Levels of Autism Spectrum Disorder
                     LEVELS OF AUTISM 
SPECTRUM 
DISORDER
Understanding Autism as 
Defined by DSM-5
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DSM-5 AND AUTISM 
SPECTRUM DISORDER
• DSM is Diagnostic and Statistical Manual of Mental 
Disorders published in 2013
• DSM-5 refer to the fifth edition of the Manual
• DSM-5 introduced a unified diagnosis: Autism 
Spectrum Disorder (ASD).
• Previous diagnoses like Asperger’s and PDD-NOS 
are now part of this spectrum.
• ASD is classified into three levels based on support 
needs.
• Focus is on communication, social interaction, and 
behavioral flexibility.
source: 
https://www.psychiatry.org/psychiatrists/practice/dsm
THE THREE LEVELS OF 
ASD
• Level 1: Requires support.
• Level 2: Requires substantial support.
• Level 3: Requires very substantial 
support.
• Differentiation based on
⚬ social communication,
⚬ restrictive behaviors, and
⚬ response to changes.
LEVEL 1 AUTISM: SYMPTOMS IN 
CHILDREN
• Social Communication: Difficulty initiating social interactions, but still 
interested in socializing.
• Behavioral Flexibility: Struggles with transitions but can manage with some 
support.
• Planning and Organization: Challenges with tasks requiring organization.
• Language: Literal interpretation of language, may miss social nuances (e.g., 
jokes, idioms).
LEVEL 2 AUTISM: SYMPTOMS IN 
TODDLERS
• Social Communication: Difficulty initiating social interactions, but still 
interested in socializing.
• Behavioral Flexibility: Struggles with transitions but can manage with some 
support.
• Planning and Organization: Challenges with tasks requiring organization.
• Language: Literal interpretation of language, may miss social nuances (e.g., 
jokes, idioms).
LEVEL 3 AUTISM: SYMPTOMS IN 
TODDLERS
• Social Communication: Severe deficits, may be non-verbal or use very few 
words.
• Behavior: Intense, repetitive behaviors like rocking or spinning.
• Social Interaction: Minimal response to social cues, avoids most 
interactions.
• Sensory Sensitivities: Highly sensitive to sounds, textures, or changes in 
the environment.
• Support Needs: Requires very substantial support, including one-on-one 
care.
KEY DIFFERENCES BETWEEN ASD 
LEVAEspLeSct Level 1 Level 2 Level 3
Social Severe deficits, often 
Mild deficits Marked deficits
Communication non-verbal
Difficulty with Distress with 
Behavioral Extreme distress 
change, but change, moderate 
Flexibility with any change
manageable flexibility
Very substantial 
Support Needs Minimal support Substantial support
support
Literal interpretation, Delays, short Limited or no verbal 
Language
mild delays phrases language
IMPORTANCE OF EARLY 
INTERVENTION
• Early intervention has been shown to 
improve language, social skills, and 
behavior.
• Therapies: Applied Behavior Analysis 
(ABA), speech therapy, occupational 
therapy and stem cell therapy.
• Crucial for improving long-term 
developmental outcomes.
• The earlier the intervention, the better the 
potential for improvement.
TAILORED SUPPORT FOR EACH ASD 
LEVEL
• Level 1: Social skills training, cognitive-
behavioral therapy (CBT), minimal 
classroom support.
• Level 2: Speech therapy, ABA, 
specialized educational programs, 
behavior interventions.
• Level 3: Intensive therapies, 
multidisciplinary approach, full-time 
care, sensory interventions.
CONCLUSION: A SPECTRUM OF NEEDS
• Autism is a spectrum disorder, and the needs of each child vary.
• DSM-5 provides a structured approach to understand these needs.
• Tailored interventions at the appropriate level can greatly enhance quality of 
life.
• Our focus must be on individualized care and support.
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