Social communication: Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social openings from others. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or she does, uses unusual strategies to meet needs and only responds to very direct social approaches.
Restricted and repetitive behaviors: Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all domains. Intense anxiety/difficulty changing focus of action.
Grade 2: "Needs notable help."
Social communication: Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social openings from others. For example, a person who speaks in simple sentences, whose interaction is limited to narrow special interests, and who has markedly odd nonverbal communication.
Restricted and repetitive behaviors: Inflexibility of behavior, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress and/or difficulty changing focus of action.
Grade 1: “Needs help”:
Social communication: Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful responses to social openings of others. May appear to have decreased interest in social interactions. For example, a person who is able to speak in full sentences and engages in communication but whose shared conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful.
Restricted and repetitive behaviors: Inflexibility of behavior causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence.
