TABLE 2

ASD Symptoms by Level of Severity

Severity LevelSocial AffectiveRestricted and Repetitive Behaviors
Level 1. “Requiring support”Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful response to social overtures of others. May appear to have decreased interest in social interactions.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”Marked deficits in verbal and nonverbal social communication skills. Social impairments apparent even with supports in place. Limited initiation of social interactions and reduced or abnormal responses to social overtures from others.Inflexibility of behavior, difficulty coping with change, or other restricted and repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts.
Distress and/or difficulty changing focus or action.
Level 3. “Requiring very substantial support”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.Inflexibility of behavior, extreme difficulty coping with change, or other restricted and repetitive behaviors markedly interfere with functioning in all spheres. Great distress at or difficulty with changing focus or action.
  • Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (copyright 2013). American Psychiatric Association. All Rights Reserved.