Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition that affects how individuals interact with others, communicate, learn, and navigate the world around them. This article explores a brief history of ASD classifications, how ASD is currently classified in the DSM-V-TR, what the “spectrum” part of Autism Spectrum means, and breaks down the three levels of Autism Spectrum Disorder to better understand what “Level 1, 2, or 3” means in practical terms.

Brief History of Autism Spectrum Disorder Classification

Autism has been conceptualized differently over time and in various diagnostic manuals. Autism was first included in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) as a subset diagnosis. In the next iteration of the DSM (DSM-IV, published in 1994), autism was divided into several subtypes, including Autistic Disorder, Asperger’s Disorder, and Rett’s Disorder. With publication of the DSM-5 (2013), these subtypes were reclassified again as a continuum of symptoms under a single diagnosis, Autism Spectrum Disorder (ASD).

Under these primary diagnoses, three levels were further distinguished due to the varying needs individuals have. Some individuals may need significant levels of support to function in their everyday lives, while others may need minor support. The purpose of identifying levels is to help professionals describe the current needs more clearly in order to identify the most appropriate supports, services, and interventions. 

Levels of ASD

Level 1 (Requiring Support) 

• Often described as “high-functioning”
• Experiences social challenges (including struggling with understanding social nuances or difficulty navigating peer social interactions)
• May demonstrate rigid thinking or inflexibility

Level 2 (Requiring Substantial Support)

• Can communicate and maintain relationships, but social challenges are more noticeable and significant enough to impact several domains of life (i.e. school, work, social life, family)
• Strong need for routine and may significantly struggle when routines change
• Interests may be all-consuming and dominate the individual’s conversations/attention
• May need regular support to manage daily activities, including prompting to take care of basic needs

Level 3 (Requiring Very Substantial Support)

• Individuals typically have significant communication difficulties
• May only engage in social interactions in order to get their needs met
• Frequent stimming behavior that interferes with daily life (such as flapping arms, rocking, spinning)
• Intense distress when routine is interrupted
• Highly sensitive to sensory input
• Requires daily support

What does the “Spectrum” part of an Autism Spectrum Disorder mean? 

ASD is referred to as a spectrum because each individual is unique, with their own strengths, challenges, and ways of navigating the world. ASD presents as a broad range of characteristics and symptoms. It can be helpful to think of the spectrum as a profile of strengths and challenges, as opposed to experiencing “less” vs “more” symptoms or characteristics.

Can ASD Levels Change? 

Yes! An individual’s level of ASD reflects how much support they need in their daily life at the current moment. This can change over time, or even within a specific environment. As individuals learn new skills, receive effective support, or their life circumstances change, their independence can increase and they may be less impacted by their diagnosis.

Final Thoughts 

Each individual that has been diagnosed with Autism Spectrum Disorder (ASD) is unique. Understanding the level of support someone needs assists in identifying the most appropriate services, treatments, and strategies. At Psychology360, we take a caring and comprehensive approach, looking at the whole person in order to best understand their individual strengths, challenges, and goals.