In ASD (autism spectrum disorder), the DSM-5 requires deficits in social communication AND restricted, repetitive patterns of behaviour. Which specifier is used to indicate the level of support needed, and what does 'Level 3' indicate?

• A Level 3: requiring very substantial support; severe deficits in social communication with very limited initiation, minimal response to others, causing severe functional impairment ✓
• B Level 3: borderline autism with mild deficits manageable in mainstream settings without support
• C Level 3: exclusively indicates non-verbal autism
• D Level 3: presence of intellectual disability comorbidity

Explanation

DSM-5 ASD is specified by severity levels 1–3 for both social communication and restricted/repetitive behaviour domains separately: Level 1 (requiring support), Level 2 (requiring substantial support), Level 3 (requiring very substantial support). Level 3 indicates very severe deficits in verbal and non-verbal social communication, very limited initiation of social interactions, minimal response to social overtures, and restricted/repetitive behaviours causing marked interference with functioning across all spheres. The specifiers do not correspond directly to intellectual disability, though both can co-occur.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.