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High end of the autism spectrum


10 Symptoms of High-Functioning Autism

  • Emotional Sensitivity
  • Fixation on Particular Subjects or Ideas
  • Linguistic Oddities
  • Social Difficulties
  • Problems Processing Physical Sensations
  • Devotion to Routines
  • Development of Repetitive or Restrictive Habits
  • Dislike of Change
  • Focus on Self
  • Unusual Movement Patterns

What is High Functioning Autism?

In 2013, the American Psychiatric Association published the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).  This edition of the DSM had some important changes to the way autism is diagnosed.  Previously, diagnoses like Asperger’s Syndrome and Childhood Disintegrative Disorder were used to describe individuals at the extreme ends of the autism spectrum.  High-functioning autism and Asperger’s are not an official medical diagnosis, but rather unofficial terms used to describe individuals who have mild symptoms of autism.   Parents and providers in the field may still refer to these terms to indicate a level of support or degree of disability.

With the DSM-5, those diagnoses all fall under “Autism Spectrum Disorders.”  Individuals with an autism spectrum disorder now include a level of severity in their diagnosis.  What would have been known as high functioning autism or Asperger’s is now considered ASD Level 1.

Regardless of the terms used, early identification of autism spectrum disorders is crucial.  Diagnosis rates for autism continue to rise, especially as parents and professionals become more familiar with the symptoms of Level 1 ASD or high functioning autism.  Tools like the Autism Diagnostic Observation Schedule (ADOS) help psychologists and other therapists make an official diagnosis.

Many patients are getting the assistance they need to live full, productive lives because their unusual behaviors are no longer seen as simple social awkwardness or eccentricity. As more caring medical and mental health professionals learn to recognize the most common signs of high functioning autism, the number of interventions available to people with autism will rise.

See Also: What are the 10 Most Common Signs of Autism Spectrum Disorder (ASD)?

Emotional Sensitivity

Although often overlooked, sensitivity to emotions is one of the most common symptoms of high functioning autism. These individuals can function in day-to-day life but struggle to control their emotions the same way that neurotypical, or non-autistic people, are able to do. For example, a frustrating morning experience like running out of milk or being cut off while driving can cause irritability and difficulty concentrating for the rest of the day. People with autism spectrum disorder may also have unusually intense emotional reactions compared to the rest of the population.

Fixation on Particular Subjects or Ideas

Continually discussing the same topics in conversation, obsessively playing the same song repeatedly, or reading every article written about a certain topic are signs of high-functioning autism in adults and adolescents. These interests can be negative if they take over the individual’s life or interfere with their relationships with others.

Of course, these obsessive tendencies can also be helpful; Dan Aykroyd, writer and star in the hit film Ghostbusters, was inspired by his focus on ghosts and the paranormal. Many other high-functioning autistic individuals have used their focus on mathematics, biology, or writing to inspire successful careers.

Linguistic Oddities

Children on the low-functioning end of the autism spectrum usually struggle with:

  • learning to speak
  • building vocabulary
  • holding conversations with others

Individuals with signs of high-functioning autism may start talking much earlier than normal and often display an impressive vocabulary. They may find conversations with others boring or difficult to follow and may avoid speaking with their peers. An autistic person may simply seem eccentric during conversations as their diverse vocabularies, frequent interruptions or focus on particular topics seem like oddities rather than neurological symptoms.

Social Difficulties

Parents and teachers may notice that young autistics have problems interacting with their peers. These high-functioning autism symptoms in children and teenagers can include:

  • a limited social circle
  • problems sharing toys or materials
  • difficulty completing group work

Sometimes youth are considered shy, quirky or socially awkward when they are truly dealing with autism spectrum disorder.  These kids need counseling services to help them learn social rules, as the problems with interacting with others usually stem from a lack of understanding appropriate behavior with peers. They have a difficult time recognizing social cues and body language.  Early intervention from mental health professionals can help autistic youth learn the best ways to interact with their classmates and potential friends.

Problems Processing Physical Sensations

Many individuals with autism have sensory difficulties. They may have an intolerance to specific:

  • noises
  • tastes
  • smells
  • feelings

Noisy public places can lead to emotional distress, as can uncomfortable clothing or unwanted touches. These issues can be disruptive and stressful, but according to the National Institute of Neurological Disorders and Stroke, autism symptoms can improve over time as children with mild autism learn to regulate their own behavior through work with professionals.

Many individuals on the autism spectrum can benefit from occupational therapy to manage sensory issues.  An occupational therapist can create goals and strategies for the individual to work on.  They might meet with the individual one day a week or a couple days, depending on the person’s needs.

Devotion to Routines

People with high-functioning autism are typically devoted to routines. They may stick with routines developed for them by others, such as reading for exactly 15 minutes before going to bed or brushing their teeth exactly five minutes after eating a meal. Any sort of deviation from the routine could cause frustration.  Examples include:

  • A parent needing to help a sick sibling at bedtime instead of reading a bedtime story
  • The school bus running late and missing first period
  • A snowstorm causing school to be cancelled

The person with high-functioning autism may devote an exorbitant amount of time to performing their routines to the detriment of:

  • self-care
  • sleep
  • exercise
  • homework
  • learning

Development of Repetitive or Restrictive Habits

Repetitive habits may also be symptoms of high-functioning autism in adults.  Those habits could interfere with the person’s ability to do what they need to do or what others want them to do. One type of repetitive habit might be related to movement. The individual might have to tie and untie their shoes multiple times before they are satisfied and are able to start walking or leave the house.

Some high functioning autistic people also develop restrictive habits that interfere with socially accepted living. For example, an individual might refuse to wear any other kind of shirt than a tee shirt. This could impact their health and well-being if they live in a place with cold weather.

Dislike of Change

One of the hallmark high functioning autism symptoms is a strong dislike of change. An individual might eat the same meal every day for breakfast, and they may eat it in the same quantity, on the same dish, and in the same place. Any disruption or change in the routine could cause an outburst in the individual. For example, if the usual brand of peanut butter has run out, and a different brand has been purchased instead, the person with high-functioning autism may have an outburst of anger or frustration. If someone has used their preferred dish, they may have a similar outpouring of volatility.

Focus on Self

People with high-functioning autism may have trouble developing deep social relationships with others. Part of this issue also includes an inordinate focus on self. A person with high-functioning autism may spend an excessive amount of time talking about themselves, not allowing another person to share a complete thought or response. This makes carrying on a conversation difficult. In the family or household setting, a person with high-functioning autism may only think of themselves when doing activities. For example, they might pour themselves a drink without asking if anyone else would also like a drink. They might take more than what others perceive as a fair share of a snack or treat, genuinely not thinking that others might also want some of the items.

Unusual Movement Patterns

A person with high-functioning autism may have unusual movement patterns. Toe walking is a common movement disorder. The person may walk on their toes or the ball and the toes of the feet without putting much bodyweight on the other parts of the foot. This can result in foot pain in the ball, hammertoe, or bunion from the excessive pressure. The shoes and socks may wear out in the forefoot area much faster than in the heel area. People who walk on their toes may experience more foot injuries, such as blisters, calluses, and corns on their footpads and toes. Toe walking is more common in young children and people with musculoskeletal, explains the American Academy of Orthopedic Surgeons.

Related Resource: Top 20 Best Applied Behavior Analysis Programs

Not all individuals with autism exhibit physical tics or an inability to maintain social ties. High functioning autistic individuals usually present symptoms not originally associated with autism. Helping professionals must continue to push for recognition of the range of behaviors associated with the autism spectrum. Familiarity with these ten symptoms of high-functioning autism helps providers, parents, teachers and others coordinate the early treatment of a person with this condition.  Resources like Autism Speaks can also provide parents and professionals with support and helpful ideas.

Related:

  • 20 Autism Charities Worthy of Your Donations
  • 30 Great Jobs for People on the Autism Spectrum
  • How Can Speech Improve in Nonverbal Children with Autism?
  • What are Distress Tolerance Skills?

Asperger's, Autism Levels & More

High-functioning autism isn’t an official medical diagnosis. It’s often used to refer to autistic people who read, write, speak, and manage life skills without much assistance.

High-functioning autism isn’t an official medical diagnosis. It’s often used to refer to autistic people who read, write, speak, and manage life skills without much assistance.

Autism is a neurodevelopmental disorder that’s characterized by difficulties with social interaction and communication. Some autistic people need minimal support, while others require substantial support on a daily basis. This is why autism is now referred to as autism spectrum disorder (ASD).

High-functioning autism is often used to refer to those with lower support needs. Read on to learn more about it.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was updated and released in 2013. Before its most recent update, the DSM used to detail a condition known as Asperger’s syndrome.

People diagnosed with Asperger’s syndrome had several symptoms in common with autistic people, but they didn’t have delays in:

  • the use of language
  • cognitive development
  • the development of age-appropriate self-help skills
  • the development of adaptive behavior
  • the development of curiosity about their environment

Their symptoms were often milder and less likely to affect their daily lives than the symptoms of autistic people. They may even have been perceived as “high-functioning.”

However, high-functioning autism has never been an official clinical diagnosis, and Asperger’s syndrome was eliminated from the DSM-5 along with some other neurodevelopmental disorders.

People who have these types of difficulties with social interaction and communication or who display repetitive or restrictive behavior would now simply be diagnosed with ASD. This is regardless of how much support they may need.

ASD is divided into three levels:

  • Level 1. People at this level may have symptoms that don’t interfere too much with their work, school, or relationships. This is what most people are referring to when they use the terms high-functioning autism or Asperger’s syndrome.
  • Level 2. People at this level require some outside support on a daily basis. Examples of outside support include speech therapy and social skills training.
  • Level 3. People at this level require substantial outside support on a daily basis. In some cases, support may include full-time aides or intensive therapy.

While it’s difficult to determine a person’s ASD level, trained psychologists have some tools that can help them accomplish this, such as the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). This assessment is typically paired with a thorough developmental history.

ASD can be diagnosed as early as 18 months. However, many children, and even some adults, may not be diagnosed until much later.

Being diagnosed at a later age can make support more difficult. If you or your child’s pediatrician think they may be autistic, consider making an appointment with an ASD specialist. Learn more about testing for ASD.

There aren’t any standardized recommendations for different levels of ASD. Support depends on each person’s unique symptoms.

People with different levels of ASD may all need the same kinds of support, but those with level 2 or level 3 ASD will likely need more intensive, long-term support than those with level 1 ASD.

Potential ASD support includes:

  • Speech therapy. ASD can cause a variety of speech issues. Some autistic people might not be able to speak at all, while others might have trouble engaging in conversations with others. Speech therapy can help to address a range of speech problems. Learn more about speech disorders.
  • Physical therapy. Some autistic people have trouble with motor skills. This can make actions such as jumping, walking, or running difficult. Physical therapy can help to strengthen muscles and improve motor skills.
  • Occupational therapy. Occupational therapy can help you learn how to use your hands, legs, or other body parts more efficiently. This can make daily tasks and working easier.
  • Sensory training. Autistic people are often sensitive to sounds, lights, and touch. Sensory training helps people become more comfortable with sensory input.
  • Applied behavioral analysis (ABA). This is a technique that encourages positive or helpful behaviors while decreasing behaviors that interfere with functionality. There are several types of applied behavioral analysis (ABA), but most use a reward system.
  • Medication. While there aren’t any medications designed to treat ASD, certain medications can help to manage specific symptoms, such as depression or emotional lability.

High-functioning autism isn’t a medical term, and it doesn’t have a clear definition.

People using this term are likely referring to something similar to level 1 ASD. It may also be comparable to Asperger’s syndrome, a condition not currently recognized by the APA.

If you think that you or your child have any of the symptoms of ASD, see a doctor or specialist. Blogs can be another great source of support.

Lisa Jo Rudy: "Why 'High Functioning Autism' Isn't Easy at All"

Currently, there are no generally accepted statistics on how many people on the autism spectrum are located near its various borders (most people are "somewhere in between"). However, it is clear that the lion's share of media attention is directed at people at the top and bottom of the spectrum, that is, with a clear disability and a very high level of functioning.

The fact is that life with severe autism is extremely difficult. And it seems logical to assume that people at the top of the spectrum have it easy, as do their families, teachers. After all, people with high-functioning autism often have very bright personalities and impressive talents. But in reality, everything is different. nine0003

Myth: People with high-functioning autism are smart and successful

According to the media, the upper end of the autism spectrum is largely populated by eccentric geniuses: Bill Gates and Albert Einstein, Dan Aykroyd and Daryl Hannah, who, in fact, have everything well, despite the fact that they are far from the same as everyone else. The reality, meanwhile, is that the combination of "high-functioning autistic" and "genius", "business tycoon" or "Hollywood star" is rare. In fact:

  • While people with high-functioning autism may (or may not) be extraordinarily intelligent, they may lack the motivation to succeed in society that led Bill Gates to look for investors and Einstein to look for a publisher.
  • They may also experience serious problems in daily activities, work, personal life, have low self-esteem. These problems are exacerbated in many ways by the fact that people around them constantly react to them with bewilderment or surprise, since they do not expect strange behavior or reactions from people who "behave normally" in many situations. nine0012
  • People with more severe autism are generally not expected to "knock down and just have a tough time" in difficult situations for them, but people on the higher end of the spectrum are often expected to do just that.
  • Finally, people with high-functioning autism are generally aware of their difficulties and are extremely sensitive to negative reactions from others.

Fact: High-functioning autism is a daily challenge

Here are just a few of the problems people with high-functioning autism (including those diagnosed with Asperger's Syndrome) often get in the way of their success and happiness:

  1. Significant sensory problems
    People with high-functioning autism, like people anywhere on the spectrum, have sensory disintegration. It means mild, moderate, or extreme sensitivity to noise, crowds, bright lights, strong tastes, smells, and touch. This means that a verbal and gifted person may not be able to walk into a crowded restaurant, go to a movie, or deal with sensory overload in shops, stadiums, and other public places. nine0012
  2. Social awkwardness
    What is the difference between a polite greeting and flirting? How do you know if you're talking too loudly? When is it appropriate to talk about personal problems or interests? When is it important to stop doing what you enjoy and focus on the needs of the other person? These questions are difficult for everyone, but for someone on the high autism spectrum, they can be insurmountable obstacles in making social connections, at work, in personal relationships. nine0012
  3. Anxiety and depression
    Anxiety disorders, depression and other emotional disorders are more common among people with high functioning autism than in the general population. It is not known whether autism leads to these disorders, or whether these disorders arise from social rejection and failure, but be that as it may, emotional disorders themselves are already a big problem.
  4. Lack of management and planning skills
    Executive functions include the skills we use to organize and plan our lives. They allow typically developed adults to set up a daily routine in advance, notice that the shampoo is running low (which means they need to buy a new one), set a time frame for completing steps in a long-term project, and stick to them. Most people with high-functioning autism have severe executive dysfunction, making it very difficult to plan and do household chores, make it difficult to cope with even minor changes at work or school, and so on. nine0012
  5. Emotional lability
    Contrary to popular belief, people with autism are not deprived of emotions. Moreover, people with autism may become overly emotional in situations that are uncomfortable for them. Imagine a 16 year old crying because of a change in plans, or a grown woman hysterical because the car won't start. These are examples of common problems for people with high functioning autism who are quite capable of doing things, but ONLY under predictable conditions and without unexpected obstacles. nine0012
  6. Difficulty with switching and change
    Many people find it difficult to adjust to change, but for people with high-functioning autism, this problem is on a completely different level. Having set a comfortable and consistent schedule for themselves, people with autism generally want to stick to it at all times. If an autistic adult is used to going out to eat nachos with friends on Wednesdays, then the suggestion of going out to eat chicken wings on Thursday may cause him anxiety or even anger. nine0012
  7. Difficulty following verbal communication. A person with high-functioning autism is quite capable of completing a task, but may not be able to take verbal instructions addressed to him. In other words, if a police officer said, "Stay in your car and give me your driver's license and registration certificate," then a person with autism can process only part of the phrase - "stay in your car" or "give me your driver's license." The same applies to other instructions, such as: in a ballroom dance class, in a doctor's office, or given by a manager in an office. It is clear that this can give rise to a large number of problems - from serious problems with the police to unintentional mistakes at work. nine0012

As you can see, the term "highly functional" means exactly what it says. However, high-functioning autism is not at all a diagnosis that is easy to live with. For anyone who cares, hires, trains or works with people at the top of the autism spectrum, it is important to remember that autism is always autism.

The above material is a translation of the text "Why 'High Functioning' Autism Is So Challenging".

Why is it so difficult to live with "high functioning" autism? nine0001

5/27/15


ASD expert on the myths and challenges of high functioning autism

Author: Lisa Jo Rudy
Source: autism. about.com

The spectrum of autism is very wide. If you think of it as a rainbow (or bell curve), you will notice that a significant proportion of the people on the spectrum do not belong to one side or the other - they are somewhere in the middle. Of course, at this point in history, we have no evidence that MOST people on the autism spectrum are “somewhere in between,” but it is clear that the media tends to focus on only the two extremes of autism—the most severely disabled and the most highly functioning people. nine0003

If you look at autism through the eyes of journalists, high-functioning autism is a bunch of eccentric geniuses. Often mentioned are Bill Gates, Albert Einstein, as well as actors Dan Ackroyd and Daryl Hannah. In other words, we are talking about people who simply stand out from the background of others. However, in real life, the concept of "high-functioning autistic" rarely coexists with such epithets as "genius", "business tycoon" and "Hollywood star".

In fact, the intelligence of people with high functioning autism may be no higher than that of their typical peers. And they may completely lack the motivation to achieve public recognition, which at one time forced Bill Gates to look for investors, and Einstein to publish an article. nine0003

They may also experience significant difficulties in daily activities, employment or personal life, and this often leads to low self-esteem. These problems are greatly exacerbated by the fact that others constantly react to them with bewilderment or indignation. The reason is that in many situations people with high-functioning autism "pass for normal" and are not expected to behave or respond in an unusual way.

Also, people with more severe autism are not usually required to "just pull themselves together and act normal" in difficult situations for them, but people on the higher end of the spectrum are often expected to do just that. nine0003

Finally, people with high-functioning autism tend to be very aware of their own difficulties and can be very distressed by the negative reactions of others.

Here are just a few of the typical problems people with high functioning autism (including those diagnosed with Asperger's Syndrome) often get in the way of their success and happiness:

Severe sensory impairments. People with high functioning autism, like everyone on this spectrum, are susceptible to sensory processing disorders. This can include mild to severe hypersensitivity to noise, crowds, bright lights, certain tastes, strong smells, and touch. In practice, this means that even a very gifted and eloquent person may be completely unable to enter a crowded restaurant, go to a movie, or endure going to a supermarket, a stadium, or other public places. nine0003

Social blindness. What is the difference between a polite greeting and a light flirt? How do you know if you're talking too loudly? When is it okay to talk about personal problems or interests, and when is it best to refrain from doing so? When is it important to stop doing what you enjoy and focus on the needs of the other person? Most people have trouble answering these questions, but if you have high-functioning autism, they can become insurmountable barriers to communication, employment, and romance. nine0003

Anxiety and depression. Anxiety disorders, depression, and other emotional disturbances are much more common in people with high-functioning autism than in the general population. We don't know if autism leads to these disorders, or if it's just a natural consequence of frequent failure and social rejection. But whatever the cause, emotional disturbances can be disabling in and of themselves.

Lack of skills in planning one's actions. nine0027 The skills we use to organize and plan our lives are called executive functions. They allow NT adults to plan ahead for their daily routine, notice when they run out of shampoo and buy more on the way home, or plan work on a complex long-term project. Most people with high-functioning autism have very severe executive dysfunction. As a result, it is extremely difficult for them to cope with household chores, the slightest change in their usual routine can be a disaster for them, and so on. nine0003

Problems of emotional regulation. Contrary to popular belief, people with autism do not suffer from lack of emotion. Moreover, people with autism can become overly emotional in inappropriate situations. Imagine a teenager crying over a change in plans, or a grown woman having a tantrum because her car wouldn't start. These are examples of typical problems for people with high functioning autism that can be very successful, but ONLY in predictable situations without unexpected obstacles. nine0003

Problems with changes and transitions. Many neurotypicals find it difficult to adapt to change, but for people with high-functioning autism, this is a problem on a completely different level. Once a familiar and comfortable routine has been established, people with autism generally want to keep that routine forever. An autistic adult can go out with friends every Wednesday for nachos without any problems, but the idea of ​​going out on Thursdays for chicken wings instead can cause a panic attack and even anger. nine0003

Difficulties with oral speech perception. A person with high-functioning autism may be ready to do a task given to him brilliantly, but if the instructions were given to him orally, then there is a risk that he simply will not be able to follow them. For example, if a police officer says "stay in the car and hand me your papers," a person with autism might only make out "stay in the car" or only "hand over the papers." The same may apply to instruction in the classroom, in the doctor's office, or in the workplace. As you might guess, this often leads to all sorts of difficulties, ranging from problems with the police to unintentional mistakes at work. nine0003

As you can see, the term "highly functional" means just that. However, this does not mean that high-functioning autism is an “easy” diagnosis. It is important for loved ones, employers, teachers, or others who interact with people on the high end of the autism spectrum to remember that autism is autism.

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