What are the 3 levels of autism? Everything you need to know

April 8, 2021, 10:55 PM UTC / Source: TODAY

Last year the Centers for Disease Control and Prevention reported that 1 in 54 U.S. children aged 8 and up was diagnosed with an autism spectrum disorder — a 10% increase from the CDC’s last study in 2000. What exactly is autism spectrum disorder, and what can it be like to live with it?

What is ASD?

Autism spectrum disorder, sometimes referred to as ASD, is a neurodevelopmental disorder that can lead to social and communication deficits.

Dr. Jessica Pipkin, a licensed psychologist with St. Bernards Counseling Center in Jonesboro, Arkansas, told TODAY Parents that ASD is an important area of research and support in the field of psychology.

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What are the 3 levels of autism?

Pipkin said the most recent edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5) has provided three levels of severity in order to better individualize autism diagnoses and communicate a person’s need for support.

She provided helpful markers in better understanding the levels of autism:

“At Level One, an individual is expected to need some degree of support based on their degree of impairment related to social communication and restricted or repetitive behaviors,” Pipkin said. “They may be someone who, with the appropriate supports, can function fairly well in most settings. However, upon closer inspection they may be seen to struggle in the back-and-forth aspects of conversation or lack close friends due to their lack of interest or inability to initiate friendships.”

At Level Two, an individual is likely to require “substantial support” based on their social communication abilities and their restricted or repetitive behaviors, Pipkin explained.

“Even more so, the individual categorized at Level Three is likely to require ‘very substantial support,’” Pipkin said. “This might be a person who has severe deficits in verbal and nonverbal communication, limited social initiation and may respond only to the most direct social cues. They may be so driven by their restricted or repetitive behaviors ... that they are unable to function effectively in different settings. Managing change is another factor which is likely to be increasingly difficult as the levels change.”

Levels of autism

Pipkin said the primary "presenting" aspects of an ASD diagnosis relate to patterns of restricted or repetitive interests, behaviors or activities.

“There might be an intense interest on a particular topic or activity,” she said. “Some individuals may seem skilled in their areas of interest, but often it is simply that they are wholly absorbed by the topic (or) focus and may find it difficult to detach from their interests, behaviors or otherwise.”

In more intense cases, ASD may involve observable behaviors such as unusual body movements when excited or agitated.

“In another individual, this might be someone who is ‘really into’ their particular interest and has trouble ‘turning it off,’” she explained.

Another important aspect of autism spectrum disorder relates to deficits in social communication.

“This can impact one’s manner of speech, ability to engage in typical social communication such as humor, sarcasm or use of idioms, and more,” Pipkin said. “Social skills deficits can also be much more nuanced. It can be very like landing in the middle of a foreign land with a language you do not speak and rules that everyone else seems to know but of which you are unaware. Reading body language, facial expressions, changes in tone or picking up on hints, such as recognizing the specific interest about which you have been talking for the last two hours is not how the listener would like to spend their afternoon.”

Autism spectrum

Pipkin told TODAY Parents that autism spectrum disorder has been portrayed in popular media in ways that have been both beneficial and detrimental.

“The term ‘autism’ is more familiar and more welcomed than it has been in the past (and) there is more information on how to be understanding and supportive of individuals on the spectrum,” she shared. “However, there is also the issue of the innumerable individuals who are not like that particular character counting toothpicks. ...

“These individuals who may not fit common stereotypes are still on the spectrum. They are still struggling. They still need support and acceptance. It is our goal as clinicians to help families and individuals by making informed diagnoses, educating families and the community and connecting them with resources.”