What is high functioning autism spectrum disorder?


Highly functional autism (HFA) is a term often used to classify autism spectrum disorder (ASD), which is characterized primarily by difficulty interpreting and responding to social cues and emotions. People with high-functioning autism can also resist changes in daily routines and be hypersensitive to noise, smell, touch, and other types of sensory information.

HFA treatment is individualized based on personal symptoms and may include sensory changes inside and outside the home, counseling, family support, and sometimes medication.

Until 2013, when the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published, people with the high-functioning end of the autism spectrum were often diagnosed with Asperger syndrome . Now, those who were previously thought to have Asperger's syndrome are now being diagnosed with an autism spectrum disorder or level 1 autism.

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Symptoms of high-functioning autism spectrum disorder

Although people with HFA are likely to have normal cognitive skills and language development, they generally struggle with communication and social interaction in characteristic ways:

  • Not reading (or demonstrating) accurately gestures, body language, and tone of voice, drawing conclusions about what the other person is thinking, or demonstrating appropriate emotional responses
  • Lack of empathy for what other people think or feel.
  • Difficulty interpreting complex social cues such as humor, irony, romantic interest, and anger.
  • Standing too close to someone while talking to them.
  • Continually talking about a specific topic without noticing the listener's lack of interest.
  • It is impossible to know when to speak and when to listen
  • Dress badly
  • Eye contact problems
  • Speak in an even high tone or speak too loud
  • Inflexibility is a must know exactly what will happen next and do the same things in the same order every day, eat the same foods, and take the same routes
  • Extreme focus on a specific topic of interest.
  • Self-stimulating (stimulating) behaviors such as clapping, walking, rocking, or buzzing.
  • Hypersensitivity to noise, light, smells, tastes or physical contact.


The cause of autism spectrum disorder is not fully understood, although experts suspect that ASD is likely the result of a combination of genes and exposure to one or more environmental factors, such as:

  • Advanced age of the mother and father
  • Fetal environment (for example, maternal infection or health problems such as obesity, diabetes, or high blood pressure)
  • Perinatal and obstetric activities
  • Medicines taken during pregnancy.
  • Smoking and drinking alcohol
  • Lack of nutrients
  • Toxic effects like air pollution or pesticides.


Unlike the more severe levels of ASD , high-functioning autism is generally diagnosed in older children and adolescents. These children tend to reach early developmental milestones with symptoms when they are expected to be able to handle difficult social relationships, conversations, or sensory problems, but show signs that they cannot.

If this sounds similar to your child (or if you are aware of these symptoms), your healthcare provider may recommend a therapist, neurologist, or autism center to perform the test.

To diagnose autism, the doctor usually looks at the medical history and asks for details of the symptoms. They will likely observe your child's behavior and take a series of tests and assessments that focus on intelligence, behavior, social and communication skills, and personal development history, including:

The results of these tests can not only confirm autism, but also rule out other disorders that have the same or similar symptoms (for example, social anxiety disorder, obsessive-compulsive disorder, or social communication disorder).

Many people feel socially embarrassed for not having received an autism spectrum diagnosis. The difference between "discomfort" and "autism" is the degree to which these delays, frustrations, and difficulties prevent a person from leading a normal life.

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How a person with high functioning autism is treated will largely depend on their age, as children and adolescents will need different support than adults and individual needs. A team of professionals, including a psychologist, occupational therapist, and social worker, can also be involved in developing a treatment plan.

Children and adolescents

Behavioral and educational interventions are at the center of the treatment of children with high functioning autism. Children with HFA generally do best when their days are structured and predictable. The key is a well-structured home environment with posted calendars and schedules, to-do lists, and well-defined rules and expectations.

This structure is important in the classroom, along with other adaptations such as:

  • Carpeted floors to reduce noise for children sensitive to loud sounds
  • Classes are divided into small study groups.
  • Motor activities (yoga, hula hopping) throughout the day to satisfy sensory needs and calm down.

Children with high functioning autism also benefit greatly from social skills training , mental health counseling, family support, a learning plan tailored to their needs and abilities, and lifestyle habits such as healthy eating and a adequate quality sleep.


Structure and predictability are also important for highly functional autistic adults who will also benefit from interventions such as:

  • Job aids, such as scheduled breaks, written (rather than verbal) instructions, earplugs, or headphones, to reduce sensory overload and facilitate concentration and thinking.
  • Cognitive behavioral therapy (CBT) to develop romantic and coping relationships between peers and support frustrations at work and in life.
  • Occupational therapy aimed at optimizing problem-solving ability, increasing self-esteem and confidence, and managing domestic and economic tasks.

Government vocational rehabilitation agencies can help people with disabilities, including autism, prepare for employment and find work .


There are no medications for the direct treatment of high-functioning autism, but a pediatrician or psychiatrist can prescribe one to treat certain symptoms that often coexist with ASD. Medications that sometimes play a role in treating autism include:

  • A selective serotonin reuptake inhibitor (SSRI), such as Prozac (fluoxetine) or Zoloft (Sertraline), to treat anxiety, obsessive compulsive behavior, fear of certain situations, or outbursts of anger.
  • Strattera (atomoxetine) or a stimulant drug such as Ritalin (methylphenidate) to treat inattention or distraction from sensory arousal.
  • An antipsychotic drug, such as Risperdal (risperidone), to suppress destructive behaviors such as tantrums, aggression, or self-harm.

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'High functioning autism' is more of a descriptive word than a specific diagnosis, but it closely resembles level 1 autism spectrum disorder as defined in DSM-5. Both describe the level of autism that normally allows for a full and productive life with the support of family, teachers, and support professionals in schools and workplace placement.

It is important to establish a definitive diagnosis of ASD at any level as soon as it is suspected. Early intervention is key to developing a treatment plan and utilizing services and opportunities for individuals with autism.

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