The Challenges of Living With High-Functioning Autism


Autism is a spectrum disorder. This means people with autism have a wide range of symptoms and abilities. High-functioning autism (HFA) is often considered mild, but that's not necessarily true.

People with HFA can struggle significantly. They may not need the same level of support as people with more severe autism. However, it can still have a major impact on their daily lives.

This article discusses the common challenges of living with high-functioning autism.

What Is High-Functioning Autism?

High-functioning autism is an unofficial term used for people whose autism symptoms appear mild. The official diagnostic term is Autism Spectrum Disorder (ASD) level 1.

In the past, people who fit the description of HFA would likely have been diagnosed with Asperger's syndrome. Asperger's was removed from the Diagnostic and Statistical Manual of Mental Disorders in 2013 when the fifth edition (DSM-5) was published.

Since then, the severity of autism spectrum disorder is described by a level from 1 to 3, based on how much support a person needs:

  • Level 1 requires some support
  • Level 2 requires substantial support
  • Level 3 requires very substantial support

In the autism community, functioning labels are discouraged because they can be misleading. A person can be able to function independently in some areas but require significant support in others. People labeled as high functioning can often have significant needs that are overlooked.

Educators and professionals should be made aware of the invisible challenges of HFA. These include sensory issues, emotional regulation, social skills, executive functioning, verbal communication, and mood disorders.

Sensory Issues

Many people with autism experience sensory processing disorder. This is more commonly known as sensory overload

Noise, crowds, bright lights, strong tastes, smells, and being touched can feel unbearable to someone with HFA.

This makes going to restaurants, movies, and shopping malls difficult. Even a simple hug or putting on socks can be challenging for someone with sensory processing problems.

Social Awkwardness

People with HFA can have a hard time recognizing social cues and body language.

Common problems people with HFA can have when interacting with other people include:

  • Understanding appropriate greetings
  • Knowing when to let someone else talk
  • Regulating the tone and volume of their voice

Social awkwardness can be a significant obstacle to making friends, finding work, and dating for some people with HFA.

Anxiety and Depression

Anxiety, depression, and other mood disorders often go hand in hand with HFA. People with HFA are more likely to be diagnosed with a mood disorder than the general population. 

Exactly why, however, is unclear. It could be that autism causes mood disorders. But it could also be due to the social rejection that often comes with being autistic. Whatever their causes, mood disorders can be disabling in themselves.

Executive Planning Problems

Executive functioning is a term for the skills people use to organize and plan their lives. This includes things like making and sticking to schedules or following a timeline to complete a long-term project.

Most people with HFA have difficulties with executive functioning. This can make it hard to manage a household or cope with minor schedule changes at school or work.

Emotional Dysregulation

People with autism can experience extreme emotions. They may seem to overreact to certain situations or under-react in others.

When something unpredictable occurs, it can be hard for an autistic person to keep their emotions in check. The transition from one setting or activity to the next can be particularly challenging.

Someone with HFA, for example, may burst into tears if there's an unexpected change in plans or become agitated if their routine is thrown off.

Difficulty With Verbal Communication

A child with HFA will typically have no problems understanding language. Learning individual words, grammar rules, and vocabulary may not be an issue for them.

The use of language to communicate, however, can be problematic. Someone with HFA may have difficulty understanding sarcasm, metaphors, or idioms. This is known as "pragmatic" language.

In addition, some people with HFA may struggle to speak when under stress or overwhelmed.


People with ASD level 1 are often referred to as having high-functioning autism. This label can be misleading because people with level 1 ASD can experience significant challenges and require support.

Common struggles among people with HFA include:

  • Anxiety, depression, and other mood disorders
  • Communication challenges
  • Difficulties with emotional regulation
  • Executive functioning problems
  • Sensory processing issues
  • Social awkwardness

A Word From Verywell

High-functioning autism can be challenging for people with autism and those in their lives.

Therapies such as speech-language therapy and social skills training can help people with HFA function more easily and effectively in daily life.

Frequently Asked Questions

  • Why do people with autism often have problems with their gut?

    Some theories suggest that picky eating and sensitivities lead to gastrointestinal problems. However, researchers have also shown that the issues are related to problems within the GI tract itself.

  • Is Asperger’s the same as High-Functioning Autism?

    Asperger's is no longer used as a diagnosis or a way to categorize autism. However, like those who have high-functioning autism, those with Asperger’s usually had an average or higher-than-average IQ and age-appropriate language skills. Those who are high functioning are now usually diagnosed with Level 1 ASD.

  • How do you know if you have high-functioning autism?

    There is a range of symptoms. These may be very mild for some people with high-functioning autism. The most common signs include problems with back-and-forth conversation, trouble with social relationships, repetitive actions, self-stimulating behaviors, limited interests, and being very sensitive.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  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.

  5. Lee M, Krishnamurthy J, Susi A, et al. Association of autism spectrum disorders and inflammatory bowel disease. J Autism Dev Disord. 2018;48(5):1523-1529. doi:10.1007/s10803-017-3409-5

  6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC; 2013.

Additional Reading

By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.