Table 2: Severity levels for Autism Spectrum Disorder

Severity Level                                                      Social Communication                                                                                       Restricted, Repetitive Behaviours

"Requiring very substantial support"

Level 3                                                        Severe deficits in verbal and nonverbal social communication                 Inflexibility of behavior, extreme difficulty coping 

                                                                     skills cause severe impairments in functioning, very limited                      with change, or other restricted/repetitive behaviors 

                                                                     initiation of social interactions, and minimal response to social                markedly interfere with functioning in all spheres. 

                                                                     overtures from others. For example, a person with few words                  Great distress/difficulty changing focus or action.

                                                                     of intelligible speech who rarely initiates interaction and, when

                                                                     he or she does, makes unusual approaches to meet needs

                                                                     only and responds to only very direct social approaches

"Requiring substantial support"

Level 2                                                         Marked deficits in verbal and nonverbal social communication                Inflexibility of behavior, difficulty coping with change,

                                                                      skills; social impairments apparent even with supports in place;             or other restricted/repetitive behaviors appear 

                                                                      limited initiation of social interactions; and reduced or abnormal           frequently enough to be obvious to the casual 

                                                                      responses to social overtures from others. For example, a                       observer and interfere with functioning in  a variety 

                                                                      person who speaks simple sentences, whose interaction is limited         of contexts. Distress and/or difficulty changing focus 

                                                                      to narrow special interests, and how has markedly odd nonverbal          or action.


"Requiring support"

Level 1                                                         Without supports in place, deficits in social communication cause          Inflexibility of behavior causes significant interference

                                                                      noticeable impairments. Difficulty initiating social interactions,               with functioning in one or more contexts.

                                                                      and clear examples of atypical or unsuccessful response to social          Difficulty switching between activities. Problems 

                                                                      overtures of others. May appear to have decreased interest in                of organization and planning hamper independence.

                                                                       social interactions. For example, a person who is able to speak in

                                                                       full sentences and engages in communication but whose to- and-fro

                                                                       conversation with others fails, and whose attempts to make friends

                                                                       are odd and typically unsuccessful.

DSM-5 Diagnostic Criteria

A.      Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by

          history (examples are illustrative, not exhaustive, see text):

     1.       Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth

               conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

     2.       Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and

               nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total

               lack of facial expressions and nonverbal communication.

     3.       Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various                 social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

               Specify current severity:

               Severity is based on social communication impairments and restricted repetitive patterns of behavior (see Table 2).

B.      Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history

          (examples are illustrative, not exhaustive; see text):

     1.       Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects,

               echolalia, idiosyncratic phrases).

     2.       Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small

               changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day).

     3.       Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects,

               excessively circumscribed or perseverative interest).

     4.       Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to

               pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or


               Specify current severity:

               Severity is based on social communication impairments and restricted repetitive patterns of behavior (see Table 2).

C.      Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited

         capacities, or may be masked by learned strategies in later life).

D.      Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

E.       These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.

          Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and

          intellectual disability, social communication should be below that expected for general developmental level.

Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.

Specify if:

- With or without accompanying intellectual impairment
- With or without accompanying language impairment
- Associated with a known medical or genetic condition or environmental factor
- Associated with another neurodevelopmental, mental, or behavioral disorder
- With catatonia 

​​What is Autism and Asperger’s?

Autism Spectrum Condition and Asperger Syndrome are lifelong developmental disorders.
An individual with Autism or Asperger’s may have difficulties with social communication, interaction, and imagination.

Many Autistic adults don’t feel like they get the support that they need.
70% of Autistic adults said that they would feel less isolated if they had more support.*
Around one third of Autistic adults develop severe mental health problems due to lack of support.*

*Retrieved from

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