The Hidden Face of Autism: Recognizing the Symptoms of High-Functioning Autism.
Autistic individuals who can function with minimal assistance are often referred to as having high-functioning autism.
While this term is relatively new, it is not an official medical diagnosis, and there is still some uncertainty about whether it accurately describes a distinct subgroup of autistic individuals.
Autism is a disorder that impacts an individual’s ability to communicate and navigate social interactions.
Since an autistic person’s capability to handle life skills independently can vary greatly, it is considered a spectrum disorder and is known as autism spectrum disorder (ASD).
What is high-functioning autism?
High-functioning autism is a term sometimes used to describe people with autism who can manage everyday tasks and function relatively independently, with limited or no assistance.
However, it is important to note that “high-functioning autism” is not an official medical diagnosis and there is ongoing debate in the autism community about the usefulness and accuracy of the term.
Autism is considered a spectrum disorder, meaning that individuals with autism may experience a wide range of symptoms and abilities, from mild to severe.
High-functioning autism vs. Asperger’s syndrome
When the American Psychiatric Association released the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2013, they grouped all disorders related to autism, including Asperger’s syndrome, into one category called autism spectrum disorder (ASD).
High-functioning autism and Asperger’s syndrome were once considered two separate diagnoses. However, with the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), in 2013, the term “Asperger’s syndrome” was removed, and individuals who would previously have been diagnosed with Asperger’s syndrome are now included under the autism spectrum disorder (ASD) diagnosis.
Historically, the main difference between high-functioning autism and Asperger’s syndrome was based on the age of language acquisition. Individuals with Asperger’s syndrome typically had no significant delay in language development, while those with high-functioning autism may have had a delay in language acquisition. However, this distinction is no longer used in the DSM-5 criteria for ASD.
Currently, the DSM-5 does not differentiate between high-functioning autism and Asperger’s syndrome. Instead, all individuals with ASD are diagnosed under the same criteria, which includes deficits in social communication and social interaction, and the presence of restricted and repetitive patterns of behavior, interests, or activities.
Still, some people continue to self-identify as having Asperger’s syndrome.
Why is the term ‘high-functioning autism’ controversial?
The term ‘high-functioning autism’ is controversial because it can be misleading and may not accurately reflect the experiences of individuals on the autism spectrum. Some people with autism who are considered high-functioning still face significant challenges and require support in various areas of their lives.
Additionally, the term implies that there is a clear line between high-functioning and low-functioning autism, when in reality, autism is a spectrum disorder with a wide range of abilities and challenges.
Some people argue that the term perpetuates harmful stereotypes and stigmatization of individuals with autism.
Research, including a 2019 study, has demonstrated that there is a weak association between IQ and everyday living skills such as dressing oneself, eating, and tying shoelaces. This implies that defining someone as “high-functioning” cannot be solely based on their intelligence quotient, and it is more complex than that.
To categorize an autistic person as either high- or low-functioning based on their ability to perform certain tasks in society is oversimplifying things. There are a multitude of factors that come into play when assessing someone’s level of functioning, such as:
- Their individual strengths and weaknesses
- The level of support they receive
- Their access to resources and accommodations
- The specific challenges and barriers they face in their environment
Therefore, it’s important to view each person on the autism spectrum as an individual with unique needs and abilities, rather than trying to fit them into a rigid category based on their perceived level of functioning.
These categories can have varying effects on different autistic individuals. For example, an autistic person who is deemed “high-functioning” may still score poorly in social and communication categories.
According to Andrew Whitehouse, who is a professor of autism research at the Telethon Kids Institute and the University of Western Australia in Perth, Australia, the term “high-functioning autism” ignores the challenges that individuals with autism face in their daily lives.
The worry is that individuals labeled as “high-functioning” may not receive the necessary care and support they require.
If a comprehensive assessment is not conducted, an autistic person may not be eligible for funding that could benefit them in therapy or other services because the areas in which they struggle have been ignored or overlooked.
What does high-functioning autism look like?
While “high-functioning” autism can be expressed in various forms among individuals on the autism spectrum, there are a few shared symptoms that one should be aware of.
Social challenges
Individuals with high-functioning autism often struggle with social interaction, which is a common symptom. A study conducted in 2018 found that the most significant difference between high-functioning autistic individuals and those who are not autistic is social impairment.
Autistic children and adolescents often struggle with socializing and may be described as socially awkward.
They may have difficulty with sharing or collaborating on group assignments and may have a tendency to be self-centered.
One common trait of high-functioning autism is the inclination to talk excessively about oneself rather than trying to connect with others. They may interrupt others during conversations and struggle to maintain focus on the topic being discussed.
This behavior can be perceived as a lack of interest in others by neurotypical individuals.
Emotional sensitivity
To some extent, emotional sensitivity is a subtle symptom of high-functioning autism.
A typical experience that can cause frustration or distress, such as spilling orange juice, stubbing a toe, or not getting what they want, can result in intense emotional responses and can affect the mood or focus of many high-functioning autistic individuals for the rest of the day.
Physical sensation sensitivity
High-functioning autistic people tend to be especially sensitive to physical sensations such as certain textures, sounds, and smells.
For example, certain fabrics may be uncomfortable or irritating, loud noises may be overwhelming, and strong smells may be unbearable.
This sensitivity can affect their daily life experiences, and they may need to make adjustments to their environment to feel more comfortable.
Focus on routines, repetition, and restrictive habits
High-functioning autistic individuals may have a strong need for routine and predictability in their daily lives. They may become upset or agitated if their routines are disrupted or if they are required to deviate from their usual schedule. This fixation on routine and repetition could manifest in various ways, such as:
- Insistence on following the same exact route to school or work every day
- Eating the same foods or sticking to a specific diet
- Insisting on completing tasks or activities in a specific order
- Having a strict daily schedule that they must adhere to
- Becoming upset or anxious when unexpected events or changes occur.
Autism is generally characterized by a dislike of change, and the routines and repetitions followed by high-functioning autistic individuals often serve to prevent change from occurring.
What’s next
To clarify, being classified as “high-functioning” in autism means that an individual can manage their daily routine with little support, but it does not mean that they do not require assistance such as counseling or other services.
The term is controversial because it may overlook the difficulties that many autistic people encounter in social interactions and adapting to their surroundings.
If an autistic person is labeled as “high-functioning,” they may not receive funding for services that can help them with social skills, emotional regulation, and adapting to changes in routine.
While there is still much to learn about autism, it’s clear that the way we talk about it can have a significant impact on how we address and manage the disorder.
3 sources
- Alvares G, et al. (2019). The misnomer of ‘high functioning autism’: Intelligence is an imprecise predictor of functional abilities at diagnosis.
sagepub.com/doi/full/10.1177/1362361319852831 - Barendse E, et al. (2018). Social behaviour and social cognition in high-functioning adolescents with autism spectrum disorder (ASD): Two sides of the same coin?
springer.com/article/10.1007/s10339-018-0866-5#Abs1 - Chawla D. (2019). Large study supports discarding the term ‘high-functioning autism’.
org/news/large-study-supports-discarding-term-high-functioning-autism/