Table 2.

Current severity specifiers for Autism Spectrum Disorder

Severity level	Social communication	Restricted, repetitive behaviors
Level 3 Requiring very substantial support	Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others	Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action
Level 2 Requiring substantial support	Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others	Inflexibility of behavior, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts Distress and/or difficulty changing focus or action.
Level 1 Requiring support	Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful responses to social overtures of others. May appear to have decreased interest in social interactions	Inflexibility of behavior causes significant interference with functioning in one or more contexts Difficulty switching between activities. Problems of organization and planning hamper independence