Mental Health Neurodevelopmental Disorders Autism High-Functioning Autism The Challenges of Living With High-Functioning Autism By Lisa Jo Rudy Lisa Jo Rudy Facebook LinkedIn Twitter Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism. Learn about our editorial process Updated on March 06, 2023 Medically reviewed by Nicholas R. Metrus, MD Medically reviewed by Nicholas R. Metrus, MD LinkedIn Nicholas R. Metrus, MD, is board-certified in neurology and neuro-oncology. He currently works at the Glasser Brain Tumor Center with Atlantic Health System in Summit, New Jersey. Learn about our Medical Expert Board Print Verywell Table of Contents View All Table of Contents What Is High-Functioning Autism? Sensory Issues Social Awkwardness Anxiety and Depression Executive Planning Problems Emotional Dysregulation Difficulty With Verbal Communication Frequently Asked Questions Autism is a spectrum disorder. This means people with autism have a wide range of needs and abilities. While those with high-functioning autism may not need as much support as others with autism, they may still struggle with day-to-day activities. Symptoms of high-functioning autism (HFA) in adults and children that can be challenging to deal with include: Experiencing sensory overloadNot understanding social cuesAnxiety or mood disordersPoor organizationDifficulty controlling emotionsProblems with verbal communication 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 supportLevel 2 requires substantial supportLevel 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. Children with high-functioning autism grow into adults with high-functioning autism. While many adults with ASD-1 are able to be successful and independent adults, most will require some form of ongoing support. 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. Some people with autism can learn to better tolerate sensory challenges with strategies and sensory occupational therapy. However, sensory issues are not something a person outgrows. An autistic child with sensory processing disorder will grow to be an adult with sensory processing disorder. Sensory Processing Disorder Symptoms 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 greetingsKnowing when to let someone else talkRegulating 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. Social Skills Therapy for Autism 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. How Executive Functioning Skills Are Affected by Autism 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. Learning to Handle Emotions With Autism 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. Speech and Communication in Autism Summary 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 disordersCommunication challengesDifficulties with emotional regulationExecutive functioning problemsSensory processing issuesSocial 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. Diagnosing High-Functioning Autism 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. Learn More: 6 Health Problems Common with Autism 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 with 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. Learn More: Healthcare Providers Who Diagnose Autism What are the symptoms for high-functioning autism as an adult? 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. Learn More: What Is Mild Autism? How does an adult get tested for autism? Getting an autism diagnosis as an adult can be a lengthy process. The first step is to find a psychologist or psychiatrist with a background in autistic adults. Sometimes, a mental health professional can diagnose autism in adults by asking questions and observing the response for common autistic traits.A more formal autism evaluation also includes forms that the patient fills out. In some cases, additional forms may be filled out by your partner, relative, close friend, or employer (with your consent). Learn More: Diagnosing Autism in Adults Do adults with autism have meltdowns? Sometimes, yes, adults with autism can become overwhelmed and have an autistic meltdown. It is often highly embarrassing to lose control of your emotions in front of others. As such, many adults with autism recognize when they are reaching their limit and remove themselves from situations that are becoming too much.Unlike children with autism, adults can often excuse themselves from the situation and go somewhere private. Sometimes going to a quiet place is all the person needs to collect themselves. Other times, they may still meltdown, but not in front of others. Learn More: Top 10 Facts About Adult Autism 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. Barahona-Corrêa JB, Filipe CN. A Concise History of Asperger Syndrome: The Short Reign of a Troublesome Diagnosis. Front Psychol. 2016 Jan 25;6:2024. doi: 10.3389/fpsyg.2015.02024. National Institute of Mental Health. Autism Spectrum Disorder. Lake JK, Perry A, Lunsky Y. Mental health services for individuals with high functioning autism spectrum disorder. Autism Res Treat. 2014;2014:502420. doi:10.1155/2014/502420 Asperger/Autism Network (AANE). Asperger profiles: Emotions and empathy. 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 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC; 2013. Additional Reading Williams DL, Mazefsky CA, Walker JD, Minshew NJ, Goldstein G. Associations between conceptual reasoning, problem solving, and adaptive ability in high-functioning autism. J Autism Dev Disord. 2014;44(11):2908–2920. doi:10.1007/s10803-014-2190-y By Lisa Jo Rudy Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit