When a child receives a Level 2 autism diagnosis, parents often have questions about what that level actually means. Does Level 2 describe how a child will communicate in the future? Does it determine how independent they can become? What type of support will they need?
Level 2 autism indicates that a child or an adult requires a lot of support with regard to his or her social communication as well as repetitive behaviors. The purpose of this diagnosis is not to define the abilities and potential of the child; rather, it is about describing their support requirements.
What Does Level 2 Autism Mean?
Autism spectrum disorder (ASD) is divided into three support levels in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):
- Level 1: Requiring support
- Level 2: Requiring substantial support
- Level 3: Requiring very substantial support
A Level 2 diagnosis generally means that differences in social communication and restricted or repetitive behaviors have a noticeable impact on everyday functioning, even when some support is already in place.
A child with Level 2 autism may need more assistance communicating their needs, participating in social situations, adapting to changes, or completing everyday routines.
However, the level alone cannot tell parents exactly what their child can or cannot do.
What Are Common Signs of Level 2 Autism?
Level 2 autism can look different from one child to another. Some children communicate using spoken language, while others use fewer words or communicate through gestures, pictures, or an augmentative and alternative communication (AAC) device.
Signs can include:
- Noticeable differences in verbal and nonverbal communication
- Difficulty starting or maintaining social interactions
- Limited responses to social approaches from others
- Repetitive movements, speech, or behaviors
- Strong or highly focused interests
- Difficulty coping with unexpected changes
- Distress when familiar routines are interrupted
- Sensory sensitivities or sensory-seeking behaviors
- Needing regular assistance with everyday activities or transitions
A child does not need to show every one of these characteristics to receive a Level 2 diagnosis.
What Can Communication Look Like With Level 2 Autism?
Communication abilities vary widely among children with Level 2 autism.
One child may speak in sentences but have difficulty with back-and-forth conversations or understanding social cues. Another may use short phrases primarily to request what they need. Some children may communicate without spoken language and use an AAC device, pictures, gestures, or other methods instead.
Communication support should reflect how the individual child currently communicates rather than focusing only on spoken language.
For some children, therapy may work on requesting help, expressing discomfort, answering questions, following directions, or communicating during everyday routines.
How Does Level 2 Autism Affect Social Interaction?
Children with Level 2 autism may want to interact with other people but have difficulty knowing how to begin or maintain those interactions.
For example, a child may have difficulty:
- Joining another child’s activity
- Taking turns during a game
- Responding to another person’s attempts to interact
- Understanding facial expressions or other social cues
- Adjusting their communication to different situations
Some children may prefer playing independently or alongside other children rather than participating in shared play.
Support can focus on helping children develop social skills that are useful and meaningful to them without expecting every child to socialize in the same way.
Repetitive Behaviors, Routines, and Changes
Restricted or repetitive behaviors are another part of an autism diagnosis.
A child with Level 2 autism may repeat movements, words, sounds, or activities. They may also have strong preferences for particular routines or become distressed when something happens differently than expected.
For example, changing the route to school, serving a familiar food differently, or ending a preferred activity unexpectedly could be difficult.
Teaching how to prepare for changes, using visual schedules and communication methods could help.
Does Level 2 Autism Mean a Child Has an Intellectual Disability?
No. An autism support level does not determine a child’s intellectual ability.
Autism and intellectual disability can occur together, but they are separate diagnoses. Children with the same autism level can have very different learning abilities, language skills, strengths, and support needs.
Developmental assessment may give a detailed analysis of various aspects of a child’s development.
Can Autism Levels Change Over Time?
A child’s support needs can change as they grow and develop.
New communication skills, changing environments, therapy, school expectations, and everyday experiences can all affect how much support a child needs in different areas.
A child may also need more help in one area than another. For example, they may become more independent with daily routines while continuing to need substantial support with communication or social situations.
For this reason, an autism level should not be treated as a permanent prediction of what a child will be able to do later in life.
What Type of Support Does a Child With Level 2 Autism Need?
There is no single treatment plan for every child with Level 2 autism. Support should be based on an assessment of the child’s abilities, challenges, family priorities, and daily environment.
Depending on the child, support may involve:
- Applied Behavior Analysis (ABA) therapy
- Speech and language therapy
- Occupational therapy
- School-based services
- AAC and other communication supports
- Parent or caregiver training
The amount and type of support can change as the child’s needs change.
How ABA Therapy Can Support Children With Level 2 Autism
ABA therapy can be used to teach kids with Level 2 autism skills that will be useful in their everyday lives.
The BCBA will conduct an assessment of the child’s current capabilities and skills before treatment. From there, the BCBA will design a customized treatment plan based on what he or she has learned from the assessment and the family’s preferences.
Depending on the needs of the individual child, the ABA therapy will focus on the following skill areas: communication, transitions, socialization, self-help, safety, play, education, and independence.
Supporting Your Child After a Level 2 Autism Diagnosis
A Level 2 autism diagnosis can provide useful information about how much support your child currently needs, but it does not describe everything about them.
Your child’s communication style, interests, strengths, challenges, and abilities are all individual. Understanding those needs can help you and your child’s care team decide which services and strategies make sense for everyday life.
At Cultivate Behavioral Health & Education, we offer personalized ABA therapy services to children with autism spectrum disorder according to their strengths and needs. If your child has been diagnosed with autism and has queries regarding ABA therapy, get in touch today.
