centers for Disease Control and Prevention (CDC), autism spectrum disorder is characterized by challenges in social communication and restricted, repetitive behaviors.
The three levels help clinicians, educators, and families understand the degree of support an individual needs:
- Level 1: Requiring support
- Level 2: Requiring substantial support
- Level 3: Requiring very substantial support
It's important to understand that these levels describe support needs, not intelligence or potential. Many individuals across all levels lead fulfilling, meaningful lives with appropriate support.
Level 1 Autism: "Requiring Support"
Level 1 autism was previously referred to as "high-functioning autism" or Asperger's syndrome (though these terms are no longer used in clinical diagnosis).
Individuals at this level typically have average or above-average intelligence and can often live independently with some support.
Characteristics of Level 1 Autism
Social Communication
- Difficulty initiating social interactions
- May appear awkward in conversations
- Struggles with back-and-forth communication
- May have trouble making or keeping friends
- Difficulty reading social cues
Behavior Patterns
- Inflexibility in routines
- Difficulty with transitions
- Problems with organization and planning
- May have intense special interests
- Can mask or camouflage autistic traits
Support Needs at Level 1
Individuals with Level 1 autism often benefit from:
- Social skills training and support
- Executive functioning coaching
- Workplace accommodations
- Therapy to manage anxiety or sensory sensitivities
- Clear, explicit communication from others
Level 2 Autism: "Requiring Substantial Support"
Level 2 autism describes individuals who need more significant support in their daily lives. Their challenges with social communication and behavioral flexibility are more noticeable to others.
Characteristics of Level 2 Autism
Social Communication
- Marked deficits in verbal and nonverbal communication
- Limited initiation of social interaction
- Reduced or abnormal responses to social overtures
- May speak in simple sentences
- Interaction limited to narrow special interests
Behavior Patterns
- Inflexibility of behavior causes significant interference
- Difficulty coping with change
- Restricted/repetitive behaviors are obvious to casual observers
- Distress when focus is changed from special interests
- May require support in multiple settings
Support Needs at Level 2
Individuals with Level 2 autism typically benefit from:
- Regular therapy sessions (including ABA therapy)
- Speech and language therapy
- Occupational therapy for daily living skills
- Structured educational environments
- Visual supports and schedules
- Support with transitions and changes
Level 3 Autism: "Requiring Very Substantial Support"
Level 3 autism describes individuals who need the most support. They have severe challenges in social communication and behavioral flexibility that significantly impact their daily functioning.
Characteristics of Level 3 Autism
Social Communication
- Severe deficits in verbal and nonverbal communication
- Very limited speech or nonverbal communication
- Minimal response to social overtures from others
- May be minimally verbal or nonverbal
- Very limited initiation of social interaction
Behavior Patterns
- Extreme difficulty coping with change
- Great distress when routines are interrupted
- Repetitive behaviors markedly interfere with all areas
- Very difficult to redirect from fixed interests
- May engage in self-injurious behaviors
Support Needs at Level 3
Individuals with Level 3 autism typically require:
- Intensive, one-on-one support throughout the day
- Comprehensive early intervention programs
- Alternative and augmentative communication (AAC) systems
- Highly structured environments with minimal changes
- Specialized educational settings
- Support with all activities of daily living
- Intensive behavioral intervention
Comparison of Autism Levels
| Aspect | Level 1 | Level 2 | Level 3 |
|---|---|---|---|
| Support Needed | Some support | Substantial support | Very substantial support |
| Communication | Verbal, some difficulties with social nuances | Limited verbal/nonverbal, marked deficits | Minimal verbal, severe deficits |
| Social Interaction | Difficulty initiating, appears awkward | Limited initiation even with support | Very limited response to others |
| Behavioral Flexibility | Some rigidity, difficulty with transitions | Significant inflexibility, obvious to others | Extreme inflexibility, great distress with change |
| Independence | Often can live independently | May need supported living | Requires significant daily support |
Can Autism Levels Change Over Time?
Yes, autism levels can change over time, particularly with appropriate interventions. Research published in the Journal of the American Academy of Child & Adolescent Psychiatry shows that early intervention can significantly improve outcomes for children with autism.
Factors that can influence changes in support needs include:
- Early intervention: Children who receive early, intensive intervention often show significant improvements
- Type of therapy: Evidence-based approaches like ABA therapy have strong research support
- Individual development: Some skills naturally develop over time
- Environmental support: Appropriate accommodations can reduce the impact of challenges
- Life transitions: Support needs may increase during stressful periods
How ABA Therapy Helps at Every Level
Applied Behavior Analysis (ABA) is considered the gold standard treatment for autism spectrum disorder, with decades of research supporting its effectiveness. ABA therapy can be tailored to support individuals at all three levels:
For Level 1
- Social skills development
- Conversation skills training
- Executive functioning support
- Anxiety management strategies
- Self-advocacy skills
For Level 2
- Communication skill building
- Daily living skills training
- Behavior management
- Transition support
- Academic skill development
For Level 3
- Alternative communication
- Intensive skill building
- Reducing challenging behaviors
- Safety skills
- Self-care independence
Start Your Child's Journey Today
Buzz ABA provides comprehensive, evidence-based ABA therapy in Concord, Manchester, Nashua, and surrounding NH communities. Our neurodiversity-affirming approach helps children thrive.
Schedule Free ConsultationFrequently Asked Questions
What are the three levels of autism?
The DSM-5 defines three levels of autism based on support needs: Level 1 (requiring support), Level 2 (requiring substantial support), and Level 3 (requiring very substantial support). These levels help describe how autism affects an individual's daily functioning.
What is Level 1 autism?
Level 1 autism, previously called high-functioning autism or Asperger's syndrome, describes individuals who require some support. They may have difficulty initiating social interactions, show inflexible behavior, and struggle with organization and planning, but can often communicate verbally and function independently in many areas.
What is Level 2 autism?
Level 2 autism describes individuals requiring substantial support. They show marked deficits in verbal and nonverbal communication, limited social interaction even with support, inflexible behavior, difficulty coping with change, and restricted/repetitive behaviors that are obvious to casual observers.
What is Level 3 autism?
Level 3 autism describes individuals requiring very substantial support. They have severe deficits in verbal and nonverbal communication, very limited social interaction, extreme difficulty coping with change, and restricted/repetitive behaviors that markedly interfere with functioning in all areas.
Can autism levels change over time?
Yes, autism levels can change over time, particularly with appropriate interventions like ABA therapy. Many individuals, especially those who receive early intervention, may develop skills that reduce their support needs. However, autism itself is a lifelong condition, and support needs may also increase during challenging life transitions.
Related Resources
High-Functioning Autism Guide
Understanding Level 1 autism characteristics and support.
Asperger's Syndrome Guide
History, modern perspectives, and relationship to ASD levels.
Autism Signs & Symptoms Guide
Learn to recognize the signs at every age.
Autism Diagnosis Guide
Complete guide to the evaluation process.
Types of Autism Therapy
Complete guide to treatment options by support level.
Benefits of Early Intervention
Why starting early is crucial for all levels.