An Overview of High-Functioning Autism Spectrum Disorder

Formerly known as Asperger's syndrome

In This Article

Table of Contents

Individuals with Asperger's syndrome have various challenges with social functioning, specifically with regards to interpreting and responding to social cues and emotions appropriately. Difficulties with changes in routine and a hypersensitivity to various sensory inputs are additional symptoms.

We use the term Asperger's syndrome here, as many still do when referring to this condition. But know that it is now considered a mild or high-functioning type of autism, so clinicians in the United States refer to it as an autism spectrum disorder (ASD).

Management of Asperger's syndrome requires an individually tailored plan—one that targets an individual's specific needs. This plan often entails structured and sensory modifications in and outside the home, counseling, family support, and sometimes, medication.

Signs of Asperger Syndrome
Verywell / JR Bee

Symptoms

While people with Asperger's syndrome/ASD have normal cognitive abilities and language development, they struggle socially, specifically with social communication and interaction.

Social communication refers to the ability, for example, to accurately read body language and vocal tone, infer what another person is thinking, or show appropriate emotional responses at the right time.

While many people with Asperger's syndrome/ASD are intelligent, articulate, and capable of holding down a job, they struggle with more complex social cues, like humor, irony, romantic interest, and anger. They often have difficulty with interpreting the "hidden agenda" in a social situation—like knowing when to speak, when to be quiet, and what to wear.

When conversing or interacting with others, a person with Asperger's syndrome/ASD may stand too close to someone or talk non-stop about a topic, failing to notice the listener's boredom.

In addition, they may interact unusually, avoiding eye contact, appearing awkward, maintaining the same facial expression (e.g., not smiling in response to someone sharing good news), not using gestures or posture changes throughout the conversation, and/or exhibiting an unusual speech pattern (e.g., a flat, high-pitched, or inappropriately loud voice).

Besides difficulties relating to other people, additional symptoms of Asperger's syndrome/ASD include the following:

  • Difficulty with change: Most people with Asperger's syndrome/ASD prefer to know exactly what's going to happen next. Many prefer to do the same things in the same order each day, eat the same foods, take the same routes, etc.
  • Extreme focus on a topic of interest: Some individuals with Asperger's syndrome/ASD are so fascinated by a particular topic of interest that they find it almost impossible to change the subject. This can be an invisible problem if your friends and classmates all share the same interest but can become an issue when you're interacting with those who have different interests.
  • Challenges with empathy: This means that a person may have trouble imaging what other people are thinking or feeling.
  • Engaging in stereotype, repetitive behaviors: Some people with Asperger's syndrome/ASD engage in self-stimulating (a.k.a. "stimming") behaviors, such as hand flapping, pacing, rocking, or humming.
  • Hypersensitivity to sensory "assaults": It may be tough for a person with Asperger's syndrome/ASD to be in a loud, bright space or function well in an open classroom or large restaurant. They may also react strongly to smell or taste, or have a hard time with physical intimacy.

    Having one or more of the above symptoms does not definitively mean a person has Asperger's syndrome/ASD.

    Cause

    The cause of Asperger's syndrome/ASD is not fully known. Experts suspect that a combination of genes and exposure to one or more environmental factors is what triggers its development.

    Some environmental factors that have been investigated as potentially contributing to the development of Asperger's syndrome/ASD include:

    • Advanced maternal and paternal age
    • Fetal environment (for example, the presence of maternal infection or health issues like obesity, diabetes, or high blood pressure)
    • Perinatal and obstetric events
    • Medications that were taken during pregnancy
    • Smoking and alcohol use
    • Nutritional deficiencies
    • Toxic exposures, like air pollution or pesticides

    Diagnosis

    Asperger's syndrome/ASD is different from other disorders on the autism spectrum, in part because it is often diagnosed in older children and teenagers, as opposed to very young children.

    Since Asperger's syndrome/ASD is a type of high-functioning autism, so many young children pass their earliest milestones with flying colors. It's when children reach an age when they are expected to manage complex social relationships, conversations, or sensory challenges (often around preschool, but sometimes later) that a diagnosis may come into question.

    If you decide to seek a diagnosis for your child or teen (or yourself), start by seeking out individual therapists, neurologists, and autism centers that are familiar with tests for high-functioning autism.

    A team of clinicians will most likely go through a series of tests and assessments that focus on intelligence, behavior patterns, "adaptive" social and communication skills, and personal developmental history.

    A few examples of potential tests include:

    As a result of these tests and various assessments, an experienced clinician will be able to tell you whether or not autism can be diagnosed or whether the symptoms are more in line with other disorders that have some of the same or similar characteristics (social anxiety disorder, obsessive-compulsive disorder, social communication disorder, to name a few).

    Keep in mind, sometimes no disorder is present—a person may simply have a shy temperament, for example. Sorting out various diagnoses can be a very tricky process and, thus, requires a trained professional.

    Can Someone Be Intelligent and Successful and Have Autism?

    Of course, plenty of people are socially awkward without being diagnosable on the autism spectrum. The difference between "awkward" and "autistic" really lies in the degree to which those delays, disorders, and difficulties impede one's ability to live a normal life.

    Treatment

    The treatment of Asperger's syndrome/ASD requires a multifaceted approach and must be tailored to each individual's age and needs. A team of professionals (e.g., psychologist, occupational therapist, social worker, counselor, etc.) is usually involved; in pediatric cases, parents and teachers are obviously also involved.

    Children and Teens

    Interventions that address behavior and education are at the crux of treatment for Asperger's syndrome/ASD.

    For instance, creating a home and school environment that is structured and organized—one where there are visual schedules, task lists, and clearly defined rules and expectations—can help children and adolescents stay focused.

    In addition, classroom settings may be adjusted in order to minimize over-arousal, such as placing carpet to reduce noise or breaking up the class into smaller learning groups where there are fewer students. Motor-based activities done intermittently throughout the school day, such as yoga, hula-hooping, or jumping on a mini-trampoline, can also help provide calmness and fulfill a child's sensory need.

    Social-skills training, mental health counseling, family support, engaging in healthy lifestyle habits (for example, eating healthfully and obtaining adequate sleep), and formulating an education plan that is tailored to an individual child or adolescent's needs are also essential components of the treatment plan.

    Adults

    For adults with Asperger's syndrome/ASD, accommodations at work, such as implementing scheduled breaks, requesting written instead of verbal instruction for a task, or using earplugs or headphones throughout the day, can reduce sensory overload and improve executive functioning.

    In addition, cognitive-behavioral therapy has emerged as a therapy for individuals with Asperger's syndrome/ASD, especially adults. This type of therapy can help adults develop concrete coping skills for navigating peer and romantic relationships, and help them address frustrations related to goal achievements in work and life.

    Occupational therapy that focuses on optimizing problem-solving skills, building self-esteem and confidence, and managing home and money tasks can improve overall daily functioning and quality of life.

    Lastly, state-based vocational rehabilitation agencies can also help individuals with disabilities, including Asperger's syndrome/ASD, prepare for and find employment.

    Medication

    Medication, prescribed by a developmental pediatrician or child or adult psychiatrist, is sometimes used to complement the care of an individual with Asperger's syndrome/ASD.

    Depending on what symptom is being targeted, various types of medications may be prescribed.

    For instance, for anxiety, individuals with Asperger's syndrome/ASD, which may manifest as obsessive-compulsive behaviors, fear of situations, or anger outbursts, a doctor may prescribe a selective-serotonin reuptake-inhibitor (SSRI), like Prozac (fluoxetine) or Zoloft (sertraline).

    For inattention or distractibility, often stemming from sensory overarousal, Strattera (atomoxetine) or a stimulant medication like Ritalin (methylphenidate) may be recommended.

    For disruptive behaviors like tantrums, aggression, or self-injurious behaviors, an antipsychotic, such as Risperdal (risperidone), may be prescribed.

    Why Medication Is Titrated With Asperger's/ASD

    Due to the fact that individuals with this disorder tend to be more sensitive to medication effects and more likely to experience side effects, doctors tend to start treatment at a low dose and ramp up very slowly (as needed).

    A Word From Verywell

    No doubt, living with Asperger's syndrome or high-functioning autism can be extremely challenging on a daily basis. Please know, though, with the right strategies and guidance in place, a person with Asperger's syndrome/ASD can live a very full and happy life.

    Remain proactive and resilient in helping your child or teen navigate this disorder. Remember to be kind to yourself in the meantime too, and seek out support and resources from loved ones and your community.

    Was this page helpful?

    Article Sources

    1. Ousley O, Cermak T. Autism Spectrum Disorder: Defining Dimensions and Subgroups. Curr Dev Disord Rep. 2014;1(1):20-28. doi:10.1007/s40474-013-0003-1

    2. Huang AX, Hughes TL, Sutton LR, et al. Understanding the Self in Individuals with Autism Spectrum Disorders (ASD): A Review of Literature. Front Psychol. 2017;8:1422. doi:10.3389/fpsyg.2017.01422

    3. Faridi F, Khosrowabadi R. Behavioral, Cognitive and Neural Markers of Asperger Syndrome. Basic Clin Neurosci. 2017;8(5):349-359. doi:10.18869/nirp.bcn.8.5.349

    4. Boschi A, Planche P, Hemimou C, Demily C, Vaivre-douret L. From High Intellectual Potential to Asperger Syndrome: Evidence for Differences and a Fundamental Overlap-A Systematic Review. Front Psychol. 2016;7:1605. doi:10.3389/fpsyg.2016.01605

    5. Shamay-tsoory SG, Tomer R, Yaniv S, Aharon-peretz J. Empathy deficits in Asperger syndrome: a cognitive profile. Neurocase. 2002;8(3):245-52. doi:10.1093/neucas/8.3.245

    6. Sinha P, Kjelgaard MM, Gandhi TK, et al. Autism as a disorder of prediction. Proc Natl Acad Sci USA. 2014;111(42):15220-5. doi:10.1073/pnas.1416797111

    7. Cermak SA, Curtin C, Bandini LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. J Am Diet Assoc. 2010;110(2):238-46. doi:10.1016/j.jada.2009.10.032

    8. Karimi P, Kamali E, Mousavi SM, Karahmadi M. Environmental factors influencing the risk of autism. J Res Med Sci. 2017;22:27. doi:10.4103/1735-1995.200272

    9. Khouzam HR, El-gabalawi F, Pirwani N, Priest F. Asperger's disorder: a review of its diagnosis and treatment. Compr Psychiatry. 2004;45(3):184-91. doi:10.1016/j.comppsych.2004.02.004

    10. Woods AG, Mahdavi E, Ryan JP. Treating clients with Asperger's syndrome and autism. Child Adolesc Psychiatry Ment Health. 2013;7(1):32. doi:10.1186/1753-2000-7-32

    11. Nadeau J, Sulkowski ML, Ung D, et al. Treatment of comorbid anxiety and autism spectrum disorders. Neuropsychiatry (London). 2011;1(6):567-578.

    Additional Reading