Autism is a spectrum, meaning it presents differently in each individual. To better understand and provide appropriate support, autism is categorized into three levels under the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition). These levels reflect the degree of support an individual requires.

It is very important to note a person's level can change over time with proper support and interventions!

  • Individuality: These levels provide general guidance but don’t define the whole individual. Every autistic person has unique strengths, challenges, and needs.

  • Strength-Based Approach: While levels highlight challenges, it’s crucial to focus on the person’s abilities and potential!

Level 1: Requiring Support

Characteristics:

  • Social Communication:
    Challenges with initiating and maintaining social interactions. May appear uncomfortable in social settings but may engage with guidance. Always give that positive reinforcement and feedback!

    • Difficulty with back-and-forth conversations or understanding social cues. May appear to not pay attention or be zoning out

  • Repetitive Behaviors/Restricted Interests:
    Rigid adherence to routines or inflexibility in behavior.

    • Resistance to change in daily schedules or hyper-focus on a specific topic

Support Needs:

  • Occasional support to navigate social or occupational demands

  • Guidance to manage rigidity in routines or expectations

Support Strategies for Level 1

1. Social Communication Support:

  • Encourage participation in structured and unstructured social activities. Whether it’s a playdate or a team sport, they may need encouragement to participate

  • Provide coaching on social skills such as understanding body language and social cues from others and engaging in conversations

  • Use visual supports or social stories to explain social expectations

2. Managing Rigidity:

  • Prepare for transitions with schedules or timers

  • Offer choices to provide a sense of control - “Do you want to use the sand timer or the phone timer?”

  • Gradually introduce changes in routine with visuals and social stories in advance if possible

Level 2: Requiring Substantial Support

Characteristics:

  • Social Communication:
    May have difficulty with either verbal and non-verbal/pre-verbal communication. Limited ability to engage in meaningful conversations or respond to social cues

    • Examples may include reduced speech, needing prompts to communicate and participate, or limited social interactions

  • Repetitive Behaviors/Restricted Interests:
    Noticeable repetitive actions or intense interests that interfere with daily functioning and stimming

    • Hand-flapping, spinning objects, verbal noises or humming, or significant distress when routines are disrupted

Support Needs:

  • Substantial support in daily life, including structured environments and consistent routines

  • Interventions such as speech, occupational therapy or behavior therapy to continue to build skills and growth

Support Strategies for Level 2

1. Social Communication Support:

  • Use augmentative and alternative communication (AAC) tools or devices

  • Engage in structured interactions, such as turn-taking games (my way, your way theory) or guided conversations

  • Reinforce attempts to communicate with positive feedback as much as possible!

2. Supporting Repetitive Behaviors:

  • Provide safe outlets for stimming like fidget toys or sensory-friendly items. More posts on stimming to come!

  • Regular sensory breaks to provide overstimulation

  • Identify triggers for meltdowns and implement proactive strategies

  • Create a structured environment with clear routines to reduce anxiety. Anytime you can post visual aids or schedules, do it!

  • Work on introducing flexibility incrementally changing one small part of a routine at a time. Then giving positive reinforcement and feedback!

3. Managing Sensory Needs:

  • Offer sensory-friendly spaces to retreat and self-regulate. We made a calming room (VIDEO HERE) and posted pictures around the house of it as a visual reminder to use the safe space

  • Use sensory tools like weighted blankets, fidgets, noise-canceling headphones, sensory swings and many more! Will also have future posts focusing on sensory tools!

Level 3: Requiring Very Substantial Support

Characteristics:

  • Social Communication:
    Severe challenges with communication, often limited to basic needs or completely nonverbal/preverbal. Difficulty understanding or responding to social interactions.

    • Example: Rarely initiating interaction, relying on alternative communication methods (AAC devices), may appear to not listen or show interest in an unpreferred topic

  • Repetitive Behaviors/Restricted Interests:
    Extreme difficulty with change, alongside highly repetitive or self-stimulatory behaviors

    • Example: Prolonged rocking, echolalia (repeating phrases), or intense sensory sensitivities

Support Needs:

  • Continuous, intensive support for basic daily activities

  • Comprehensive interventions to address communication, sensory needs, and behavior

  • Visual aids and other communication devices

Support Strategies for Level 3

1. Enhancing Communication:

  • Implement robust AAC systems tailored to the individual’s preferences and abilities

  • Simplify language and use clear, consistent phrasing

  • Pair verbal instructions with visual or physical cues

2. Supporting Sensory and Repetitive Needs:

  • Regularly schedule sensory breaks throughout the day to prevent overstimulation

  • Identify triggers for meltdowns and implement proactive strategies

  • Respect repetitive behaviors when they are not harmful, as they often provide comfort or regulation

3. Building Life Skills:

  • Use task analysis to teach daily living skills in small, manageable steps - (specific contents posts and workshops will address creating and implementing task analysis)

  • Incorporate supports to help with independence (visual aids,

  • Provide hand-over-hand guidance initially, fading assistance as skills develop.

CAPE Tips with ALL Levels:

  1. Celebrate Strengths: Recognize and nurture the child’s unique talents and interests! Focusing on the strength-based approach is essential because it builds confidence, fosters growth, and helps them thrive in a world that often focuses on challenges

  2. Build Consistency: Create predictable routines while allowing space for gradual adaptation to change

  3. Collaborate: Work closely with therapists, educators, and other caregivers for support! This is SO important for growth and consistency!

  4. Practice Patience: You may not see progress right away, but just like with anything, consistency, repetitiveness and support are keys to success

  5. Self-Care for Caregivers: Seek respite and support groups to recharge and stay motivated. And of course CAPE is always here for you!


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Understanding Autism Levels: What Do They Mean?