What is High-Functioning Autism?

Autism, particularly related to its full spectrum of nuances and diagnoses, is an extremely complex developmental disability. The American Psychiatric Association (APA) is the authority on defining autism and its different parts, via the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM has been edited, rewritten, and changed five times (current edition is the DSM-5); autism is a diagnosis that changed significantly during the most recent rewrite.

If you are at all familiar with autism, you may find yourself asking what the term ‘high-functioning autism’ means. According to the APA, high functioning autism is not an official medical diagnosis. It is a term used to refer to people who are on the milder end of the autism spectrum and can adequately manage life skills like reading, writing, and speaking.

The Centers for Disease Control and Prevention (CDC) reports that approximately 1 in 54 children have been identified with autism spectrum disorder (ASD). These numbers have grown in past years, likely related to better tracking and diagnosis protocols. Because of its prevalence, care providers need to understand what autism is (and what it isn’t) and what to look for.

What is Autism?

Autism is no longer the appropriate diagnosis for those with this developmental disability. According to the DSM, autism is now known as Autism Spectrum Disorder (ASD). This change occurred in 2013, but it is not uncommon to continue to hear the diagnosis of autism used instead of ASD.

Signs of the developmental disability typically start appearing during early childhood. According to the Autism Society, autism can be defined by “a certain set of behaviors and is a ‘spectrum condition’ that affects individuals differently and to varying degrees.” The CDC reports that ASD is more than four times more common in boys than in girls. It is not unusual for symptoms to go unrecognized until one’s social situation(s) demands too much of them (like a child beginning school). According to the DSM, those with a true ASD diagnosis must exhibit experience social communication/interaction symptoms and restricted or repetitive behavior problems.

Before 2013, the DSM classified three main types of ASD: autistic disorder, Asperger syndrome, and pervasive developmental disorder (PDD).

• Autistic Disorder: This disorder is most commonly thought of when one hears ‘autism’. People under this category have significant social/communication challenges, language delays, and unusual interests. People under this category may also have some sort of intellectual disability.
• Asperger Syndrome: This type is typically milder than an autistic disorder. These people usually have social challenges or unusual interests, but no problems with intellectual disabilities or language.
• Pervasive Developmental Disorder (PDD): Those who fall under this category usually meet some of the criteria for Asperger syndrome, but maybe not all of them. Overall, these individuals have milder symptoms than those in the other types but still have social or communication challenges.

As noted above, when the DSM-5 was released in 2013, there were big changes to the way autism was diagnosed and referred to medically. Today, all three of the previously discussed autism diagnoses are instead all referred to as ASD and they are classified based on the severity of symptoms. ASD Level 1 patients “require support,” ASD Level 2 patients “requiring substantial support,” and ASD Level 3 patients “require very substantial support.”

How Is ASD Diagnosed?

Diagnosing ASD can be difficult because there is no definitive blood test or diagnostic tool which can confirm an ASD diagnosis. Many often wonder ‘how is it diagnosed in children,’ as many little ones can normally display different signs of ASD symptoms during different seasons of development. Qualified physicians are best able to diagnose autism by looking at one’s developmental and behavioral history (and current behaviors). The CDC also has an excellent program called “Learn the Signs. Act Early.” which provides free resources to families as they are monitoring their child’s developmental milestones. Any concerning information noted can then be passed on to the appropriate care provider.

What is High-Functioning Autism?

As noted above, high-functioning autism is not a medical diagnosis. It is more a classification of an ASD individual with a milder level of severity on the autism spectrum. Those referred to as high functioning used to (usually) fall into the out-of-date Asperger syndrome or PDD diagnostic classification. Today’s DSM would likely diagnose them as ASD Level 1 patients who may or may not need treatment. Rarely would a high-functioning ASD individual be diagnosed as ASD Level 3.

As defined by Autism Speaks, the adjective high-functioning simply means that the individuals “have average or above average intelligence but may struggle with issues related to social interaction and communication.” The term isn’t clearly defined and can be frustrating to parents and medical staff alike. One relatively common trait of those with high-functioning autism is that they usually do not show significant delay in language development, whereas low-functioning children with autism usually do. Typically, children with high-functioning autism tend to have more behavioral issues than intellectual ones.

Usually, people who have high-functioning autism (Level 1) will be able to lead ‘normal’ lives and be functioning members of society. They may have occasional difficulties in social situations or struggle with unusual behaviors or interests, but their intellectual capacity is usually fully capable of managing and engaging with life. If one is unfamiliar with ASD and its nuances, it would not be uncommon for them to be unable to tell the difference between a child that has high-functioning ASD and one that does not have any form of ASD.

Related Resource: 15 Best Applied Behavior Analysis Online Programs

Autism spectrum disorder has a lot of unanswered questions. Because of this, it can feel very complex, foreign, and scary. However, as its prevalence and diagnosis continue to grow, its related terms, symptoms, and management should continue to be more socially familiar (and hopefully a little less scary). There are a variety of trusted resources (CDC, Autism Speaks, Autism Society, etc.) with excellent information available for concerned care providers and parents. Pay attention to where your information is coming from as you and your child potentially begin to walk the ASD road together.

ABA Programs Guide Staff

Updated April 2020

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• What Are the Signs That My Child Might Have Autism?
• How Can I Teach a Child with Autism Self-Help Skills?
• Is EFT Tapping Effective with Those with Autism?