High-Functioning Autism: What It Is & How It's Diagnosed

What was once called Asperger’s syndrome is now known as high-functioning autism. It’s not strictly a medical diagnosis, but it’s a very necessary distinction. Of course, there are people with autism spectrum disorder (ASD) who are severely disabled. Meanwhile, plenty of folks with ASD meet the diagnostic criteria for the condition but, on the surface, can present as neurotypical. Obviously, we must differentiate between the two when it comes to treatment.

The term “high-functioning autism” is useful when describing someone who can navigate everyday life. Understanding this position on the autism spectrum is crucial for making sure individuals get the proper support.

ASD and Asperger’s Syndrome

For many years, a diagnosis of autism was reserved solely for patients with severe symptoms. Meanwhile, a Viennese psychologist named Hans Asperger identified a condition in which people might display subtle autism symptoms. It was classified as a separate disorder in 1994, but in 2013, Asperger’s Syndrome was recognized as a form of ASD that manifested with above-average cognitive and language skills. It’s now very rare for the name Asperger’s Syndrome to be used in a clinical setting.

Common Signs of High-Functioning Autism (HFA)

• As children, they are deemed mature and intelligent for their age. As they move into adulthood, they are still smart — possessing a great memory but coming off as socially awkward.

• They avoid eye contact and often physical touch.

• In conversation, someone with HFA is prone to interrupting, speaking in a monotone voice, missing social cues, and being confused by nuance, hidden motives, and sarcasm.

• People with HFA tend to be isolated, perceived as shy, and obsessed with routines and rituals. They are obsessed with their interests, can have a laser-like focus to the exclusion of everything else around them, and experience emotions intensely.

• They will avoid social situations whenever possible.

• The person with HFA notices changes ahead of everyone else. If things are getting louder, for example, they can be overwhelmed by it before anyone else discerns the change.

• Sensory input (loud noises, bright lights, strong smells, food textures, sensations from clothing, etc.) can cause frustration, irritation, and emotional distress. In this state, they get overloaded, cannot make decisions, and may rely on repetitive behaviors to calm themselves, known as stimming.

• They can succeed at school or work but struggle with the social aspects.

• Relationships are a challenge, as anyone with HFA can miss unspoken communication.

As you can see, some major signs can be subtle enough to go unrecognized by the people in their lives. So, how is HFA diagnosed?

Diagnosing High-Functioning Autism

There are no specific tests for identifying HFA. Ideally, you’ll connect with a professional who has experience in this area and can use observational assessments to identify clues. This developmental work begins most often during childhood and falls under these broad steps:

• Monitor: The people in a child’s life (parents, caretakers, siblings, teachers, and more) are the eyes and ears of this process.

• Screen: Screenings for a child are typical regardless of any possible concerns. They begin at 9 months, but after 18 months, possible HFA symptoms can become apparent.

• Diagnosis: The observation and testing lay the groundwork for a possible diagnosis. The next step would be a very particular type of developmental evaluation — designed specifically for anyone (including adults) who displays signs that HFA may be present.

Treatment for High-Functioning Autism

Of course, every case is different. For example, as many as 7 out of 10 people with HFA will also be diagnosed with an anxiety disorder, depression, or attention-deficit/hyperactivity disorder (ADHD). Depending on such details, a person with HFA may begin with occupational or physical therapy, along with talk therapy like applied behavior analysis.

If you or someone you love has these symptoms or has recently been diagnosed with HFA, it can be difficult to adjust to this new normal. Contact our office today to learn more about ADHD therapy so we can help you navigate the road ahead.