ASD Severity Levels: DSM-5 Support Needs Rating

What it does

DSM-5 specifies autism spectrum disorder severity separately for each of its two core domains: Social Communication and Interaction (Domain A) and Restricted and Repetitive Behaviors (Domain B). Each level reflects the current amount of support the person needs, not a fixed trait, and it can change with development, intervention and environment. This tool walks through the level descriptions for both domains and builds a documented formulation. It does not replace a diagnostic evaluation (ADOS-2, ADI-R, clinical interview), and co-occurring conditions such as intellectual disability, ADHD and anxiety need separate assessment.

Levels and specifiers

Level	Label
1	Requiring Support
2	Requiring Substantial Support
3	Requiring Very Substantial Support

For each domain, select the level whose description fits best. Each option shows the DSM-5 description plus a clinical example or functional-impact note. Both domains must be rated before the tool will generate an assessment. Four specifiers can be checked: with intellectual impairment, with language impairment, associated with a known medical or genetic condition, and associated with catatonia.

What the assessment shows

Generate Assessment displays a level card for each domain and an "overall support level", which the tool sets to the higher of the two domain levels. It then shows a diagnostic formulation, an interpretation paragraph for each domain, and support recommendations matched to the overall level. These are grouped as behavioral and therapeutic, educational and vocational (or residential at Level 3), pharmacotherapy targets, and monitoring. Two reference tables follow: screening and diagnostic instruments (M-CHAT-R/F, ADOS-2, ADI-R, SRS-2, SCQ, CARS-2, ASRS, RAADS-R, CAT-Q) with age ranges and administration format, and pharmacotherapy options by target symptom.

What the summary includes

The plain-text summary, copied with one click, lists the date, the diagnosis line, the level for each domain and the overall level, any specifiers checked, both domain interpretations, the support recommendations, and the DSM-5 reference (American Psychiatric Association, 2013). The results can also be printed or saved as a PDF. Keep in mind that the two domains can sit at different levels and that the overall level is the tool's own summary, not a DSM-5 rating.