The Three Levels of Autism

What Level of Autism is Aspergers? What Is High-Functioning Autism Called Now?

Asperger’s syndrome was named after Hans Asperger, who is rather infamous for being a eugenicist in Nazi Germany as well as being one of the first individuals to discuss autism. Doctors, therapists, and psychologists diagnosed children with Asperger’s syndrome as a way to describe children who have autistic traits and have little to no support needed. 

Part of the reason why “Asperger’s syndrome” isn’t used anymore is to distance the autism diagnosis away from a Nazi collaborator, the other reason being to make it clear that there isn’t a separate type of autism. An individual who was originally diagnosed with Asperger’s would now be considered to have “level 1” autism.

What Are the Different Types of Autism?

There is only one “type” of autism. As discussed in a section below, high-functioning autism was originally called Asperger’s syndrome. One of the reasons the DSM-5 removed the diagnosis is that they didn’t want the general public thinking that there was a second type of autism.

While today ADHD and ASD are often comorbid, prior to 2013, the two could not be diagnosed at the same time. There was thought to be too much overlap between the two, which we know today is not accurate. 

What Are the 3 Levels of Autism? What Is Level 2 Autism?

The DSM-5 considers there to be 3 different levels of autism that try to capture that spectrum. They are as follows:

• Level 1: This is considered “high functioning” autism. Individuals on this level need no to little support. They have, in general, an easy or easier time making and maintaining friendships. They can care for themselves with no to minimal issues and can be independent across situations. Many individuals on this level can “pass” or “mask” as “normal” due to their being able to use their skills well.
• Level 2: This is considered “moderate functioning” autism. Individuals on this level need some support in most, if not all, situations. They have a wide range of social and coping skills, but they may struggle with the implementation of those skills. These individuals can usually talk about their internal experiences, but they may not be aware of everything going on in the background around them. These individuals may be aware that they are different from their peers, but may not be able to fully explain why they feel that way.

• Level 3: This is considered to be “low functioning” autism. This tends to be the stereotype of what some folks think when they hear the word “autism”: children who sit in the corner, play with their toys in a limited manner, and are non-verbal. They tend to be content to be in their own world and show no to little interest in others, and they may only prefer their family. They tend to be very rigid about situations and may struggle when they need to be flexible. They also tend to have very limited communication skills as they may heavily script, or repeat certain phrases that they’ve heard, over and over again and may even use those scripts inappropriately. They may need a communication device to help them communicate. They frequently need a moderate to a high level of support across settings in order to successfully navigate them.

The challenges above happen for both boys and girls, though girls with autism can sometimes mask their symptoms more easily and remain undiagnosed for longer.

Individuals with autism may also stim (making repetitive movements or behaviors), such as rocking back and forth, or hand flapping. Stimming can be as subtle as rubbing one’s hands together when distressed, or as overt as rocking or jumping.

Among the levels of autism, many individuals have special interests that they research and engage in frequently, almost to the exclusion of everything else. This is where the stereotype of autistic children being considered “little scientists” comes from, as many (not all) have a special interest in science. 

There also tends to be a degree of anxiety in an autism diagnosis. As such, they typically rely on rules to organize their world and keep things as predictable as possible. When those rules get broken or are deviated from, people with autism can experience significant distress, which can lead to stimming, needing to be in a quiet space, or tantrumming. 

What Are the Differences Between the 3 Different Levels of Autism?

The DSM-5 considers there to be 3 different levels of autism that try to capture that spectrum. They are as follows:

• Level 1: This is considered “high functioning” autism. Individuals on this level need no to little support. They have, in general, an easy or easier time making and maintaining friendships. They can care for themselves with no to minimal issues and can be independent across situations. Many individuals on this level can “pass” or “mask” as “normal” due to their being able to use their skills well.
• Level 2: This is considered “moderate functioning” autism. Individuals on this level need some support in most, if not all, situations. They have a wide range of social and coping skills, but they may struggle with the implementation of those skills.
  These individuals can usually talk about their internal experiences, but they may not be aware of everything going on in the background around them. These individuals may be aware that they are different from their peers, but may not be able to fully explain why they feel that way.
• Level 3: This is considered to be “low functioning” autism. This tends to be the stereotype of what some folks think when they hear the word “autism:” children who sit in the corner, play with their toys in a limited manner, and are non-verbal.They tend to be content to be in their own world and show no to little interest in others, and they may only prefer their family. They tend to be very rigid about situations and may struggle when they need to be flexible, such as taking a different route home due to traffic which then leads to them complaining that they’re “going the wrong way.” They may also have very limited communication skills as they may heavily script, or repeat certain phrases that they’ve heard, over and over again and may even use those scripts inappropriately. They may need a communication device to help them communicate. They frequently need a moderate to a high level of support across settings in order to successfully navigate them.

It is important to note that the challenges described above typically describe autistic boys. As such, autistic girls typically have an easier time “passing,” as girls, as a whole, are socialized to carry the weight of social interaction.

What Are the Differences Between the 3 Different Levels of Autism?

As noted above, there are multiple differences between the three levels of autism. Remember, autism runs on a spectrum. The point of the three levels is to give clinicians an idea of the intensity of support the individual may need to be successful. Due to autism being on a spectrum, where the individual falls on that spectrum depends on a wide range of things. 

Many autism and disability advocates do not like the way the DSM-5 breaks up autism into different levels. They report that they find it to be excessive while inaccurately informing the individual, the family, or the therapists who would be working with them. 

As a result, some individuals believe the needs should be broken down into various domains that further identify what those needs are. For example, an autistic child may navigate school effectively during lessons and need no support during that time but may need a little bit of extra support during recess to resolve disputes with peers. 

Another example would be an adult who needs no help at home, as they can take care of their tasks independently, but may need a little bit of support in the community to get to places, and need high support at work as they struggle to do the work but can do it well when they are well supported through reminders and having their tasks clearly listed for the day. 

Advocates argue that those descriptions give a better idea of what the needs are than saying that an individual is at “level 2” does. Thus, they are getting the appropriate amount of support they need to navigate their life effectively.

The different levels of autism may give a therapist an idea of how open the individual is to learning those skills, but they’re not going to know how quickly the person picks them up until they start working with them.