Concerned? 5 Questions to Ask Yourself About Your Child’s Development

Exploring the 3 Levels of Autism

July 2, 2024

Explore the 3 levels of autism, their traits, and the unique strengths and challenges tied to each.

Understanding Autism Levels

Autism is a complex neurodevelopmental disorder that affects social interaction, communication, interests, and behavior. It's known as a "spectrum" disorder because people with autism can have a range of symptoms, from mild to severe. Recognizing the distinct traits and characteristics of each level is vital for understanding and supporting individuals with autism.

Overview of Autism Spectrum Levels

There are three general levels of autism: Level 1, Level 2, and Level 3, each characterized by varying degrees of impairment and requiring different levels of therapy and intervention [1].

Level 1: This level describes individuals who are more independent and have lower support needs. Despite facing some difficulties in social situations, they can perform daily tasks without much assistance.
Level 2: People at this level exhibit more significant challenges and require substantial support in their daily lives. They often struggle with social interactions and communication.
Level 3: This level refers to individuals living with intense traits and high support needs. They experience significant challenges in social communication and exhibit repetitive behaviors.

DSM-5 Classification

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the authoritative guide to the diagnosis of mental disorders. It classifies autism spectrum disorder (ASD) into three levels (Level 1, Level 2, and Level 3) based on two areas of functioning: social communication and restricted, repetitive behaviors.

According to the DSM-5, the three levels of autism are as follows:

Level 1 (Requiring support): Individuals at this level have difficulty initiating social situations and demonstrate atypical or unsuccessful responses to social overtures from others.
Level 2 (Requiring substantial support): Marked difficulties in verbal and nonverbal social communication skills are evident in these individuals. They may also exhibit inflexible behaviors, difficulty coping with change, and distress or frustration in response to small changes in their environment or routines.
Level 3 (Requiring very substantial support): People at this level have severe difficulties in verbal and nonverbal communication that cause severe impairments in functioning. They may demonstrate very repetitive or restrictive behavior patterns and extreme difficulty coping with change.

The classification by DSM-5 enables clinicians to accurately diagnose and provide the appropriate level of support that individuals with autism need in their daily lives. The 3 levels of autism, each with distinct traits, help in understanding the varying needs and challenges faced by individuals on the autism spectrum.

Level 1 Autism Traits

Individuals classified under level 1 of the autism spectrum, often referred to as "mild autism," can exhibit certain traits that affect their social interactions, communication, and behavior. Understanding these characteristics is key in tailoring the right support and interventions.

Social Challenges

People with level 1 autism often face social challenges that require some support. They may struggle to engage in social situations, find it difficult to establish social bonds, and exhibit an increased level of social anxiety. This can make it challenging for them to make friends without the right support. Furthermore, these individuals may also find it difficult to transition between activities, and prefer to stick to established routines for a sense of security [5].

Communication Difficulties

Communication difficulties are another common trait in individuals with level 1 autism. They may have trouble with social cues, find it difficult to initiate conversations, and struggle to engage in reciprocal communication. These challenges can be particularly noticeable when they interact with neurotypical individuals. This difficulty in communication can sometimes lead to anxiety and even panic attacks in social settings.

Behavioral Characteristics

Behavioral characteristics of individuals with level 1 autism can include a preference for routines, and restricting or repetitive behaviors. They may tend to obsess over specific topics or ideas, potentially finding comfort in the predictability these provide. Additionally, they may have difficulty predicting the reactions of others or engaging in imaginative play. These traits can pose challenges with organization and planning, and they may require limited assistance in their daily activities [5].

These traits, while distinctive, will vary widely among individuals as autism is a spectrum disorder. Therefore, the support needed for each individual with level 1 autism will be unique and should be tailored to their specific needs and challenges. With the right guidance and understanding, individuals with level 1 autism can effectively navigate their daily lives.

Level 2 Autism Characteristics

Within the 3 levels of autism, Level 2 autism is characterized by a greater need for support compared to Level 1. Individuals with Level 2 autism experience substantial challenges in social interaction, communication, and behavior, which often require significant support and accommodations.

Need for Substantial Support

Individuals with Level 2 autism require substantial support in their daily life. The severity of their symptoms is such that they may require accommodations in school settings, social skills groups, and job training programs [4]. These individuals may experience significant distress when coping with changes, which can pose challenges to their daily function.

Repetitive Behaviors

Repetitive behaviors are common among individuals with autism, but they are more intense and uncontrollable in those with Level 2 autism. Such behaviors may include violent rocking, door slamming, and moaning, which can occur with high frequency and intensity [2]. These behaviors are often insistent and may interfere with daily activities, necessitating additional support and management strategies.

Communication Struggles

Communication poses a significant challenge for individuals with Level 2 autism. Despite receiving support, these individuals often find it difficult to communicate in ways that are accepted by neurotypical society. Their communication may be limited and often requires substantial support to facilitate effective interaction. Additionally, they may respond in ways that neurotypical individuals may find surprising or inappropriate [3].

In the context of the 3 levels of autism, understanding the specific characteristics of Level 2 autism is crucial for providing appropriate support and accommodations. Recognizing these traits can help caregivers, educators, and medical professionals tailor support efforts to meet the individual's unique needs, ultimately enhancing their quality of life and potential for growth.

Level 3 Autism Features

Level 3 autism, the most severe according to the DSM-5 classification, is characterized by significant challenges in social interaction, communication, and behavior. Individuals with Level 3 autism require very substantial support to navigate through daily life and to ensure their safety.

Very Substantial Support Required

Individuals diagnosed with Level 3 autism are at high risk for neglect and abuse, and are unable to mask their autistic traits. Many of these individuals may face difficulties expressing themselves accurately through verbal or non-verbal means. They require very substantial support, often on a daily basis, to assist with various aspects of life such as social interaction, communication, and behavior management.

Challenges in Communication

Communication poses a significant challenge for those with Level 3 autism. They find it extremely difficult to use or understand both verbal and nonverbal communication. This can make social interactions, expressing needs, and understanding the world around them particularly challenging. As a result, these individuals typically require significant and tailored support to develop and improve their communication skills.

Behavioral Patterns

Behavioral patterns for those with Level 3 autism often present unique challenges. For instance, individuals with high support needs often wander off or run away, a behavior referred to as eloping. This can put them in dangerous situations as they generally lack the tools to communicate with first responders.

Further, self-injury is more common among autistic people with high support needs, with behaviors such as head-banging and pica (eating non-food items) being prevalent. Aggressive behaviors like hitting, biting, and kicking are also more common in level 3 autism [2].

Understanding these features and challenges of Level 3 autism is key to providing the necessary support and interventions that can help individuals with this diagnosis lead a quality life. It's important to remember that despite these challenges, individuals with autism possess unique strengths and abilities that can be nurtured and developed with appropriate support and understanding.

Individualized Support for Autism

When discussing the 3 levels of autism, it is important to note that treatment and support are not one-size-fits-all. The needs of individuals with Autism Spectrum Disorder (ASD) can greatly vary, hence, the importance of personalized therapies and interventions. Also, early diagnosis plays a vital role in managing ASD.

Tailored Therapies and Interventions

According to the National Institute of Child Health and Human Development (NICHD), highly structured and specialized programs are often the most effective therapies for individuals with ASD. The effectiveness of these therapies and interventions can vary for each person, with some individuals showing significant improvement and symptom reduction through treatment.

Treatment for ASD should focus on the specific needs of the individual rather than solely on the diagnostic label. It is crucial to tailor interventions based on the person's requirements, considering potential overlapping symptoms with other disorders like Attention Deficit Hyperactivity Disorder (ADHD). Tailored therapies and interventions can significantly reduce symptoms and support individuals with autism in their daily activities, highlighting the importance of personalized treatment approaches for those with ASD.

There is no single standardized treatment for ASD. However, various interventions can help minimize symptoms and enhance the abilities of individuals with ASD. Effective treatments can vary depending on the person, emphasizing the need for individualized approaches to therapy.

Importance of Early Diagnosis

Research indicates that early diagnosis and interventions for ASD, particularly during preschool years or before, are more likely to have positive effects on symptoms and skills development later in life. An early assessment and individualized approach following a diagnosis of autism can help children or adults develop skills that allow them to live as independently as possible. Each level of autism requires different levels of support, from relatively independent living to depending on others for daily life tasks.

Understanding the different levels of autism and the unique needs associated with each level can guide the development of tailored therapies and interventions, leading to improved outcomes and an enhanced quality of life for individuals with ASD. Thus, early diagnosis and individualized support are key elements in managing the 3 levels of autism.

Strengths and Challenges of Autism

Understanding the 3 levels of autism involves not only identifying the characteristics and traits associated with each level but also recognizing the strengths and challenges that individuals with autism may experience.

Cognitive and Behavioral Strengths

Autism is often associated with a range of cognitive strengths. These can include a correlation with giftedness, the presence of a powerful memory system, superior problem-solving skills, and in some cases, savant syndrome. These traits are commonly found in autistic individuals, contributing to their unique abilities and talents beyond the normal range of human experience [7].

In terms of behavioral strengths, individuals with autism often demonstrate a strong work ethic. This is a valuable trait that sets them apart in a positive manner and can be leveraged to make unique contributions to society and personal growth.

Common Challenges Faced

Despite their strengths, individuals with autism often face a range of challenges. These can include cognitive challenges such as a low theory of mind, rigid or inflexible thinking, a high prevalence of PTSD, and the co-occurrence of alexithymia. These challenges can vary among individuals and may require management strategies for better adaptation and improvement [7].

Sensory differences are another common challenge faced by autistic individuals. These can include sensory overload, meltdowns, shutdowns, and hyperacusis. These differences can pose challenges and may require specific accommodations or coping mechanisms for individuals with autism.

Autistic individuals may also demonstrate unique behavioral traits such as reduced affect display, fear response to calm chemicals, and excessive daydreaming. These traits can be part of the challenges faced by individuals with autism and may necessitate tailored support and understanding [7].

In essence, while the 3 levels of autism present a range of unique challenges, they are also associated with significant strengths. Understanding these strengths and challenges is key to supporting individuals with autism in the most effective way.