The Challenges of Living With High-Functioning Autism

Autism

Verywell

Autism is a spectrum disorder, meaning it includes people with a wide range of symptoms and functional abilities. Hence, it might be easy to assume that being on the "high-functioning" end of the spectrum doesn't present many challenges.

While those with with high-functioning autism (HFA) are unlikely to require the same degree of support and accommodations as people diagnosed with moderate or severe autism, symptoms of HFA—which can include sensory issues, social awkwardness, and difficulties with organization and planning—can have a major impact on daily life.

High-functioning autism is an unofficial term used for people who would likely have been diagnosed with Asperger's syndrome in the past. Asperger's was removed from the Diagnostic and Statistical Manual of Mental Disorders in 2013, upon the publication of the fifth edition (DSM-5). Since then, the severity of autism spectrum disorder is indicated by a level from 1 to 3, with HFA represented by level 1.

The following are hallmark symptoms of high-functioning autism.

Sensory Issues

The majority of people with a diagnosis of autism spectrum disorder are predisposed to sensory overload. Noise, crowds, bright lights, strong tastes, smells, and being touched can feel unbearable to someone with HFA, making it difficult to tolerate crowded restaurants, movies, shopping malls, or even a simple hug.

Social "Cluelessness"

People with high-functioning autism typically have a hard time deciphering social cues and body language when interacting with other people. They may not understand how to greet someone appropriately, how to know when to let someone else talk, or how to regulate the tone and volume of their voice. For some people, social awkwardness can be a significant obstacle to making friends, finding employment, and seeking a romantic partner.

Anxiety and Depression

Anxiety, depression, and other mood disorders are more common among people with high-functioning autism than they are among the general population. There is no consensus on whether being on the autism spectrum is responsible for the mood disorders, or whether the disorders are the result of social rejection and frustration—but whatever their causes, mood disorders can be disabling in themselves.

Lack of Executive Planning Skills

Executive functioning describes the skills people use to organize and plan their lives, such as making schedules in advance, or creating and following a timeline in order to complete a long-term project.

Most people with high-functioning autism have compromised executive functioning skills, which can make it tough to plan and manage a household or cope with minor schedule changes at school or at work.

Emotional Dysregulation

Contrary to the stereotype, people with autism do experience emotions, and may overreact to situations that are only mildly frustrating for neurotypical people. For an autistic person, it can be hard to keep emotions in check when something unpredictable occurs, or when they have to transition from one setting or activity to the next (e.g., from school to home).

Someone with HFA, for example, may burst into tears if there's an unexpected change in plans, or become unusually agitated and frustrated if their routine is thrown off. For example, if they eat the same meal for lunch every day, at the same time, off the same dishes, they might get very upset if, say, one of the ingredients of the meal isn't available.

Difficulty With Verbal Communication

A child with HFA will typically have no problems understanding the meaning of individual words, developing a vocabulary, and comprehending grammar. Instead, they struggle with what's known as "pragmatic" language—the use of language to communicate. Someone with HFA often can't comprehend language that isn't meant to be taken literally, e.g., sarcasm, metaphors, or idioms.

A Word From Verywell

The symptoms of high-functioning autism are challenging, both for the person with autism and those in their lives—including parents, teachers, and employers. However, there are numerous types of therapies, such as speech-language therapy and social skills training, that can help people manage their symptoms and function more easily and effectively in daily life.

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Article Sources
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  1. Autism Speaks. DSM-5 and autism: Frequently asked questions.

  2. Autism Speaks. What are the symptoms of autism?

  3. Lake JK, Perry A, Lunsky Y. Mental health services for individuals with high functioning autism spectrum disorderAutism Res Treat. 2014;2014:502420. doi:10.1155/2014/502420

  4. Asperger/Autism Network (AANE). Asperger profiles: Emotions and empathy.

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