What is High Functioning Autism & How Does it Differ From Other Levels?

High-functioning autism is a term often used to describe individuals with autism spectrum disorder (ASD) who have cognitive abilities within or above the average range but still experience challenges related to social communication and behavior. It’s important to note that “high-functioning” is not an official diagnostic term and is not used in clinical settings, particularly in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

High Functioning Autism

Individuals with high-functioning autism may have strengths such as good language skills, average to above-average intelligence, and the ability to perform daily living activities independently. However, they still exhibit features associated with ASD, particularly in the areas of social interaction and repetitive behaviors.

Common characteristics of high-functioning autism may include:

• Social Challenges
  • Difficulty understanding social cues and norms
  • Challenges in making and maintaining friendships
  • Limited interest in or understanding of others’ perspectives
• Communication Differences
  • Fluent speech, but may struggle with pragmatic language (use of language in social contexts)
  • Literal interpretation of language
  • Challenges in understanding nonverbal cues, such as body language and facial expressions
• Repetitive Behaviors and Special Interests
  • Engaging in repetitive movements or activities
  • Intense focus on specific topics or interests
• Sensory Sensitivities
  • Heightened sensitivity or aversions to sensory stimuli, such as light, sound, or touch

It’s important to recognize that the term “high-functioning” can be controversial, as it may oversimplify the experiences of individuals with ASD. Each person with autism is unique, and their strengths and challenges can vary widely. Some individuals may excel in certain areas but struggle in others.

Clinically, the diagnosis of autism spectrum disorder considers the overall presentation of symptoms, and individuals are categorized based on the severity of their challenges rather than a binary classification of “high-functioning” or “low-functioning.” Understanding and supporting the individual’s specific needs and strengths are crucial for providing effective interventions and accommodations.

What are the levels of autism?

The current diagnostic criteria for autism spectrum disorder (ASD), as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), no longer use the terms “high-functioning” or “low-functioning.” Instead, the DSM-5 introduced the concept of “levels of support” based on the severity of social communication impairments and restricted, repetitive behaviors. These levels are used to guide treatment planning and support strategies. The three levels of support are:

• Level 1: Requiring Support
  • Individuals at Level 1 have mild impairments in social communication that cause noticeable difficulties. They may struggle with initiating and maintaining social interactions and may show atypical responses to social cues. Repetitive behaviors may be present, but they are less pronounced.
• Level 2: Requiring Substantial Support
  • Individuals at Level 2 have moderate impairments in social communication. They may exhibit marked deficits in verbal and nonverbal social communication skills. Additionally, they may have difficulty adapting to changes in routines or showing limited interest in activities. Individuals at this level require more substantial support to navigate social situations and to manage daily activities.
• Level 3: Requiring Very Substantial Support
  • Individuals at Level 3 have severe impairments in social communication and their repetitive behaviors are often more prominent. They may have limited or no verbal communication, struggle with basic social interactions, and exhibit significant challenges in adapting to change. Individuals at this level require very substantial support in multiple areas of daily functioning.

It’s important to emphasize that these levels are not static or fixed; they are meant to capture the individual’s needs at a specific point in time. Individuals with ASD can make progress with appropriate interventions and support. Additionally, the focus is on providing individualized support based on the person’s unique strengths and challenges rather than labeling them as “low-functioning” or “high-functioning.”

High functioning vs low functioning autism

The terms “high-functioning autism” and “low-functioning autism” are often used colloquially but are not formally recognized or used in clinical diagnoses, including the latest edition of the Diagnostic and Statistical Manual of Mental Disorders. Instead, the DSM-5 introduced the concept of “levels of support” to describe the severity of autism spectrum disorder. Here’s how the two informal terms are sometimes used:

• High-Functioning Autism
  • Informally, high-functioning autism is used to describe individuals with ASD who have cognitive abilities within or above the average range. These individuals may have good language skills, average to above-average intelligence, and the ability to perform daily living activities independently.
  • People labeled as “high-functioning” may have fewer challenges in certain areas, such as communication and adaptive functioning, compared to those labeled as “low-functioning.”
• Low-Functioning Autism
  • Informally, low-functioning autism is used to describe individuals with ASD who have more significant challenges in cognitive abilities, communication, and daily living skills. These individuals may have intellectual disabilities, limited or no verbal communication, and a greater reliance on support for daily activities.
  • The term may be used to highlight the more noticeable and pervasive nature of challenges in various areas.

It’s important to note that these terms can be misleading and oversimplify the complex and varied nature of autism. As mentioned earlier, the DSM-5 emphasizes a more nuanced approach by categorizing individuals based on the severity of their social communication impairments and restricted, repetitive behaviors at specific points in time, using three levels of support (Level 1, Level 2, and Level 3).

Using the terms “high-functioning” and “low-functioning” can perpetuate stereotypes and may not accurately capture the strengths and challenges of individuals with ASD. Emphasizing the individual’s unique profile and providing support based on their specific needs is a more respectful and accurate approach.

Examples of high functioning autism

Individuals with high-functioning autism can sometimes be similar to those categorized as Level 1 autism. These individuals can have a range of strengths and challenges and their experiences vary widely. Here are some examples of characteristics often associated with high-functioning autism that are also often associated with Level 1 autism.

• Good Language Skills
  • Individuals with high-functioning autism typically have intact language skills, and some may have advanced vocabularies. However, they may struggle with pragmatic language, such as understanding and using language appropriately in social contexts.
• Average to Above-Average Intelligence
  • Many individuals with high-functioning autism or Level 1 autism have cognitive abilities within or above the average range. Some may excel academically in certain subjects, showcasing areas of expertise.
• Specialized Interest in Specific Topics
  • Individuals with high-functioning autism or Level 1 autism may have intense and focused interests in specific topics. These interests can become areas of expertise and passion.
• Routine and Predictability
  • Like many individuals with autism, those with high-functioning autism or Level 1 autism may thrive on routine and predictability. Sudden changes or disruptions in routines can be challenging for them.
• Social Challenges
  • While they may desire social interaction, individuals with high-functioning autism or Level 1 autism often struggle with social nuances. They may find it challenging to initiate and maintain friendships, interpret social cues, and understand others’ perspectives.
• Repetitive Behaviors
  • Repetitive behaviors or routines may be present but are often less pronounced compared to individuals with more significant support needs.
• Sensory Sensitivities
  • Heightened sensitivities to sensory stimuli, such as light, sound, or touch, are common in individuals with high-functioning autism or Level 1 autism. Sensory sensitivities can be present for individuals with Level 2 and Level 3 autism, as well.
• Literal Thinking
  • Individuals with high-functioning autism or Level 1 autism may interpret language literally, leading to challenges in understanding humor, sarcasm, or figurative language.

It’s important to remember that these characteristics are generalizations and each individual with high-functioning autism or Level 1 autism is unique. Additionally, strengths and challenges can evolve over time, and individuals with high-functioning autism or Level 1 autism may develop coping mechanisms and strategies to navigate social situations and daily life.