Is It High-Functioning Autism? Symptoms to Watch for

Understanding high-functioning autism (HFA) is like unraveling a complex puzzle within the autism spectrum. Despite their intelligence, individuals with HFA encounter unique hurdles in social interaction and sensory processing. To help them succeed, we need to learn about their unique challenges and offer them empathy, education, and support so they can shine in society. Before delving deeper, let's take a moment to appreciate the intricate landscape of HFA and its profound impact on those who navigate it.

Note: The DSM-5 no longer uses terms such as "high" or "low" functioning to describe autism. Instead, it classifies autism into three levels of support needs: Level 1 (requiring support), Level 2 (requiring substantial support), and Level 3 (requiring very substantial support).

What is high-functioning autism?


High-functioning autism (HFA) is not a clinical diagnosis but a label used for people with autism spectrum disorder (ASD) to indicate normal or above-normal cognitive abilities. Unlike individuals with low-functioning autism, those with HFA tend to require less support with daily routines, yet may still exhibit social communication, emotional, and sensory difficulties.

Individuals with HFA are prone to interpret language in a more literal manner, which can often lead to difficulties when they are expected to grasp abstract concepts as well as figurative language. Consequently, this leaves them in a challenging situation where they cannot comprehend jokes or slang terms because they may have impaired pragmatic language skills and other social communication difficulties.

Children with high-functioning autism very often have repetitive behaviors; either they engage in self-stimulating actions or play with toys in unusual ways, such as lining them up instead of using them the way they were meant to be used. They usually keep to their own routines, and an abrupt change can provoke distress.

Is Asperger's the same as HFA?

Not exactly. Autism spectrum disorder is broad and complex and encompasses various conditions, including both Asperger's syndrome and high-functioning autism. These are among the most prevalent forms of the disorder, sharing commonalities, especially in social and communication challenges.

However, there are some subtle distinctions to be noted:

  • Language development. Studies have shown that the classic Asperger diagnosis did not include significant language delays, unlike HFA.
  • Current diagnostic focus. From a diagnostic point of view, emphasis is now put on the level of support needed. HFA is commonly used to describe individuals who need lower levels of support when dealing with their daily lives and tasks.

It is also noteworthy that Asperger's syndrome no longer features as a separate diagnosis. In 2013, it was merged into autism spectrum disorder in the DSM-5, which is used by specialists in the mental health field.


What are the symptoms of high-functioning autism?

Here's a breakdown of some common symptoms associated with HFA, keeping in mind the spectrum is wide and individuals may experience some or all of these to varying degrees. It's important to mention that while social interaction and communication are closely related, they are distinct concepts. Social interaction refers to the exchange of behaviors and emotions within social contexts, while communication involves the exchange of information through verbal and nonverbal means.

Social interaction

Here are some typical social interaction difficulties observed in individuals with HFA:

  • Social communication issues where one struggles to get facial expressions, body language, or sarcasm
  • Difficulty in both starting or maintaining conversations
  • Difficulty making eye contact
  • Lack of social interest or difficulty in interactions that involve exchange of information (sharing jokes, games, and others)
  • Appearing socially awkward or withdrawn
  • Challenges that arise from empathizing and understanding other people's emotions


These are some common communication challenges that may be experienced:

  • Literal interpretation of language (may miss sarcasm or jokes)
  • Non-verbal communication problems (gestures, facial expressions)
  • Repetitive speech patterns (echolalia)
  • Having trouble exchanging or taking turns in conversation
  • Flat or monotonous speech patterns

Repetitive behaviors and sensory sensitivities

High-functioning autistic people will frequently exhibit the following common repetitive behaviors and sensory sensitivity issues:

  • Extreme concentration on specific subjects or hobbies, occasionally to an expert level
  • Repetitive behaviors or routines (stimming) such as rocking, walking back and forth, or hand flapping
  • Difficulty in dealing with disruptions or changes in the daily routine
  • Having a great need for order and predictability
  • Overreacting (hypersensitivity) or underreacting (hyposensitivity) to sound, touch, light, taste, or smell (this could result in a meltdown or avoidance in the case of certain stimuli)
  • Disliking certain textures or clothes materials

HFA: adults vs. children

Although children and adults with ASD have common core problems in social interaction, communication, and sensory processing, their experiences may still vary.

The similarities are:

  • Lack of social engagement skills, including reading facial expressions and sarcasm
  • Repetition of behaviors and routines in order to gain comfort
  • Rigorous focus on particular fields of interest
  • Sensory sensitivities

The differences are:

  • Children may have a harder time with speech development, social skills with peers, and difficulty controlling meltdowns. The school environment often makes circumstances more complex to cope with due to social demands and unpredictable situations. For instance, a child who has HFA might misread a teacher's frustration as a sign of encouragement that, in turn, will cause more confusion or frustration from the teacher.
  • Adults may also develop a fear of social situations that can make them doubt their ability to succeed in the workplace or build meaningful romantic relationships. Anxiety and depression are more common in this population. Working environments that place a value on their specific skills and where there is clear communication can be very good career options. However, things can go wrong in some situations; for instance, an adult with HFA outperforming in a technical profession but failing to pick up on the nonverbal feedback of colleagues during meetings. This may result in the loss of friends or worse — a misunderstanding about their true intentions.

How is high-functioning autism diagnosed?

Autism spectrum disorder screening usually starts during childhood, and yet, patients with slightly less severe symptoms can remain undetected until adulthood. The multi-phase process of diagnosing high-functioning autism does not have any particular medical tests. Instead, healthcare practitioners ask for information about an individual's developmental history to understand the relevance of current behaviors.

Here's what to expect:

  • Detailed interview. The physician will explore developmental milestones, social behavior, communication style, daily routines, favorite things, and sensitivity toward sensations. They will also get information from parents, teachers, or caregivers who interact with the individual in varying settings.
  • Standardized assessments. These assessments can be required for the evaluation of different areas such as social skills, communication, and cognitive abilities. They can be in a questionnaire format or some task that is performed by the person themselves.
  • Clinical observations. The doctor can observe the patient's behavior in the session and pay attention to their social interactions, their communication style, and how they respond to certain sensory stimuli.

When it comes to the appointment itself, it's crucial to have all the relevant documentation and records available to show the doctor, including school reports and past evaluations. Also, it's equally important to be open and honest throughout the meeting, as well as ask questions, since this will help the specialist understand your experiences or those of your child.

Can a person self-diagnose?

Although the internet has made a lot of information about high-functioning autism (HFA) easily accessible, self-diagnosis is still risky. Definitely, you might be able to link up symptoms and think you actually have HFA, but some other conditions like anxiety and ADHD also have similar symptoms. The reason why professional diagnoses by a certified mental health professional are important is because professional diagnosis helps improve treatment.

First and foremost, a therapist or a psychiatrist should be able to give you a more accurate assessment to make sure you get the necessary assistance. Similarly, after confirming the official diagnosis, various resources offered to the patient become available. Although self-diagnosis is a good beginning, it is the professional evaluation that is key to getting the assistance you merit.

Support for individuals with high-functioning autism

Providing services for persons with HFA, regardless of their age, includes different measures targeted to their individual needs.

These may include:

  • Speech therapy. It facilitates the development of communication skills such as language formation, participation in conversations, and applying concepts in practical language usage.
  • Physical therapy. It tackles sensory sensitivity, motor coordination problems, and gross and fine motor skill issues.
  • Behavioral therapy. It uses methods like applied behavior analysis (ABA) to work on challenging behavior, master social skills, and develop better adaptive functions.
  • Social skill development. It provides structured programs or interventions to work on skills such as social interaction, perspective-taking, making friends, and understanding the rules for social behavior.
  • Mental health support services. Such services provide counseling, psychotherapy, or support group meetings to manage co-morbid mental illnesses such as anxiety, depression, and obsessive compulsive disorder.
  • Parent training. This involves supplying guidelines, resources, and support for parents and caregivers on how to manage their children with HFA and includes behavior management, communication, and advocacy strategies.

Parenting tips for high-functioning autism

Navigating the journey of parenting is a blend of both joys and challenges. Central to this endeavor is the provision of structure, which fosters a sense of security and predictability for your child. Using visual charts and calendars serves as an effective method to establish and maintain this structure. Additionally, collaborating with teachers ensures that your child receives the necessary academic support and accommodations, facilitating their success in school.

Participating in social skill training for your child through activities such as role-playing and social stories may enable them to navigate social interactions with more ease. Furthermore, speech and language therapy may be useful in improving their communication skills, which ultimately may free up your child to express themselves more effectively. Reach out for support from other parents who can appreciate what you are going through, and focus on reinforcing positive behaviors that will increase your child’s confidence and motivation.

Normalizing sensory sensitivities with such tools as noise-canceling headphones or weighted blankets will have a calming impact on the environment for your child. Periodic medical check-ups are important to monitor their growth and development and to treat any underlying medical issues early. In cases of challenging behavior, try to approach the situation with understanding and love, appreciating the unique talents and individuality of the child.

In conclusion, the world of high-functioning autism (HFA) is a journey which is a mix of both triumphs and tribulations. When we, with empathy and understanding, embrace the unique journey of every individual, by offering unwavering support and encouragement, such an environment can be created where each HFA person will blossom and shine.


Key takeaways:


Leave a reply

Your email will not be published. All fields are required.