Understanding Autism: Levels of Support and Individual Differences

This guide is meant to support your understanding of the language used in your child’s evaluation report, especially around autism and levels of support. We also offer an alternative, holistic model to describe your child’s unique strengths and support needs.

Autism spectrum disorder is a neurodevelopmental condition that shapes how a person experiences and interacts with the world. Autism is referred to as a spectrum because needs and strengths vary widely from one autistic person to the next. Because of this, levels of support are identified as part of an autism diagnosis to generally describe an individual’s need for greater or lesser support in their daily life.

What Do “Levels of Autism” Mean?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses Level 1, 2, and 3 to describe how much external support an autistic person might need. These levels focus on observable behavior and daily functioning.

Level	What It Means	Examples of Support
Level 1 (‘Requiring Support’)	Support needed in some social or organizational situations	Coaching, access to sensory tools, peer groups
Level 2 (‘Requiring Substantial Support’)	Noticeable challenges across communication, flexibility, and self-regulation	Structured routines, visual supports, aide support, need for direct therapy services
Level 3 (‘Requiring Very Substantial Support’)	Significant support across most areas of daily life	1:1 assistance, alternative communication methods, caregiver guidance for sensory or emotional regulation, need for multiple direct therapy services

 

Important Notes About Levels:

• Levels do not indicate the severity of an individual’s autism (e.g., mild, moderate, severe).
• Levels are not fixed. A child might need different levels of support in different environments—or at different points in life.
• Describing someone by a level is a clinical shorthand, not a full picture of who they are.

What Does “With or Without” Cognitive and Language Impairments Mean?

When a child receives an autism diagnosis, the evaluation may indicate whether the diagnosis occurs with or without additional areas of difficulty:

• Cognitive or intellectual impairment means difficulties learning, remembering, or problem-solving
• Language impairment means difficulties with understanding and/or using language

Why include this?

These terms can give a fuller clinical picture of the individual’s developmental profile so supports can be tailored, not standardized.

• Autism can co-occur with other differences but does not itself equal cognitive or language impairments
• Including these terms can guide what services and accommodations may be needed or beneficial