Autism
The Levels
Dear Special Parent,
Autism Spectrum Disorder (ASD) is precisely that—a spectrum. It encompasses a broad range of symptoms and behaviors, affecting individuals uniquely. The spectrum’s very nature defies a one-size-fits-all description, underscoring the diversity of experiences and needs among those diagnosed with ASD. For many parents, the journey toward an autism diagnosis for their child is fraught with uncertainty, questions, and, understandably, a measure of anxiety. The path can seem winding and opaque, with the term “spectrum” itself suggesting a vast range of possibilities. One of the more nuanced aspects of understanding an autism diagnosis lies in grappling with the “levels” of autism as defined by diagnostic criteria.
The Levels Defined
In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), introduced a system to categorize these diverse experiences into three levels:
• Level 1: Requiring Support
• Level 2: Requiring Substantial Support
• Level 3: Requiring Very Substantial Support
These levels aim to provide a framework for identifying the degree of support an individual with autism might need in daily life, particularly in social communication and restrictive, repetitive behaviors.
Level 1: Independence with Nuance
Children diagnosed at Level 1 often manage a high degree of independence. They may struggle with social nuances, like initiating conversations or understanding subtle social cues, which can make social interactions challenging. Support at this level often focuses on developing social skills, flexibility in thinking, and managing anxiety or depression that might co-occur.
Level 2: The Need for Clearer Support
Level 2 denotes individuals who face more significant challenges in social situations and may exhibit more noticeable repetitive behaviors. Verbal and nonverbal communication is often more strained, requiring clearer and more direct forms of support to navigate social interactions and adapt to changes in routine or environment.
Level 3: Intensive Support for Daily Living
At Level 3, children require more intensive support. They may have very limited verbal communication and find social interactions extremely challenging. This level often involves comprehensive support, including assistance with daily living skills and a highly structured environment to provide predictability and reduce anxiety.
What This Means for Your Child’s Future
Understanding your child’s level within the autism spectrum is crucial, not as a limit to what they can achieve, but as a guide to tailoring the support they receive. It’s about recognizing and nurturing their potential, understanding their challenges, and advocating for resources that align with their needs.
Every child on the autism spectrum has a unique set of strengths and interests. With the right support, children at all levels can lead fulfilling lives, build meaningful relationships, and achieve personal milestones. The level of autism does not dictate your child’s future; it merely informs the approach to their education, therapy, and care.
For parents on this journey, it’s essential to remember that an autism spectrum disorder diagnosis, including its level, is not the entirety of your child’s identity. It’s a part of them, certainly, and understanding it can unlock doors to resources, support, and communities that can help. But your child’s future is as open and full of potential as any other’s.
Dr. Kimberly
Dr. Kimberly Idoko
Certified Special Parent Coach
Dr. Kimberly is the mother and fierce advocate of Aiden and Lexi; Lexi is developmentally disabled by Rett Syndrome. Dr. Kimberly is a board-certified neurologist in clinical practice for more than 15 years; she is also a children’s rights attorney — the former director of healthcare advocacy at a Los Angeles-based legal agency. She is Yale College, Penn Medicine, Columbia Business, and Stanford Law trained.
Sign up!
#SpecialParenting Newsletter
Exclusive resources & tips in your inbox to empower your special parenting journey.