Autism looks different for every child, and some need more support than others. When a diagnosis includes the words “level 2 autism,” it means the child may struggle with social skills, communication, and daily routines without regular help. These challenges can affect how they learn, play, and connect with others. Understanding what is level 2 autism can give parents and caregivers a clearer path forward. With the right tools and support, children at this level can build important life skills and thrive in their way.
Understanding Autism Spectrum Disorder
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition that affects how a person perceives and interacts with the world around them. The term “spectrum” reflects the wide variation in challenges and strengths possessed by each person with autism.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), introduced a three-level classification system for autism based on the amount of support an individual needs. This replaced earlier diagnostic categories such as Asperger’s syndrome, autistic disorder, and childhood disintegrative disorder. The three levels are:
- Level 1: “Requiring support” – Individuals show noticeable challenges with social communication and may have difficulty initiating interactions.
- Level 2: “Requiring substantial support” – Individuals have marked deficits in verbal and nonverbal communication skills and struggle with change.
- Level 3: “Requiring very substantial support” – Individuals have severe challenges with social communication and extreme difficulty with change.
Research suggests that both genetic and environmental factors play a role in the development of autism. While there is no single cause, early detection and intervention can significantly improve outcomes for children with autism.
What is Level 2 Autism?
Level 2 autism sits in the middle of the autism support spectrum, characterized by more significant challenges than Level 1 but less severe than Level 3. Individuals with Level 2 autism require substantial support in their daily lives.
According to the DSM-5, Level 2 autism is defined by:
- Social Communication: Marked deficits in verbal and nonverbal social communication skills, limited initiation of social interactions, and reduced or abnormal responses to social overtures from others.
- Restricted, Repetitive Behaviors: Inflexibility of behavior, difficulty coping with change, restrictive or repetitive behaviors that appear frequently enough to be obvious to the casual observer, and interfere with functioning in various contexts.
Children with Level 2 autism often speak in short sentences or focus conversations solely on topics of special interest. They may struggle with maintaining eye contact, walk away during conversations, or display unusual responses to social cues. Their repetitive behaviors are more pronounced than in Level 1 autism and are easily noticeable to others.
It’s important to understand that Level 2 autism is not the same as “high-functioning autism” (though this term is increasingly discouraged). The level system focuses on support needs rather than functioning, acknowledging that individuals may need different levels of support across different domains.
Symptoms and Characteristics of Level 2 Autism
Social Communication Challenges
Children and adults with Level 2 autism experience substantial challenges with social communication:
- Speaking in simple sentences or only communicating about special interests
- Difficulty maintaining back-and-forth conversations
- Limited understanding and use of nonverbal communication cues
- Reduced eye contact or unusual eye gaze patterns
- Walking away during conversations
- Abnormal responses to social cues
- Challenges in forming and maintaining friendships
- Difficulty understanding others’ perspectives
- Limited social imagination
- Struggles with figurative language and abstract concepts
These challenges can lead to social isolation and frustration, but with appropriate support, individuals can develop effective communication strategies.
Repetitive Behaviors and Restricted Interests
Repetitive behaviors and restricted interests in Level 2 autism are more pronounced than in Level 1:
- Adherence to specific routines with marked distress when disrupted
- Repetitive movements such as hand-flapping, rocking, or spinning
- Rigid thinking patterns and difficulty with transitions
- Intense focus on specific topics with exceptional detail
- Unusual sensory interests or sensitivities (over- or under-responsiveness)
- Repetitive phrases or questioning
- Strong attachment to certain objects
- Difficulty adapting to changes in the environment or expectations
These behaviors often serve important purposes for the individual, including self-regulation, coping with anxiety, or providing predictability in an overwhelming world.
Diagnosing Level 2 Autism
Early diagnosis is crucial for children with Level 2 autism. The diagnostic process typically involves:
- Developmental Screening: During routine check-ups at 9, 18, and 24 months, with specific autism screening at 18 and 24 months.
- Screening Tools: Including the Modified Checklist for Autism In Toddlers (MCHAT), Ages and Stages Questionnaire (ASQ), Communication and Symbolic Behavior Scales (CSBS), Parents’ Evaluation of Developmental Status (PEDS), and Screening Tool for Autism in Toddlers and Young Children (STAT).
- Comprehensive Evaluation: Conducted by specialists using diagnostic tools such as the Autism Diagnosis Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS-2), Childhood Autism Rating Scale (CARS), and Gilliam Autism Rating Scale (GARS-2).
For a Level 2 diagnosis, children must show substantial challenges in social communication and repetitive behaviors across multiple environments that significantly impact daily functioning. Parents’ observations play a crucial role in the diagnostic process, as they provide valuable insights into the child’s behavior in various settings.
Treatment Approaches for Level 2 Autism
Early Intervention
Early intervention services are vital for children with Level 2 autism. Research consistently shows that interventions beginning before age 3 have the greatest impact on development. These services typically include:
- Speech therapy to improve verbal and nonverbal communication skills
- Occupational therapy for sensory processing, fine motor skills, and daily living skills
- Physical therapy to address motor coordination and balance challenges
- Behavioral interventions to develop social skills and reduce challenging behaviors
Early intervention sets the foundation for future development and can significantly improve long-term outcomes.
Applied Behavior Analysis (ABA)
ABA therapy is one of the most effective and well-studied treatments for autism. For children with Level 2 autism, it often includes over 20 hours of therapy each week, focused on building social, communication, and daily living skills. The therapy also helps reduce challenging behaviors, teaches coping strategies for sensory issues, and supports using new skills in different places. Each plan is tailored to fit the child’s specific needs, strengths, and goals.
Educational Accommodations
Children with Level 2 autism often need substantial support in school, such as visual schedules, sensory breaks, modified assignments, and help with writing or communication. They may benefit from social skills training, assistive technology, and structured routines, along with small group or one-on-one instruction. These supports should be clearly outlined in an Individualized Education Program (IEP) based on the child’s specific needs.
Supporting Individuals with Level 2 Autism
Parental Advocacy
Parents play a key role in supporting a child with Level 2 autism by securing the right services through an IEP, working closely with therapists and doctors, and creating a stable home routine. They also teach important life skills, plan for school transitions, and build a strong support network. Staying informed about proven strategies and joining parent training programs can make a big difference in their child’s growth and daily success.
Building Social Skills
Social skills development is especially important for individuals with Level 2 autism and often includes structured group sessions, peer mentoring, visual aids, and social stories. Techniques like video modeling, role-playing, and gradual exposure to social situations help build confidence and understanding. With regular practice and the right support, many individuals at this level can form meaningful social connections.
Prognosis and Long-Term Outlook
The outlook for individuals with Level 2 autism can vary based on several factors, such as early diagnosis, the quality of support, personal strengths, family involvement, and any other medical conditions. With the right care, many can make steady progress over time. Long-term success often depends on ongoing access to the right services and a supportive environment.
While Level 2 autism is a lifelong condition, many people can learn to communicate better, form relationships, manage sensory challenges, and develop daily living skills. Focusing on their unique abilities and goals helps build a more meaningful and fulfilling life. Progress may look different for each person, but with patience and support, growth is always possible.
Conclusion
Every child with Level 2 autism has their own strengths, challenges, and path forward. With early support, structured interventions, and strong advocacy, children can build the skills they need to communicate, connect, and grow with confidence. Understanding level 2 autism is the first step in giving your child the tools to succeed both now and in the future.
If you’re looking for expert support in New Jersey, Apple ABA provides personalized ABA therapy for children with Level 2 autism. Our team works closely with families to create flexible, effective care plans that meet each child’s needs. Contact us today to learn how we can help your child thrive at home, in school, and in everyday life.
FAQs
How serious is level 2 autism?
Level 2 autism is moderately serious, requiring “substantial support” for functioning in daily life, especially with speech or communication challenges that become apparent in early childhood and persist throughout development.
Can Level 2 autistic children talk?
Yes, most Level 2 autistic children can talk, though they typically use limited verbal communication and may focus conversations exclusively on special interests, with abilities varying widely among individuals and often requiring ongoing support to develop conversational skills.
What are level 2 behaviors in autism?
Level 2 autism behaviors include marked difficulty initiating social interactions, inflexibility with routines, noticeable repetitive behaviors, distress with changes, and sensory sensitivities that are apparent to casual observers and significantly impact daily functioning.
Can a child with autism be normal?
This question frames autism as abnormal, which isn’t helpful; children with autism develop differently, not incorrectly, and many with early childhood interventions lead fulfilling lives while contributing their unique perspectives and talents to society.
