Those diagnosed with high-functioning autism (HFA) exhibit normal or above-average intelligence, verbal skills, and language development. While individuals with HFA may experience some limitations in social and nonverbal communication, their lives are not greatly impacted by this. However, while necessary for clinical use, many people stress the importance of straying away from categorizing autistic individuals as “high” or “low” functioning.
What Is Autism?
Autism spectrum disorder (ASD) is an umbrella term for a group of neurological disorders that affect how a person communicates and behaves. Autism looks different in everyone, and some may be non-verbal while others are highly independent. The wide autism spectrum includes many different diagnoses including Asperger’s Syndrome, Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), Rett syndrome, and Childhood Disintegrative Disorder.2
According to current diagnostic criteria, a person with autism will experience:
- Social differences: These may include difficulty understanding others’ perspectives, preferring more alone time, struggles with communicating emotional needs, and challenges with interpreting social cues.
- Sensory issues: Sensory issues may cause discomfort with certain clothing textures, smells and sounds, or food textures.
- Special interests/repetitive behaviors: Autistic individuals can become highly knowledgeable in specific topics of interest or engage in repetitive motor movements, also known as autistic stimming.
What Is High-Functioning Autism?
The term “high-functioning” is intended to describe an autistic person who is independent and not as restricted by their symptoms as others. In the DSM-5, this would be referred to now as Level 1 as we begin to shift away from the use of high and low functioning labels.
Can Asperger’s Be Considered High-Functioning Autism?
Asperger’s has been removed from the DSM-5 and incorporated into the expanded diagnosis of Autism Spectrum Disorder.3 Many people may still associate Asperger’s with “high-functioning autism” due to this recent change.
DSM-5 Levels of “Functioning”
Although there are other terms used to describe autistic individuals, such as high and low functioning, the DSM-5 provides three levels of autism to describe the severity of one’s symptoms.
These levels help individuals and caregivers recognize the ways in which their autism impacts them, as well as learn how to manage more challenging symptoms.
Then DSM-5 levels of symptom severity include:
- Level 1: Requires Support
- Level 2: Requires substantial Support
- Level 3: Requires very substantial Support
Examples of the DSM 5 levels of autism include:
|Level 1: Requires Support |
This may look like difficulties with having a continuous dialogue, but one is able to communicate independently and share their thoughts, feelings, and input.
|Level 1: Requires Support |
A person may come off as inflexible, have difficulty transitioning from one thing to another, or struggle to stay organized.
|Level 2: Requires Substantial Support |
A person may speak in simple sentences and struggle to find words for what they’d like to share or articulate with others.
|Level 2: Requires Substantial Support |
One may be unable to develop good coping skills, which can cause challenging or repetitive behaviors.
|Level 3: Requires Very Substantial Support|
Someone speaks very minimally, is non-speaking, or needs support tools to communicate their needs.
|Level 3: Requires Very Substantial Support |
Those in Level 3 are extremely distressed by change or disruption in the repetitive behavior they wish to engage in.
How Is Autism Diagnosed?
Autism is a complex neurological disorder that manifests in many ways. While everyone will experience slightly different symptoms, there are some common threads that can help professionals identify autism in children and adults. A clinician will look for difficulties with social interaction, delayed speech and language skills, repetitive behaviors, and other challenges associated with autism.
Autism may be diagnosed with one of the following:
- The Autism Diagnostic Observation Schedule (ADOS): This includes direct observations of an individual in order to determine a diagnosis. This tool allows a clinician the option to observe a person’s social interaction, communication, and behavior.5
- The Autism Diagnostic Interview, Revised (ADI-R): This tool can be used to interview caregivers about their loved ones.4
- The Autism Spectrum Rating Scale (ASRS): This tool is a rating scale used to identify autism by looking at variances in social responsiveness.6
Support Options for High-Functioning Autism
Support and treatment options for autistic individuals are varied, and can include medication, therapy, family counseling, and specialized education. There are also unique social supports offered through local organizations. It’s important to find a neurodiversity-affirming therapist and any local resources that offer a neurodiverse lens to treatment. This ensures that an approach supports an autistic person, rather than aim to change them.
Support options for autistic individuals include:
- Speech therapy: Speech therapy is used to help people learn and practice communication skills, such as vocabulary and social language. It can also be used to teach autistic children and adults how to express their emotions in ways that don’t cause emotional distress, and understand the emotions of others.
- Physical therapy: Physical therapy works to improve one’s motor skills, physical abilities, and muscle tone, as well as reduce fatigue. The goal of physical therapy is to maximize functional abilities and reduce limitations.
- Occupational therapy: Occupational therapy (OT) can help an autistic person develop skills in areas such as fine motor, gross motor, and sensory processing. The goal of OT is to promote social competence, adaptive living, and handle everyday situations.
- Sensorimotor psychotherapy: Sensorimotor psychotherapy focuses on improving one’s sensory processing, attention, and regulatory skills. This can help autistic individuals learn how to better self-regulate their behaviors and emotions.
- Applied behavioral analysis (ABA): Applied behavioral analysis (ABA) helps a client change their behavior by teaching them skills to improve their quality of life. ABA can be a controversial treatment and should be used to benefit the person, not force the person to conform to societal norms.
- Medication: Medications can be a big help in treating the symptoms of depression, anxiety, or other mental illnesses. These conditions are often common for autistic individuals, so using medication in combination with therapy can help restore balance in your life.
- Psychoeducation: Psychoeducation plays a vital role for autistic people, as it helps them understand how autism shows up for them and how to cope with it.
- Self-advocacy: As a self-advocate, you can objectively express what you need and want so others understand your thoughts and feelings. This is an important skill, because it allows you to share your experiences with caregivers and other influential people in your life.
How to Support Someone With High-Functioning Autism
Understanding how autistic people react to and view the world will help you better provide them with support. It is important to respect their feelings and needs by asking questions. For example, if you are confused about what they are trying to express, consider repeating it in a different way or even writing it down on paper for yourself. In terms of daily tasks, an autistic person may require more time to complete something, so be patient. When possible, let them know if plans have changed so that they can prepare themselves ahead of time.
Here are some ways you can support an autistic individual:
- Educate yourself: Educating yourself about neurodiversity and how people experience this can be one of the most powerful tools to help support your loved one.
- Be mindful of their gifts: It’s Important to remember many talents, beauty, and a different perspective on the world comes with autism. We need to embrace our loved ones for these gifts–not seek to change them.
- Be a voice against ableism: Our society is built on an ableist structure that does not support autistic people living as their authentic selves. Whenever possible, fight against ableism in your communities or in your families. An example could be helping folks accept stimming and not outcast someone for it.
- Be flexible: People’s needs change over time and with different experiences in life. Don’t assume that because you know the person or have educated yourself that you know the best ways to support someone–their needs may change.
- Plan ahead: Not all people can “go with the flow” or are comfortable with not having plans. Make space for your loved one to cope and reorganize themselves if plans change.
- Join advocacy groups: There are tons of organizations that offer sibling support, parent support, or self-advocacy groups for your loved one.
- Support for self-advocacy: Supporting your loved one when they express their needs and advocate for themselves is crucial. Allow them to keep the control of their life in their own hands.
- Stay active with your support: Staying engaged in providing support, for anyone, is a lifelong process and journey. Maintaining consistency and dependability with someone and showing up for them how they need is crucial.
Fighting Against the Stigma Towards Autism
When it comes to autism, much of the stigma surrounds the idea that autistic people are not as intelligent or capable as ‘neurotypical’ people. The obvious problem with this is that it’s false. Autistic people can have especially high IQs, possess unique creative thinking skills, and are often able to think in abstract ways that neurotypical individuals simply cannot. Fighting to remove the stigma associated with autism is important–not only for autistic people, but our community as a whole.
In My Experience
I hope those of you reading this find solace in learning that supporting an autistic person, and anyone really, means meeting them where they are and accepting them for who they are. Let them be experts of their own experience while providing them with a source of empowerment. We are continuing to fight against an ableist structured world, and autistic individuals deserve the power and privilege to help change our world.