Autism spectrum disorder (ASD) is a developmental disability that affects a person’s ability to communicate, changes behavior, and is characterized by sensory sensitivities. Social difficulties involve expressing and interpreting nonverbal communication (body language, eye contact, or tone of voice (while some individuals with autism engage in repetitive or fixated interests or activities. That’s why it’s hard for people with ASD to relate to others and maintain relationships.
Symptoms often begin in early life, though the severity can increase over time. An early diagnosis means that the child can live a successful life in the future without too much assistance.
For a while, only people with severe autism were diagnosed, but since the 1990s, many mild forms have been recognized. Aside from Asperger’s syndrome, high-functioning autism is also a condition recognized by doctors.
What is high-functioning autism?
High-functioning autism (HFA) is a relatively new term, yet it’s not an official medical diagnosis. This “term” is informal and problematic, and it refers to people with autism who can speak, read, write, and handle basic daily tasks (e.g., dressing by themselves).
High-functioning autistic people can live independently with limited assistance and have successful careers. However, the term is considered controversial as it advocates ableism and is misleading.
In the broadest sense, HFA can mean the following:
- A person who had an Asperger’s syndrome diagnosis
- Someone who had mild symptoms but are significant enough to merit an autism diagnosis
- Someone who can pass as neurotypical by masking their symptoms
- A person with a high IQ (over 70)
Symptoms of Autism
As with all conditions on the spectrum, individuals with high-functioning autism have difficulty socializing and communicating. People with ASD shut down in social situations and can’t make eye contact or even small talk. It doesn’t come naturally for them to read social cues, and they won’t be able to make friends.
Related: How to Help Children with Autism Make Friends.
Individuals on the spectrum also like routine and order and can have restrictive interests that seem odd to others. Since autism is a spectrum, some do well at school while others can’t hold a job.
However, the common symptoms of high-functioning autism are:
- Emotional sensitivity: People with autism can function in day-to-day life, but they might struggle to control their emotions like neurotypical people. On the other hand, some might even have unusually intense emotional reactions.
- Fixed interests or habits: These interests can interfere with an autistic individual’s relationship with others. These fixed habits can include obsessively playing the same song or reading everything about a specific topic.
- Social difficulties: It might include a limited social circle, problems sharing toys, and having a challenging time completing group work. Sometimes, children are considered shy or socially awkward and have problems interacting with others.
- Linguistic oddities: Some children with high-functioning autism struggle to speak, build vocabulary, or hold conversations. On the other hand, some might even talk too early and have an impressive vocabulary. They might seem eccentric during social scenarios and can focus on particular topics.
- Sensory sensitivities: People with autism find specific noise, tastes, textures, or smells intolerable. For example, noisy or crowded places can lead to emotional distress and trigger meltdowns. These issues can lead to stress and anxiety, but therapy can improve the symptoms over time.
- Likes routines: Autistic individuals like routines and want to stick with them. Any disruption or deviation can lead to meltdowns and can cause frustration. The bad part is that they can devote a good amount of time to the routine and forget self-care or other tasks.
- Dislike of change: Since children on the spectrum are devoted to routine, they dislike change. Since they eat the same thing for breakfast, a change can cause an outburst.
- Too focused on themselves: A child with high-functioning autism spends a lot of time talking about themselves and won’t allow others to respond. In addition, a person might only think of themselves when doing activities, not intentionally.
- Unusual movement patterns: It’s not uncommon for a person with autism to walk on their toes or put excessive pressure on their feet. This can result in pain and often injuries, and the socks can wear much faster.
However, these signs don’t apply to everyone. Individuals with high-functioning autism present symptoms not originally associated with an autism spectrum disorder. These symptoms will help professionals, caregivers, parents, and teachers find the correct diagnosis to apply the proper treatment.
Causes
No one knows what causes autism. Preliminary searches link several genes to have a higher risk of developing autism. However, no single gene or a combination of genes leads to autism spectrum disorder.
Some signs point to the interaction between genes and the environment that leads to autism. A person with a genetic predisposition to autism can develop the condition under certain circumstances.
Biological factors can also contribute to the risk of autism due to the changes in the brain’s connection and metabolism or the body’s immune system.
Vaccines don’t cause autism.
Diagnosis
Currently, there are no blood tests that can detect autism. But a doctor can recommend certain tests to rule out a condition depending on a person’s symptoms. To diagnose autism, a specialist can ask for the child’s medical history, then assess them for common autism symptoms.
Some standard measures to diagnose autism include:
- The Autism Diagnostic Observation Schedule (ADOS): It’s the ‘gold standard’ for an autism assessment. It assesses the child’s social interactions and imaginative play.
- The Autism Diagnostic Interview, Revised (ADI-R): It’s a structured interview form that assesses autism in children aged four or older.
- The Autism Spectrum Rating Scale (ASRS): It uses observational data from teachers and parents to determine whether a child meets the autism criteria. It’s best used for children between one and 18 years old.
Treatment
While there is no cure for autism, the symptoms can be alleviated. In adulthood, some children can grow out of their behaviors. Some might even not realize they have autism until they are an adult.
That’s why any autistic person needs support. A high-functioning autistic individual can have a better quality of life with support. Early intervention means that the autistic child will gain the social skills, emotional awareness, language skills, and other essential skills they will need.
he most popular option is applied behavioral analysis, although many adults with autism claim the practice is abusive. But there are other types of treatments that can help your autistic child, such as speech therapy, physical therapy, occupational therapy, or sensory training.
A psychological evaluation is needed to determine the child's other diagnoses. Children with autism spectrum can have at least one comorbid diagnosis (approximately 70%), such as attention-deficit/hyperactivity disorder (ADHD), depression, bipolar, suicidal behavior, anxiety, etc.
Medication also helps autistic children manage specific autism symptoms, like anxiety or repetitive behaviors.
Activity Ideas for High-Functioning Autistic People
Make a Sensory Bottle
Sensory bottles are easy to make and a perfect sensory toy for children with autism spectrum. They are peaceful objects the children can focus on. The proprioceptive input they get from shaking the bottle will calm an autistic person down. The various floating objects inside the bottle will keep the autistic child captivated.
Learn how to make a sensory bottle here.
Play a Smelling Game
Smelling can boost your child's brain—the best part is that autistic kids love to explore their senses and environment. All you have to do is fill a selection of small containers with a mix of fragrant ingredients. Place a seal over the jar using a piece of fabric or a rubber band. Then you can ask your child to identify the different smells.
Try Ice Painting
This is a perfect activity for the summer. It’s fun—and it can count as an easy science experiment. It will stimulate your child’s curiosity. You can pour different colored acrylic paints into an ice tray and put wooden sticks in each compartment. Once frozen, remove the paints and let your child create beautiful and unique art.
Use a Sensory Bin
Sensory bins come in various kinds and sizes and can be filled with different colors, shapes, and textures. They are essential to the child's learning experience since they can learn by touching and feeling objects. The goal of a sensory bin is to calm the child and make him focus.
Use these to create your sensory bin:
The best part is that you can create the sensory bin however you like.
Related: 10 Fun Sensory Activities for Children with Autism.
High-Functioning Autism Vs. Asperger’s Syndrome
In 2013, the American Psychiatric Association grouped all autism conditions into one when they published the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Many people who might be said to have HFA were diagnosed with either pervasive developmental disorder (PDD-NOS) or Asperger’s syndrome. Yet there are differences between the two conditions.
Asperger's syndrome is a diagnosis that describes a person of average or higher-than-average intelligence and age-appropriate language skills. They also have significant challenges with social interaction. PDD-NOS, often misunderstood as "high-functioning autism," incorporates individuals at all functional levels whose symptoms don't really correlate with classic autism.
Identified in the 1940s by Hans Asperger, Asperger's syndrome is a subgroup in the autism spectrum where children display significant motor skills but fewer speech delays. The condition is more noticeable in boys.
High-functioning autism applies to children who have an IQ of 70 or higher. They usually exhibit mild autism symptoms. The usual symptoms mean fewer language delays and no intellectual disabilities.
People with Asperger’s have common autistic symptoms, but there are no delays in:
- Cognitive development
- Adaptive behavior
- The use of language
- Age-appropriate self-help skills
- Curiosity about their environment
Individuals with Asperger's syndrome have milder symptoms and are less likely to affect their daily lives than autistic people. Research showed that an individual's diagnosis depended on which provider granted the diagnosis rather than the specific symptoms.
Furthermore, people with Asperger’s have different symptoms than those with autism and higher IQs. Anxiety is often a symptom of Asperger’s syndrome, but it might not be shared with those described as having high-functioning autism.
It’s vital to know the differences between the two. Knowing can help you better attend to your child’s needs.
Why Is the Term Controversial?
The term ‘high-functioning’ is controversial due to its lack of accuracy. It is thought to refer to a person with autism who doesn’t have an intellectual disability. However, studies have revealed that there is a correlation between adaptive behaviors and IQ.
This means that there are too many categories of functioning in society to label an autistic individual as either low or high-functioning:
- Motor skills
- Communication abilities
- Sensory processing
- Social awareness
- Information processing
For example, an autistic person can have a high IQ and be categorized as "high-functioning" while scoring low in other categories like communication. Andrew Whitehouse, a professor of autism research at the Telethon Kids Institute, has this to say:
The term completely disregards the difficulties these individuals have on a day-to-day basis.
The biggest concern is that those labeled "high-functioning" won't receive the care and services they need. A holistic evaluation is required in order to help autistic people benefit from therapy and other services. They might not qualify for funding because the categories in which they have difficulties are overlooked or disregarded.
What Are the Levels of ASD?
Autism is a condition that is divided into three levels:
- Level 1: At this level, individuals may have symptoms that don’t interfere too much with their life. When talking of Asperger’s syndrome or high-functioning autism, this is the level they are referring to.
- Level 2: People at this level require support on a daily basis, such as speech therapy or social skills training.
- Level 3: At this level, people with autism need substantial help daily. In some cases, full-time aides or intensive therapy is required.
How Are ASD Levels Determined?
It's challenging to determine a person's ASD level, but trained psychologists have some tools that can help them. The Autism Diagnostic Observation Schedule, Second Edition, is a tool, though it is typically paired with the child's developmental history.
Autism can be diagnosed as early as 18 months of age, but many adults might not be diagnosed until much later. However, being diagnosed later in life can make getting support more challenging. If you feel like your child is autistic, consider making an appointment with a specialist.