Autism is a neurodevelopmental condition characterized by problems with communication and interaction with others as well as repetitive behaviors or limited interests. This brain condition also affects development and learning.

Health providers use a handbook called the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose mental disorders, including autism spectrum disorder (ASD). Until 2013, the DSM-4 (fourth edition) listed four separate diagnoses within the category of pervasive developmental disorder: autistic disorder, Asperger’s syndrome, childhood disintegrative disorder, and pervasive developmental disorder (PDD-NOS).

The updated DSM-5 (fifth edition) and DSM-5-TR (fifth edition text revision) no longer separate autism into different types. Rather, autism is now a single diagnosis — ASD — categorized by levels of severity: level 1, level 2, and level 3.

As the name implies, autism spectrum disorder is a neurodevelopmental condition with symptoms and severity that fall across a spectrum. Each autistic person’s symptoms are unique, and severity varies from person to person. Some people with autism may have severe symptoms that impact their daily functioning, while others may experience less severe challenges.

Level 1 autism means you require support to redirect your restricted, repetitive behaviors and navigate social communication challenges. These challenges may include initiating social interactions or having difficulty interpreting and responding to social cues. You may also have little interest in social interactions.

It may be difficult to redirect your attention away from something on which you’re fixated. Switching between settings and activities may prove difficult, and you may struggle with organization and planning. These symptoms may cause noticeable but manageable impairments that interfere with daily functioning and independence.

People with level 2 autism experience significant delays in both verbal and non-verbal communication and require substantial support. Impaired social functioning makes it challenging to form and maintain relationships, even with the proper support. If you have level 2 autism, you might display unusual nonverbal communication, speak in simple sentences, and only want to interact with others about a specific interest.

Restricted interests and behaviors are obvious to observers and significantly disrupt your daily functioning. Changing your focus or activity can be highly distressing because of your inflexibility. Similarly, it is very difficult to deviate from your normal routine.

People with level 3 autism require very substantial support to address severe impairments in many areas of everyday life. Verbal and nonverbal communication is severely limited in people with level 3 autism.

In many cases, a person with level 3 autism’s speech may be unclear, making it difficult for others to understand verbal communication attempts. People with level 3 autism also experience compromised social interactions: They may not initiate social interactions at all and minimally (if at all) respond to others’ social gestures.

Changing focus, actions, and routines is incredibly difficult and causes extreme distress. It’s very difficult to redirect someone with level 3 autism from their fixated activity or interest. And doing so causes great frustration.

Autism spectrum disorder is no longer categorized into different types but is now diagnosed based on levels of support needs. This approach recognizes the individual challenges and needs of each person with autism.
People with ASD share core difficulties in social interaction and communication as well as repetitive behaviors and restricted interests, though symptoms vary widely.
The levels of ASD — ranging from level 1 (requiring support) to level 3 (requiring very substantial support) — help healthcare providers tailor interventions and resources, promoting better outcomes for individuals.
Early diagnosis and support can enhance a person with autism’s quality of life and functional skills. So if you need more support for autism, or if you show symptoms of ASD but haven’t been evaluated, talk to your healthcare provider to find out the best next steps to meet your needs.

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