Part 4: Autism Level 3 – Deep Support, Deep Connection

In this series, we’ve explored the wide-ranging experiences of people on the autism spectrum, from those with minimal support needs to those who require more consistent help navigating daily life. Today, we focus on Level 3 Autism Spectrum Disorder, where individuals require very substantial support,

not just to thrive, but sometimes simply to participate in daily routines and relationships.

While Level 3 ASD often involves more visible challenges, it also reveals profound capacities for connection, expression, and love. It is here that we are reminded that communication does not always come through words, and that worth is never measured by independence.

What Is Level 3 Autism?

According to the DSM-5, Level 3 Autism refers to individuals who face severe difficulties with verbal and nonverbal communication, social interaction, flexibility, and sensory processing. Many individuals at this level are nonverbal or minimally verbal, and may use augmentative or alternative communication (AAC) devices, gestures, or behavior-based expression to communicate.

They may:

• Require assistance with basic daily living tasks (e.g., eating, dressing, hygiene)

• Experience frequent meltdowns or shutdowns due to sensory overload or changes in routine

• Struggle with transitions or unstructured environments

• Rely on caregivers for consistent, full-time support

Despite these challenges, individuals with Level 3 autism are whole people with rich inner worlds, emotional depth, and often unexpected strengths.

What Support Looks Like

Support at this level is not just clinical, it’s relational. It may involve:

• Full-time caregiving or one-on-one assistance in school or at home

• Ongoing therapies like occupational therapy, sensory integration, and speech-language therapy

• Use of communication boards, PECS (Picture Exchange Communication System), or voice output devices

• Highly structured routines and clear visual aids

• Specialized education plans tailored to individual needs and strengths

At SMR Wellness Center, we’ve witnessed the transformative power of nonverbal communication through animal-assisted therapy. A gentle hand on a horse’s neck, a shared moment of calm grooming a goat, or the rhythm of leading a miniature horse—these moments speak volumes.

Understanding, Not Judging

Because Level 3 autism can involve behaviors like stimming, repetitive movements, or intense emotional outbursts, individuals are often misunderstood or even excluded from community spaces. But these behaviors are not “bad”, they are coping mechanisms, forms of communication, and expressions of sensory or emotional need.

Empathy, patience, and inclusive environments make all the difference.

Strengths That Deserve to Shine

People with Level 3 ASD may:

• Show extraordinary emotional awareness, even without words

• Express joy in pure and unfiltered ways

• Demonstrate strong memory or pattern recognition

• Connect deeply with animals, music, or nature

• Teach those around them how to slow down, listen differently, and love unconditionally

At SMR, we’ve learned just as much from our Level 3 clients as we’ve given. They remind us that communication is more than speech, and connection is more than conversation.

How You Can Support Someone with Level 3 ASD

• Be present and patient, connection may take time, but it’s worth it

• Learn and respect their preferred communication method

• Avoid overwhelming environments, support sensory needs

• Don’t underestimate their understanding or awareness

• Provide consistent routines, visual supports, and gentle transitions

Next Up: Living the Spectrum – Stories, Strengths, and Advocacy

In the final post of this series, we’ll celebrate the voices and experiences of autistic individuals across the spectrum. We’ll highlight real-life stories, advocacy efforts, and how we can all be part of creating a more inclusive world, not just during Autism Awareness Month, but every day.

🧩 To learn more about how SMR Wellness Center supports individuals across the spectrum through equine and animal-assisted therapy, visit us at smrwellnesscenter.org.