What are the characteristics of Autism Spectrum Disorder (ASD) level 2?

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From the Guidelines

Level 2 autism, also known as moderate autism or requiring substantial support, is characterized by noticeable challenges in social communication and restricted, repetitive behaviors that interfere with functioning in various contexts, requiring substantial support in daily life, including specialized educational interventions, speech and language therapy, occupational therapy, and sometimes behavioral therapy like Applied Behavior Analysis (ABA) 1. The characteristics of Autism Spectrum Disorder (ASD) level 2 include:

  • Noticeable challenges in social communication, such as difficulty initiating social interactions and maintaining conversations
  • Restricted, repetitive patterns of behavior, interests, or activities, such as inflexibility in behavior and difficulty coping with change
  • Symptoms that appear in early development, though may be missed, and may include tantrums, self-injury, and aggression
  • Associated medical and mental health conditions, such as epilepsy, severe eating and feeding issues, GI disorders, and disrupted sleep, which affect a significant proportion of individuals with ASD 1
  • Requirement for substantial support in daily life, including individualized and structured interventions, to improve outcomes and accommodate the person's specific needs while building on their strengths and interests 1 Some key points to consider when supporting individuals with Level 2 autism include:
  • Early intervention is crucial for improving outcomes, and creating a supportive environment that accommodates the person's specific needs while building on their strengths and interests 1
  • The support needed is individualized and often includes structured routines, visual schedules, social skills training, and sensory accommodations 1
  • While there are no medications specifically for autism itself, certain medications may help manage associated symptoms like irritability, attention issues, or anxiety 1

From the Research

Characteristics of Autism Spectrum Disorder (ASD) Level 2

  • ASD is characterized by pervasive delays in the development of language and socialization, and the presence of stereotyped, repetitive behaviors or nonfunctional interests 2
  • Individuals with ASD may exhibit abnormalities in social interaction and communication skills, as well as stereotypic behaviors and restricted activities and interests 3
  • The severity of ASD is currently defined and measured based on the severity levels of two core symptom domains: social-communication and restricted or repetitive patterns of behaviors and interests 4
  • However, autistic individuals often have co-occurring medical, developmental, and psychological conditions that can impact their daily lives and adaptive functioning 4
  • A comprehensive approach to understanding ASD should consider both core symptoms and other challenges, such as intellectual disability, limited expressive and/or receptive language, and anxiety disorders 4

Support and Intervention for ASD

  • Comprehensive, naturalistic early intervention with active caregiver involvement can facilitate early social communication, adaptive functioning, and cognitive development 5
  • Targeted intervention can help to enhance social skills and aspects of cognition 5
  • Augmentative and alternative communication interventions may be beneficial in minimizing communication barriers 5
  • Speech and language therapy (SLT) can play an important role in supporting autistic individuals, particularly in addressing communication difficulties and increasing awareness of communication differences 6

Classification and Assessment of ASD

  • The current classification system for ASD is based on the severity levels of core symptoms, but may not fully capture the impact of co-occurring conditions and individual factors on a person's life 4
  • A multidimensional approach to autism, considering impairments, capabilities, co-occurring conditions, and environmental factors, may provide a more comprehensive system for classification of impairment 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Applied behavior analytic interventions for children with autism: a description and review of treatment research.

Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists, 2009

Research

Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD).

The Cochrane database of systematic reviews, 2010

Research

Autism severity and its relationship to disability.

Autism research : official journal of the International Society for Autism Research, 2023

Research

Autistic adults' views of their communication skills and needs.

International journal of language & communication disorders, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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