So I'm autistic, Level 1, and recently I started adding this to the beginning of all my videos.

And the reason I started doing that is because I feel like it's really important context to explain my perspective as an autistic person and the content that I'm sharing on social media.

And I've been getting a lot of questions about the levels.

Some people don't know that the levels even exist, and some people just don't know what they mean or have a vague understanding of them.

So today I'd like to talk about how the levels are defined in the DSM.

For those who don't know, the DSM is the diagnostic manual used in the U.S. by practitioners in the process of evaluating for autism.

And with that…

So, first let me explain what you're looking at here. This is a table from the autism spectrum disorder section of the DSM.

And if you look at the table, you'll see that there are three columns.

On the far left you see the levels, and then on the right you see two columns that represent the two main categories of autism as defined in the DSM.

The first category being social communication challenges, and the second category being restricted repetitive patterns of behavior.

So what the DSM does is outline how each level manifests or presents for each category.

And so every person who gets a diagnosis, at least right now in 2024 using the DSM-5-TR, which is the most current version of the DSM, which this screenshot is from, every person that gets a diagnosis gets a level designation for each category.

And for me personally, I got a Level 1 designation for both categories.

So I typically just say that I'm Level 1.

But really that means I'm Level 1 for social communication and I'm also Level 1 for restricted repetitive behaviors.

So now I'm going to read the actual words from the DSM.

First, let's talk about what the levels actually represent.

Level 1, according to the DSM, requires support.

Level 2 requires substantial support, and Level 3 requires very substantial support.

So what I'm going to do is I'm going to first go down the social communication category by level, starting at Level 3.

And then I'll go down the restricted repetitive behavior category, also starting at Level 3.

So Level 3 for social communication is as follows.

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.

For example, a person with few words 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.

Now for Level 2.

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.

For example, a person who speaks simple sentences, whose interaction is limited to narrow special interests, and who has markedly odd nonverbal communication.

Now Level 1 for social communication.

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.

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.

Okay, now we'll do restricted repetitive behaviors, starting with Level 3.

Inflexibility of behavior, extreme difficulty coping with change, or other restricted repetitive behaviors markedly interfere with functioning in all spheres.

Great distress and difficulty changing focus or action.

Now Level 2.

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.

And now Level 1 for restricted repetitive behaviors.

Inflexibility of behavior causes significant interference with functioning in one or more contexts.

Difficulty switching between activities.

Problems of organization and planning hamper independence.

Okay, so that's how the DSM defines and describes the levels of autism.

Now I do want to call attention to the fact that this is specifically talking about support needs.

This is not talking about functioning.

This is still quite a bit of a misconception that people have about autism.

And I want to be clear that the DSM is specifically referring to how much support a person needs as an autistic person.

Okay, so that's what I got for you today.

If you have any questions about any of this, please comment below and I'll try to respond.

Thanks for watching.