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DSM-5 Severity Levels



The DSM 5 specifies the severity levels of autism as follows:

Level 1- Requiring Support:

  • Social Communication: Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and demonstrates clear examples of atypical or unsuccessful responses to social overtures of others. May appear to have decreased interest in social interactions.

  • Restricted Interests and Repetitive Behaviors: Inflexibility of behavior causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence.


Level 2- Requiring Substantial Support:

  • Social Communication: Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with social supports in place; limited initiation of social interactions and reduced or abnormal response to social overtures from others.

  • Restricted Interests and Repetitive Behaviors: Inflexibility of behavior, difficulty coping with change or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observers and interfere with functioning in a variety of contexts. Distress and/or difficulty changing focus or action.


Level 3- Requiring Very Substantial Support:

  • Social Communication: Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others.

  • Restricted Interests and Repetitive Behaviors: Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action.


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