How Many Types of Autism Are There? DSM-5 Levels vs. Older Labels

Officially, there is one. Under the DSM-5-TR, the diagnostic manual U.S. clinicians use, autism is a single diagnosis: autism spectrum disorder (ASD). The "five types" many parents search for (autistic disorder, Asperger's, PDD-NOS, childhood disintegrative disorder and Rett syndrome) come from an older manual, the DSM-IV, that was retired in 2013. Today a clinician records one diagnosis, a support level from 1 to 3 for each of two areas, and a few specifiers.

If your child's report, a relative's records or an old school file uses the older words, this guide translates them. It also explains what Levels 1, 2 and 3 do and don't tell you, whether a level can change, and why an old-sounding label can still appear on insurance paperwork.

The Old "Types" and Where They Went

The DSM-IV (1994) grouped five conditions under "pervasive developmental disorders." Here is what happened to each in the DSM-5 (2013) and the current DSM-5-TR (2022).

The DSM-5-TR tells clinicians that a person with a well-established DSM-IV diagnosis of autistic disorder, Asperger's disorder or PDD-NOS should be given the diagnosis of ASD. There is no official chart that converts an old label into a level. Levels are assigned from a person's current support needs, not from the name they were once given.

Regression, the loss of skills a child already had, is the hallmark of what the old childhood disintegrative disorder label described, and it can also occur in autism more generally. If your child has recently lost skills, tell your pediatrician promptly, and see our guide to autism regression for what skill loss can mean at different ages.

What Autism Levels 1, 2 and 3 Actually Mean

Levels describe how much support a person currently needs. A clinician rates two areas separately: social communication, and restricted and repetitive behaviors. A child can be Level 2 in one and Level 1 in the other, so the single number on a report is a summary, not the whole picture.

Three cautions are worth knowing:

• Levels describe support needs, not intelligence or potential.
• They are not "mild, moderate and severe." Level 1 does not mean a person needs little help.
• They aren't fixed, and they shouldn't gate services. The DSM-5-TR notes that levels can vary by context and change over time, and that severity ratings shouldn't be used to decide who is eligible for services.

Specifiers: The Details Behind the Level

A complete diagnosis also notes whether the autism occurs with or without intellectual impairment, language impairment, a known medical or genetic condition, another neurodevelopmental or mental health condition, or catatonia. These specifiers often say more about what help a child needs than the level number does. 

If your report lists a level but no specifiers, it's reasonable to ask the evaluator about them. Autism and ADHD can also occur together, and our guide to AuDHD vs. ADHD vs. autism explains how the profiles overlap and differ.

Can a Child's Level Change?

Yes. Support needs can shift in either direction. The best-known data come from a UC Davis MIND Institute study that followed 125 children from about age 3 to age 6. It used the ADOS Calibrated Severity Score, a 10-point research measure of symptom severity (not a DSM level). 

Severity decreased for 28.8% of the children, stayed about the same for 54.4% and increased for 16.8%. Girls were more likely to decrease than boys, and in some cases children no longer met criteria for an autism diagnosis by age 6.

Two takeaways. Stability was the most common outcome, and change ran both ways. The study also wasn't designed to show what caused a change, and researchers can't yet predict which child will move. Anyone promising a specific outcome or timeline is overstating the evidence.

Terms You'll Still Hear

• "Classic autism" or "Kanner's autism." Older names for what the DSM-IV called autistic disorder.
• "High-functioning" and "low-functioning." Informal, and not DSM-5-TR terms. They don't line up neatly with levels, and they can hide real needs: a person with strong spoken language may still need substantial support, and a person who doesn't speak may understand a great deal. Many clinicians prefer to describe specific strengths and specific support needs.
• "Autism Type 1, 2 or 3." Not diagnostic terms. When they appear online they usually mean Levels 1 to 3, so ask your evaluator which is meant.

Why Old Labels Still Show Up on Paperwork

U.S. insurance and billing use a different system, ICD-10-CM. In the current fiscal year 2027 edition, the code for ASD is F84.0, and that code's title is still "Autistic disorder," with autism spectrum disorder listed under it. Asperger's syndrome (F84.5) and Rett's syndrome (F84.2) also keep their own codes. 

So an older-sounding label on an authorization form doesn't mean your child received an outdated diagnosis. Check the evaluation report itself for the diagnosis, level and specifiers, and ask the evaluating clinician to clarify anything that looks inconsistent. Our explainer on the ICD-10 code for autism goes further on how these codes are used.

What This Means for Next Steps

Autism is common: CDC data from 2022 identified about 1 in 31 eight-year-olds in 16 U.S. communities. A level is a starting point for planning, not a prediction.

At Apex ABA, a BCBA builds each program from an assessment of your child's skills, preferences and daily routines, not from the number on a report. Our team can walk through what your evaluation says, what ABA can and can't address, and what your insurance typically requires before services begin. If you're still sorting out the evaluation itself, start with our guide to ADOS testing. If you're thinking about how learning carries over at home, read about parent coaching in ABA.

Apex ABA supports children ages 2 to 12 across North Carolina, Georgia and Maryland through in-home ABA therapy and school and daycare settings. If a report left you with more questions than answers, talk with our team and bring it with you. We'll help you make sense of it before you decide anything.

Frequently Asked Questions

Q: Is Level 1 the same as "mild" autism?

A: No. The DSM-5-TR doesn't use "mild," "moderate" or "severe." Level 1 means "requiring support," and a Level 1 child can need meaningful help with flexibility, social communication, anxiety or organization. Describing the specific support needs is more useful than a single word.

Q: Does my child's level decide whether they qualify for ABA or school services?

A: Not by itself. The DSM-5-TR says severity levels shouldn't be used to determine eligibility for services. Insurers and schools set their own criteria, usually a qualifying diagnosis plus an assessment of needs, so ask your plan or school team what they require. Our guide to Cigna, Aetna and UHC coverage shows how much plans can differ, and our team can help you check yours.

Q: Is an ADOS-2 score the same as an autism level?

A: No. The ADOS-2 produces a classification and a 1 to 10 comparison (calibrated severity) score. A DSM-5-TR level is a separate judgment a clinician makes from the full evaluation. A clinician may weigh both, but neither is a direct conversion of the other.

Q: My child's older report says Asperger's or PDD-NOS. Do we need a new evaluation?

A: Not necessarily. The DSM-5-TR says a well-established DSM-IV diagnosis should be given the ASD diagnosis. Whether a school, insurer or provider accepts an older report varies, though, so ask what they require. Some request an updated evaluation that includes a current level and specifiers.

Q: Can an ABA provider diagnose autism or assign a level?

A: No. A diagnosis comes from a qualified clinician, such as a developmental pediatrician, psychologist or psychiatrist. A BCBA assesses skills and behavior to build a treatment plan, which is a separate step.

Sources

• American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR, 2022), Autism Spectrum Disorder — https://www.psychiatry.org/psychiatrists/practice/dsm
• American Speech-Language-Hearing Association, Practice Portal: Autism (DSM-5-TR diagnosis, severity levels and the DSM-IV transition note) — https://www.asha.org/practice-portal/clinical-topics/autism/
• CDC, Data and Statistics on Autism Spectrum Disorder (ADDM Network, 2022 data) — https://www.cdc.gov/autism/data-research/index.html
• Waizbard-Bartov et al., Trajectories of Autism Symptom Severity Change During Early Childhood, Journal of Autism and Developmental Disorders (2020) — https://link.springer.com/article/10.1007/s10803-020-04526-z
• UC Davis Health, Autism severity can change substantially during early childhood (2020) — https://health.ucdavis.edu/news/headlines/autism-severity-can-change-substantially-during-early-childhood/2020/05
• National Institute of Neurological Disorders and Stroke, Rett Syndrome Fact Sheet — https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/rett-syndrome-fact-sheet
• CMS, ICD-10 Codes (ICD-10-CM FY 2027, category F84; effective October 1, 2026) — https://www.cms.gov/medicare/coding-billing/icd-10-codes
• Adaptation and Validation of the ADOS-2, Polish Version (describes the ADOS-2 classification and its 10-point Comparison Score), PMC — https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5681938/