Decoding the Autism Spectrum: From Symptoms to Support

Overview: This article explores the “spectrum” of autism symptoms, the severity levels for diagnosis, and the support that each of those levels requires.

A “Spectrum” Disorder

Autism, as you likely know, is a “spectrum” disorder. This language has become so ubiquitous that people often refer to those with the diagnosis as being “on the spectrum,” and describe autistic traits as simply being “spectrumy.” While this language may be handy in colloquial terms, it is important to know what it means in psychological terms as well.

The autism “spectrum” is a tremendously wide range of symptom severity. People with an autism spectrum diagnosis may have limited fine motor ability or be adept at manipulating fine machinery. They could have no intellectual impairment or have significant intellectual disability. This vast difference is present with most every autism symptom, and yet the term “autism” captures each varying presentation equally as long as certain qualifying symptoms are present. A quality assessment will highlight if a symptom does rise to the level of disability. To exemplify the “spectrum” of potential symptom severity, below is the wide range of verbal capacity for people on the autism spectrum.

If this spectrum seems overly broad or confusing (you wouldn’t be alone in thinking that), refer to the article “Understanding Autism Symptoms” for a refresher on what conditions do and do not qualify for a spectrum diagnosis.

To capture the severity of autism symptoms, diagnosing clinicians may specify where an individual rates in a series of diagnostic levels. The levels are explained below.

Levels of Autism

To adequately capture the wide variance in autism symptom presentation, it is critical that diagnosing clinicians understand and identify the severity levels that an individual client is experiencing. The levels range from Level 1 (least severe) to Level 3 (most severe). The levels are described below with examples of how each level could manifest itself.

If this spectrum seems overly broad or confusing (you wouldn’t be alone in thinking that), refer to the article “Understanding Autism Symptoms” for a refresher on what conditions do and do not qualify for a spectrum diagnosis.

To capture the severity of autism symptoms, diagnosing clinicians may specify where an individual rates in a series of diagnostic levels. The levels are explained below.

Independence and Care Expectations

The majority of “Level 1” autistic people will gain age-appropriate levels of independence and be able to live without support from a guardian as an adult. Independence and age-appropriate behavior is more likely and will persist for longer when receiving consistent support. Managing symptoms and other mental health struggles may require ongoing therapy or coaching. 

People with “Level 2” symptoms may acquire a level of independence in adulthood but will likely rely on a support network for some life tasks. They may benefit from living with their support network if possible. Early intervention and coaching are essential in order to ensure the person learns the emotion regulation, social, and life skills needed for self-care. 

Most people with “Level 3” symptoms will require support from a guardian throughout their life. People with “Level 3” autism require assistance to accomplish many daily activities, and will likely need the support of family, care givers, or assisted living communities daily throughout their life. 

For all Levels of autism, it is certainly possible to achieve a happy, fulfilling life. With level-appropriate amounts of support, coaching, therapy, and care most every autistic person can find purpose, community, and fulfillment. 

Differing Levels for One Person

It is possible for a person to qualify for different levels of severity within the same diagnosis. For example, a person may receive the following diagnosis:

“ICD-10 – F84.0 – Autism Spectrum Disorder, without intellectual or language impairment, Social Communication Level 1, Restricted and repetitive behaviors Level 2”*

In this situation, the diagnosed individual’s social difficulties are “Level 1” which means that their impairment has less of an impact on the individual’s overall functioning and that they do not require substantial support. However, the individual’s restricted, repetitive behaviors are “Level 2,” meaning that they present a larger impact on daily functioning and that the individual requires more direct support and care. This specific identification of varying levels allows care providers to tailor support to meet the client’s biggest needs.  

*The number at the start of a diagnosis is a billing code for the ICD-10, which is the European version of the DSM.