High-functioning Autism: Characteristics and Symptoms

High-functioning autism is a term applied to mild cases of autism. We'll explain what it consists of and how it's treated here.

Reviewed and approved by the doctor Diego Pereira.

Written by Carmen Martín

Last update: 03 July, 2023

“High-functioning autism” is an informal term that isn’t technically found in official psychiatric manuals. This concept refers to cases in which the symptomatology is milder.

Therefore, these are people who present an autism spectrum disorder but have a higher level of cognitive and behavioral functioning, so the impact on their daily lives is lower. The problem is that it’s often underdiagnosed, especially in women, which makes it difficult to treat. How to detect it? We’ll tell you all about it here.

What are autism spectrum disorders?

Autism spectrum disorders (ASD) are a series of conditions that affect development. They can cause social, behavioral, and communication problems.

In the past, the conditions that make up this spectrum were diagnosed as separate entities. However, this term is now used to encompass them. As an article from the Centers for Disease Control and Prevention explains, they include the following:

• Autism
• Pervasive developmental disorder not otherwise specified
• Asperger’s syndrome

All of these conditions also affect the sufferer’s interests and motivation. According to a publication in USA Today, approximately 1 in 35 children has an autism spectrum disorder. However, it’s divided into several levels according to its severity.

• Level 1 classifies those who present mild symptoms. This includes high-functioning autism, as we will explain later.
• Level 2 refers to those cases that require more support and treatment.
• Finally, level 3 is reserved for the most severe cases. Patients may require assistance all the time.

High-functioning autism

High-functioning autism isn’t considered an entity within autism spectrum disorder. Neither the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) nor the International Classification of Diseases (ICD-10) consider it a subcategory. Even so, some scientists do consider it to be different.

That is, it has the same characteristics as other pictures of the spectrum, but its symptoms are milder. As we’ve pointed out in the previous section, we could include it within level 1. In addition, the IQ of these people is usually similar to that of the rest of the population, or slightly higher.

There are those who confuse it with Asperger syndrome; however, in the latter case, there are more difficulties with respect to non-verbal skills, visual memory, and perception of emotions. In contrast, children with high-functioning autism have better motor coordination.

In this type of autism, there’s a significant delay in speech acquisition. In addition, there’s a shortage of vocabulary, a tendency to babble and repeat phrases or expressions, and difficulty in understanding certain content.

The symptoms of high-functioning autism

Despite being a mild form of autism, it presents the same typical symptoms of this disorder. For example, patients often have trouble making eye contact with other people.

On the other hand, as detailed in an article published in the Indiana Institute on Disability and Community, communication skills are usually impaired. Thus, they have difficulty picking up rhetorical forms of speech – such as irony or sarcasm – as well as understanding gestures.

Other relevant symptoms include the following:

• Difficulties in forming friendships or romantic relationships. In general, they tend to be suspicious of strangers.
• They have difficulty understanding long sentences or responding appropriately in conversations. Even so, they usually have more communication skills than the rest of the autistic conditions.
• Regarding school or work performance, the impact is very variable. Some people with this type of autism excel in activities that attract their attention. However, they may also be unable to concentrate.
• They are prone to depression, anxiety, and stress. This is because there’s a great absence of empathy toward them and they feel misunderstood. It’s common for them to have explosive behaviors and a very irritable character.

How is the degree of autism diagnosed?

The diagnosis of any autism spectrum disorder can be complex. High-functioning autism is often overlooked or confused with another disorder. In fact, in some cases, it’s not confirmed until adulthood.

The main problem is that -on numerous occasions- these children are diagnosed and treated for other conditions. For example, they may be treated as if they were suffering from obsessive-compulsive disorder or attention deficit hyperactivity disorder.

In any case, it’s common for most of spectrum disorders to be easily identified in the first years of life. Children with autism usually have problems with verbal development, communication skills, and social interactions.

Therefore, signs that may point to this problem appear around 18 months of age. For example, abnormal behaviors are observed when playing. They are infants who also tend to have a limited expression or absence of attachment to other people.

Thus, the diagnosis is usually made through observation. Some specific tests (such as the M-CHAT test, which is answered by parents) or other tools can also be used.

What treatments are available?

There are numerous treatments available for autism spectrum disorders. Treatment must be completely individualized, depending on the most characteristic problems of each patient.

In addition, it must be carried out by a multidisciplinary team. The main thing is that there is good psychological support, both for the affected person and for the family.

• Therapies aimed at improving speech are usually carried out. Although this aspect is not usually so impaired, it can serve to improve the ability to engage in conversation.
• Occupational therapy is another fundamental pillar of treatment. It seeks to improve motor coordination and psychomotor skills.
• Physical therapy sessions are recommended to improve movement and balance.
• Medication may be necessary. Especially if certain symptoms cannot be controlled by therapy or training. Frequently used medications include antipsychotics, antidepressants, and anxiolytics.

People with high-functioning autism may also be sensitive to stimuli. For example, they may be sensitive to bright lights, loud noises, or even to certain tactile sensations. Therefore, another part of the treatment seeks to train to control or withstand such sensations.

High-functioning autism is not considered a separate disorder

In summary, it should be remembered that high-functioning autism is not currently described as an entity in its own right. This is a term used to refer to mild cases of autism.

However, the symptomatology is similar, albeit limited. The main problem lies in the tendency to confuse this disorder with other conditions. This leads to a large number of these patients being treated inappropriately.

In addition, it’s important to try to understand that these people face numerous difficulties in their daily lives. Therefore, we must be understanding and avoid marginalizing certain behaviors.