Autism Spectrum Disorder is a developmental disability that has substantially increased in prevalence in the U.S. from an average of 1 in 150 children in 2000, to 1 in 54 as of 2016, according to the Autism monitoring network of the Centers for Disease Control and Prevention (CDC). With this rise in prevalence rates, Autism Spectrum has received greater attention through increased insight, understanding, and research. Diagnostically speaking, the psychiatric community has replaced the diagnosis of Asperger’s Disorder with Autism Spectrum Disorder, now conceptualized as a spectrum of functioning, including High Functioning Autism (HFA).
High Functioning Autism has unique, distinguishing factors that differ from a more traditional profile of Autism. Individuals with HFA can be highly intelligent and often excel in some specific intellectual, computational, or other specified talent or area of interest. HFA traits can also be subtle and often, deficits can be disguised or offset by areas of strength. For example, it is not uncommon for the diagnosis to be missed during childhood because their higher intelligence may have masked less obvious or more subtle areas of difficulty. Specifically, there is often social, behavioral, and/or adaptive differences that appear somewhat atypical when compared to their level of intelligence and with peer functioning. It is a misnomer that individuals with HFA are lower functioning, non-verbal, or have some significant behavioral issues. Although traditional Autism is consistent with significant social impairments, individuals with HFA profile may struggle with knowing what to say in social situations, how to interpret facial expressions and other non-verbal gestures, or how to use pragmatic (social) language. Additionally, educational, neuropsychological, and behavioral/adaptive testing often assesses for more significant limitations and deficits that impact the person’s functioning, and do not often sufficiently evaluate the more understated characteristics that seem different yet not debilitating. Therefore, a diagnosis of HFA is prone to being overlooked, misrepresented, or misunderstood because Autism measures and traits typically capture more debilitating traits.
In looking at more specific traits within the spectrum, HFA can entail differences in how the individual perceives oneself and others, and how the individual relates to the world socially and interpersonally. This can result in experiencing difficulties with relating to, communicating with, understanding and accurately perceiving another’s point of view. Likewise, individuals with HFA tend to have some level of cognitive and behavioral inflexibility, and prefer schedules, routines, and greater predictability. For instance, an individual with HFA may use routines and familiar things in daily life such as eating the same foods nearly daily as a way to create predictability and self-soothe when feeling overstimulated. Nonetheless, individuals with HFA can still achieve many goals including academic and occupational pursuits and high levels of success, lead an independent lifestyle, and find the proper fit for their needs in both professional and personal domains in life. According to a quick online search, there are a number of successful individuals diagnosed with HFA/Asperger’s: Anthony Hopkins, Courtney Love, Dan Aykroyd, Daryl Hannah, Satoshi Tajiri (Pokémon inventor), Susan Boyle (singer), Tony DeBlois (musician), Dr. Vernon Smith (Nobel prize winning professor), and Dr. Temple Grandin (professor/spokesperson). While these individuals may not exhibit the traditional expected behaviors of Autism Spectrum they share similar experiences. In summary, there are many important distinctions to understand about the varying degrees of Autism Spectrum, particularly when referring to high functioning individuals within this spectrum. Overall, individuals with HFA typically present with more subtle or overlooked differences and difficulties across a few domains of functioning, while still having great capacity to lead independent and successful lives.