Level 2 Autism: Challenges and Therapies

Reviewed by:
Hannah Andreasen
M.Ed BCBA

June 4, 2022

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders-five) measures three functional levels of autism, designed to assist therapists with the development of proper support plans. Each of these levels of autism serves as a guide to the amount of help that a child needs to function properly throughout daily life.

Autism spectrum analysis and diagnosis can deliver a more detailed view of a child's capabilities and needs; likewise, it provides goals to parents and caregivers, helping to participate in their child’s care.

Understanding level 2 autism

Social interaction challenges and restricted or repetitious behaviors are the core signs of autism spectrum disorders. In autism spectrum disorder, level 2 symptoms usually begin in early childhood, but they might go undetected. 

Usually, there is nothing to distinguish a child with level 2 autism from other children with typical development. However, a child with autism may interact, communicate, behave, and learn in ways that are different from their typically developing peers.

The capabilities of children within this range are as diverse as they are, with individual talents and challenges. Some children may require substantial support, while others may require little.

Social communication difficulties may include non-verbal, verbal, and written challenges that may affect joint engagement, conduct, emotional regulation, language, social reciprocity, and related cognitive aptitudes. 

Children facing social problems may have a difficult time monitoring emotional states, recognizing and understanding social cues, initiating interaction, learning and using non-verbal and verbal communication, and effectively controlling their own emotional states.

Common challenges in level 2 autism

The diagnosis of level 2 autism indicates more substantial challenges that impair a child's day-to-day activities than a level 1 diagnosis. Communication hardship is usually more significant, and the gaps in social aptitudes are often wider, especially as the child moves into middle school, where social dynamics are complex and nuanced. 

These children are often notably awkward, and they find nonverbal interaction especially complicated, specifically in situations involving eye contact, sensory sensitivity, spatial awareness, and interpersonal communications. 

Apart from this, they may struggle with transitioning from one activity to another. When plans change, they may find it difficult to adapt. They may find themselves struggling with thought focus, the habit of rigid thinking or perseverance on a persistent subject. It is common to find severe fixated interests and repetitive behavior activities, such as fidgeting with objects, hand-flapping, or body rocking done with a distinctive pattern.

What are the criteria for DSM-5?

In the fifth edition of the DSM, a recent modification to the diagnosis of autism spectrum disorder involved the organization of four distinct classifications of autism disorders under the common term "autism spectrum disorders" 

The former classifications were:

  • Asperger's syndrome
  • Autistic disorder
  • Childhood disintegrative disorder
  • Pervasive developmental disorder-not otherwise specified (PDD-NOS).

Autism symptoms were often listed under three classifications:

  • Language and communication impairment
  • Social impairment
  • Repetitive/limited behaviors.

Now, the updated DSM-5 manual reclassified symptoms into only two types: continuous deficits in social interaction and limited, repetitive behavior habits.

As a result, the manual dismissed the specific symptom classification of speech or communication challenges and identified a new and separate diagnosis of social communication disorder for disabilities in social communication without repetitive behaviors.

Sensory issues were categorized as symptoms within the restricted/repetitive behavior heading, which also comprises hyper- or hypo-reactivity to stimulants (sounds, sights, tastes, touch) or unusual attractions in stimuli (staring at spinning objects or light). 

There is also a severity assessment scale varying from Level 1 to Level 3 based on the assistance required to facilitate comfortable daily operation. 

The manual also includes additional diagnostic measures for evaluating intellectual disability, speech level, any known genetic reasons for autism, and the existence of autism-associated medical disorders such as anxiety, seizures, and gastrointestinal disorders.

Therapies for level 2 autism

The care plans for level 2 autism are more diverse than those necessary for children with level 1 autism, often involving: 

  • Sensory integration therapy: therapies to assist children with understanding how to deal with sensory information, such as loud noises or bright lights. 
  • Occupational therapy: therapies that help children acquire skills necessary to perform everyday tasks independently. Occupational therapy also helps individuals learn how to make their own decisions or carry out job functions.
  • ABA therapy: Applied behavior analysis is a more common therapy for people with Level 2 autism. ABA therapy can help Level 2 children learn how to function and understand how to interact with their environment and other people as well as manage their behaviors.

In conclusion

Taking the time to examine a child's autism diagnosis and discussing any behavioral or social parameters with the expert therapist can help parents ensure their child is healthy and productive while determining the optimum therapy methods to produce the greatest results. An autism diagnosis expands beyond the child and into social circles and families, meaning parents should educate themselves and other people around them to provide an ideal environment for their child.

Songbird Therapy is a technology-enabled provider setting a higher standard for children’s autism care. With a deeply passionate team and innovative technology, we’re building a world where every child can access world-class care at home, uniquely tailored to them.