Signs and Symptoms of High-Functioning Autism

There are three levels within ASD and what is considered “high-functioning” would fall in the level one category.

High-functioning autism means that a person is able to read, write, speak, and handle daily tasks, such as eating and getting dressed independently.

Despite having symptoms of autism, their behavior doesn’t interfere too much with their work, school, or, relationships.

High-functioning autism vs. Asperger’s syndrome

In 2013, the American Psychiatric Association grouped all autism-related disorders, including what was known as Asperger’s syndrome, into autism spectrum disorder when they published the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Previously, Asperger’s syndrome was a diagnosis for those who showed difficulties with social interactions and nonspeaking communication, and displayed restrictive and repetitive patterns of behavior and interests.

However, these symptoms are now grouped into ASD and people who previously would have been diagnosed with Asperger’s syndrome are often now referred to as autistic but high-functioning.

Still, some people continue to self-identify as having Asperger’s syndrome.

Why is the term ‘high-functioning autism’ controversial?

The main reason the term “high-functioning” is controversial within the autism community is because of its lack of accuracy.

Generally, high-functioning autism is thought to refer to an autistic person who doesn’t have an intellectual disability.

However, studies — including one from 2019 — have revealed that there’s a weak correlation between IQ and adaptive behaviors like eating, getting dressed, tying shoelaces, and so forth.

What is considered ”high-functioning”, therefore, is more complicated than mere intelligence quotients.

In other words, there are too many categories for functioning in society to label an autistic person as either high- or low-functioning, such as:

• communication abilities
• social awareness
• information processing
• sensory processing
• motor skills
• and more

These categories affect all autistic people differently. An autistic person with a high IQ, for instance, would generally be categorized as ”high-functioning” yet could still score low in all social and communication categories.

“The term completely disregards the difficulties these individuals have on a day-to-day basis,” explains Andrew Whitehouse, PhD, professor of autism research at the Telethon Kids Institute and the University of Western Australia in Perth, Australia.

The concern is that those who are labeled as ”high-functioning” will not be able to receive the care and services they need.

Without a more holistic evaluation, an autistic person who would benefit from therapy and other services may not qualify for funding because the categories in which they face difficulties have been overlooked or disregarded.

Although “high-functioning” can manifest in many different ways within autistic individuals, there are several common symptoms to look out for.

Social challenges

A common symptom of high-functioning autism is having trouble interacting with one’s peers. In fact, a 2018 study revealed that social impairment is the greatest differentiator between high-functioning autistic individuals and neurotypical individuals.

Many autistic children and teenagers tend to have challenges with making friends and will often be labeled as socially awkward.

They also tend to have trouble sharing or managing group assignments, and it’s not uncommon for them to focus much of their attention on themselves instead of others.

For instance, neurotypical individuals may perceive that a high-functioning autistic person may spend an excessive amount of time talking about themselves instead of trying to get to know their peers. The autistic person may also interrupt their peers and have a hard time concentrating on a conversation.

Emotional sensitivity

A more subtle symptom of high-functioning autism is emotional sensitivity.

For many high-functioning autistic people, a frustrating or upsetting normal life experience — like spilled orange juice, stubbing a toe, or not getting their way — may cause intense emotional reactions and affect their mood or concentration for the remainder of the day.

Physical sensation sensitivity

In addition to emotional sensitivities, high-functioning autistic people tend to be particularly sensitive to physical sensations, including:

• loud noises
• uncomfortable clothing
• physical touching by another person
• bad smells or tastes

These physical sensations often cause emotional distress for high-functioning autistic individuals.

Focus on routines, repetition, and restrictive habits

High-functioning autistic individuals tend to be fixated on routine and repetition.

This could look like:

• brushing one’s teeth for exactly 2 minutes
• wearing the same outfit every day
• getting exactly 8 hours of sleep each night
• eating the same meal every day

In general, a common symptom for autism is a dislike of change, and these routines help prevent change from occurring.

Although high-functioning autism means that an autistic person is able to go about their daily lives with limited assistance, this doesn’t mean that they wouldn’t greatly benefit from counseling and services.

The term ”high-functioning autism” is considered controversial because it tends to disregard the challenges many autistic people face in navigating social interactions and the environment around them.

Once labeled as ”high-functioning”, autistic individuals may not qualify for funding that could help them learn how to navigate social dynamics, manage emotional distress, embrace small changes in routine, and more.

There is still so much to learn about autism spectrum disorder, but it seems clear that how we discuss this disorder has profound impacts on how we navigate managing it.