Do you know what it means to have high-functioning autism?
High-Functioning Autism (HFA) is not recognized as a medical diagnosis. Rather, it refers to people with a much milder form of autism, who need only minimal supervision and has no intellectual disabilities. Still, High-Functioning Autism is still autism and it’s not an easy condition to live with.
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties with social interaction and communication. Other notable features include flat or monotonous speech, a lack of eye contact, unusual posture, and repetitive body movements (Seltzer, et al., 2003). Not all these symptoms will be present across all cases of autism because the condition varies with severity.
Recent surveys show that autism affects 1 in every 68 children in the American population, making it one of the most prevalent developmental disorders in the United States (Xu, Strathearn, Liu & Bao, 2018). ASD is often diagnosed in children from the ages of 2-5 years old, but symptoms can start to surface as early as 12-18 months. The earlier a diagnosis is made, the easier it will be to treat the child.
With that said, here are 7 things you need to know about High Functioning Autism:
1. There Are Varying Levels of Autism
First and foremost, it’s important to understand that autism is a spectrum disorder. What this means is that cases of Autism Spectrum Disorder (ASD) are categorized according to their degree of severity. There are three levels, with level 1 being the mildest and level 3 being the most extreme. Once a child is diagnosed with ASD, the attending physician or psychologist usually tries to gauge their level by assessing their emotional intelligence, social capabilities, and both verbal and nonverbal communication skills. What we refer to as High Functioning Autism is known as level 1 autism. Those at this level generally have the fewest symptoms, and so, have an easier time navigating their work-life, academic life, and social relationships (Shopler & Mesibov 2013).
2. HFA Used To Be Called Asperger’s Syndrome
Before the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) combined all autism-related conditions under the umbrella term ASD, Autistic Disorder (its old name) was considered separate from Asperger’s syndrome (American Psychological Association, 2013). This was because, for the longest time, only people with very severe symptoms were diagnosed with autism and it wasn’t until the early 1990s that psychologists began to recognize its milder forms (National Institute of Neurological Disorders and Stroke, 2018).
Asperger’s syndrome shares many of the same key characteristics as Autistic Disorder or ASD; patients typically display social impairment, communication deficits, and monotonous speech. The main difference is, those with Asperger’s have average to high intelligence and normal development of their language, cognitive skills, and age-appropriate self-help skills. This means that their autism is much more manageable and has a much lesser impact on their day-to-day life.
3. People With HFA Still Need Support
Having said that, however, while HFA is certainly the mildest form of autism, people with HFA still require special care and attention. They may have difficulty getting along with others and maintaining meaningful relationships. They need help understanding simple social cues (like humor, sarcasm, etc); take everything we say at face value; and don’t feel the need to be mindful of their words like most of us do.
And while many of those with high functioning autism go on to do amazing things – like Charles Darwin, Emily Dickinson, Albert Einstein, Steve Jobs, and Bill Gates – they still need guidance from time to time because of their tendencies to be obsessive, frantic, stubborn, overly rigid, and socially inept.
4. People With HFA are Self-Aware
While they may have trouble communicating it or expressing it through their emotions, people who have High-Functioning Autism are actually more self-aware than you think. They understand the challenges that their autism brings and they are mindful of their own limitations. They know that most people don’t think or act the way they do and they recognize that they are different from those around them. Of course, this self-awareness also makes them extremely sensitive to the negative reactions of others and it hurts a lot for them to be outcast, judged, rejected, or mocked for their condition. Because of this, they are also at higher risk of developing anxiety, depression, and other mood disorders (Kim, Szatmari, Bryson, Streiner, & Wilson, 2000).
5. People With HFA are Highly Sensitive
One of the most distinguishable signs of autism is a heightened sense of perception and extreme emotional sensitivity. And while people with High-Functioning Autism do have less trouble controlling this than most, that doesn’t mean it’s no longer a problem for them. People who have HFA are still incredibly sensitive to bright lights and loud noises but might not react as suddenly or as overtly as those on the lower end of the spectrum. They also have a tendency to get too emotional or panic when they encounter unexpected setbacks, and they can feel overwhelmed by change. They need predictability and familiarity with their surroundings/situations for them to really thrive and excel at what they do.
6. Not All Forms of Autism Look The Same
Whether high-functioning or not, people with autism all act differently. Autism is a disorder with many faces, so if you think you know what autism looks like just because you watched a show about it or know someone who has it, think again. Some autistic people may be overly chatty and outgoing, while others are silent and introverted. Some might smile a lot and laugh inappropriately at times, while others come off as rude, harsh, or cold-hearted. People who have autism are still normal people, which means that like us, they can have many different personalities.
7. High Functioning Autism is Highly Treatable
Yes, autism is usually a lifelong diagnosis, and yes, a large majority of children who have it never really outgrow it. But while there is no cure for ASD and probably never will be, High-Functioning Autism is still highly treatable and those who have it can easily manage their condition. Treatment doesn’t need to be as long-term or as intensive for HFA as they are with level 2 or 3 ASD, and the outlook is much more favorable. Psychologists mah recommend speech therapy, physical therapy, occupational therapy, sensory training, applied behavioral analysis, and in a few cases, medication to treat depression or excessively high levels of energy (Gillberg, 2013).
High-functioning or not, having autism poses a challenge for anyone. But while the condition does come with its limitations, it’s worth noting that there’s also a lot of admirable qualities in people with High-Functioning Autism. They are often honest, conscientious, organized, and highly perceptive. And with the right care and treatment, they are able to rise above their disadvantages and have a great life with plenty of meaningful relationships and accomplishments.
- Seltzer, M. M., Krauss, M. W., Shattuck, P. T., Orsmond, G., Swe, A., & Lord, C. (2003). The symptoms of autism spectrum disorders in adolescence and adulthood. Journal of autism and developmental disorders, 33(6), 565-581.
- Xu, G., Strathearn, L., Liu, B., & Bao, W. (2018). Prevalence of autism spectrum disorder among US children and adolescents, 2014-2016. Journal of American Psychology, 319(1), 81-82.
- Schopler, E., & Mesibov, G. B. (Eds.). (2013). High-functioning individuals with autism. Springer Science & Business Media.
- American Psychological Association (2013). Diagnostic and Statistical Manual of Mental Disorders – 5th Edition. Washington, DC; APA Publishing.
- National Institute of Neurological Disorders and Stroke (2018). Autism Spectrum Disorder Fact Sheet. Retrieved 29 March 2020 from https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/autism-spectrum-disorder-fact-sheet
- Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Clinical Studies on Autism, 4(2), 117-132.
- Gillberg, C. (Ed.). (2013). Diagnosis and treatment of autism. Springer Science & Business Media.