What is High-Functioning Autism?
The term ‘High-functioning autism’ is often used to describe autistic people without a learning disability who possess average to above-average intelligence and experience no delays in speech or language development. It generally refers to autistic traits enabling them to function more easily in society. People on the autism spectrum who experience high-functioning autism have fewer difficulties in cognitive and language skills compared to people who experience other types of autism.
Regarding social and communication challenges, despite people’s intellectual capabilities, they often experience challenges in social interactions (nonverbal communication, understanding social cues, and maintaining eye contact). Sometimes, language interpretation can be challenging as they may interpret it literally. Autistic people without a learning disability also experience sensory sensitivities (hypersensitivity or hypersensitivity) to stimuli such as touch, taste, light and sound.
An autistic person with high-functioning autism often displays a strong attachment to routines and engages in repetitive behaviours. Additionally, they may develop intense interests or fixations on specific topics or ideas. At Leaf Complex Care, we provide proactive and compassionate support for autistic people, tailoring our approach to each person’s unique needs and preferences.
Signs and Symptoms of High-Functioning Autism
High-functioning autism includes a range of signs that affect social interaction, communication, behaviour, and sensory processing. Autism spectrum disorder diagnosis depends on recognising the signs and is essential for early intervention, which can improve outcomes for autistic people.
Below is a list of the most common high-functioning autism symptoms:
- Intellectual abilities (intense focus on specific activities or subjects of interest)
- Excellent pattern recognition
- Repetitive behaviours
- High levels of emotional sensitivity and anxiety
- Extreme shyness, withdrawal, and behaviours that are perceived as socially inappropriate
- Coping mechanisms and autism masking
- Co-occurring conditions (ADHD, OCD, anxiety disorders, depression, developmental disorders, etc.)
- Exceptionally rich vocabulary
- Strict routines
- Sensory sensitivities
High-Functioning Autism in Adults
Adults experience high-functioning autism a little differently. Besides having common social interaction difficulties, communication challenges, sensory sensitivities and co-occurring conditions, they face additional employment challenges. Adults with high-functioning autism often encounter notable difficulties in the workplace, such as challenges with job interviews, navigating social norms in the office, and coping with routine changes. To support them succeed professionally, access to support services and vocational training programmes is crucial.
Therapies such as Cognitive Behavioural Therapy (CBT), speech therapy and on-the-job support are integral and improve social skills, manage anxiety and address employment-related challenges. For adults with high-functioning autism to live fulfilling lives, they must have access to the right resources and services. Independent living skills training, social skills development, and mental health support all play a vital role in ensuring their well-being.
Why is High-Functioning Autism Often Diagnosed Later in Life?
Parents and teachers can usually provide an early autism diagnosis in toddlers or school-age children due to signs. However, HFA causes milder symptoms that generally don’t impact the person’s intellectual abilities, thus remaining unnoticed in older children, adolescents, and adults. High-functioning autism late diagnosis is often due to above-average intelligence levels and efforts to fit in by masking symptoms.
High-functioning children on the spectrum can effectively perform basic tasks, use language, and pass IQ tests – which keeps parents and teachers from suspecting a difference. Some HFA children can use their unique strengths to go through elementary school with minor issues. However, they start facing difficulties later in their education when social interaction with their peers gets more complex and schoolwork becomes more demanding. Research shows that autistic women and girls are less likely to receive a timely ASD diagnosis. Experts suggest that high-functioning girls tend to be less aggressive and more dedicated to hiding their symptoms, which is why they don’t fit the stereotypical image of the autism spectrum.
Overlooking Symptoms Due to Other Diagnoses
Many HFA people can be characterised with other related differences instead of getting an early diagnosis of autism. For instance, they may be diagnosed with social anxiety, attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and other mental health challenges or neurological differences. Signs of autism in children with co-occurring conditions may be overlooked, so they often receive a proper diagnosis in their teenage years or even adulthood.
Factors Contributing to Late Autism Diagnosis
Various factors contribute to the late diagnosis of high-functioning autism, including social, psychological and systemic barriers. Besides autistic masking, which we will discuss more of in the paragraph below, gender differences in presentation are one of the factors that impact. How? Autism can manifest differently in women, who may have a greater interest in people or animals and are often more likely to mask their autistic traits compared to men. As a result, these differences in how autism appears can lead to missed diagnoses since traditional diagnostic methods tend to focus on male patterns of autism.
Other factors leading to late autism diagnoses:
Barriers to accessing diagnoses – Adults seeking an autism diagnosis often encounter several obstacles, such as difficulty finding a specialist with the necessary expertise, the significant expense of the diagnostic process, and the requirement for someone to offer details of their developmental history.
Financial and systemic challenges – Obtaining a diagnosis can be costly because many healthcare professionals do not accept insurance for diagnostic assessments. Moreover, the healthcare system tends to prioritise diagnosing children, which can make it challenging for adults to access suitable diagnostic services.
Prolonged Masking – Sustained masking can result in mental health challenges like anxiety, depression, and burnout, which may also hinder the diagnostic process. The continuous effort to uphold a mask often leads to exhaustion and a sense of lost identity, making it harder for people to reach out for support.
Masking Behaviours
Autism masking is the process of altering behaviour to conform to neurotypical standards. People may participate in various masking behaviours, including maintaining eye contact, imitating facial expressions, and disguising personal interests. Such behaviours are frequently adopted to blend in social situations and avoid calling notice to their autistic traits.
The consequences of masking behaviours can seriously impact autistic people’s mental and physical health, presenting itself as profound exhaustion, depression, heightened anxiety and identity loss. The emotional and cognitive efforts required to keep up with the masking behaviour are overwhelming and take a toll on people’s overall well-being one step at a time.
Overlapping Symptoms with Other Conditions
In the UK, according to the information the Government’s site published based on The national strategy for autistic children, young people and adults: 2021 to 2026, around 700,000 people, roughly 1% of the population, are diagnosed with autism, underscoring the need for precise diagnosis. High-functioning autism, a variant of the autism spectrum, poses distinct challenges in diagnosis because its characteristics can closely resemble those of other conditions.
Autism often co-occurs with other conditions and has overlapping signs with the following:
Obsessive-Compulsive Disorder (OCD) – Overlapping signs: repetitive behaviours, sensory experiences, neurological similarities.
Attention Deficit Hyperactivity Disorder (ADHD) – Overlapping signs: genetic overlap, executive functioning, sensory processing, attention, social and behavioural challenges (hyperactivity and a preference for a routine).
Social Anxiety Disorder – Overlapping signs: social communication difficulties, nervousness in social situations, difficulty adapting to changes, and fear responses.
Lack of Awareness
The overlap in signs with other conditions can lead to frequent misdiagnosis and result in a lack of awareness among health professionals and the general public, complicating the assessment process and affecting treatment outcomes. The lack of understanding and awareness is reflected in the high rates of misdiagnosis, complex assessment process, the need for routine autism screening, distinct treatment needs and many challenges related to diagnosis and treatment.
Is Asperger's Syndrome High-Functioning Autism?
High-functioning Autism and Asperger’s syndrome (AS) are similarly defined as milder forms within the autism spectrum. However, the most notable difference between these two is their effect on the person’s language skills. Children with Asperger’s syndrome usually acquire language without significant disruptions, whereas HFA can cause language delays in early childhood.
For this reason, autistic children without a learning disability might have been discovered earlier than those with AS. In some cases, children initially may have had an Asperger’s diagnosis. After a better assessment of their social, communication, and cognitive skills in their school-age year, ASS is no longer a formal diagnosis. It is now seen as part of Autism Spectrum Disorder. However, some people may prefer to keep the term.
Emotional and Psychological Impact of a Late Diagnosis
As per the National Autistic Society, around 70% of people on the spectrum cannot access the support they need on their journey until much later in life. Autistic children without a learning disability often have lower support needs, making their traits less noticeable to parents and teachers. Furthermore, some individuals may not have undergone a formal assessment, often due to negative attitudes towards autism, leading to reluctance in seeking a diagnosis. This contributes to the consequences of late diagnosis of autism.
Receiving a proper diagnosis is vital for the improvement of autistic people’s quality of life at any age, especially in their adolescence and adulthood. Obtaining an autism diagnosis can scientifically explain a person’s differences and give them a sense of self-identification. This prevents people on the spectrum from interpreting their characteristics as a personal failure and developing low self-esteem. New studies show that neurodivergent people diagnosed in adulthood rather than childhood often struggle with more intense symptoms, develop related mental health issues, and generally have a lower quality of life.
Before receiving an Autism diagnosis, people on the spectrum struggle with sensory challenges and social difficulties affecting various areas of their lives. It enables people on the spectrum to finally understand themselves with all their unique traits and start living up to their full potential. It also allows people to address social and professional issues, improve their self-esteem, and advance their overall well-being.
Late Diagnosis of High-Functioning Autism and Anxiety
Autistic people without a learning disability on the spectrum are prone to developing anxiety, especially when they go years without a proper diagnosis. They may experience significant levels of stress in complex social relationships and situations and the presence of sensory triggers. Furthermore, their dedication to restricted routines causes distress in cases of unexpected change.
Undiagnosed autistic children and adults are prone to anxiety because they struggle to identify, understand, and manage their emotions. Society puts them in a constant state of being misunderstood and masking their symptoms to fit in and be accepted by neurotypical people. These circumstances often lead to increased anxiety and have a negative effect on the person’s general mental health.
Impact on Family and Friends
High-functioning forms of autism can affect a person’s relationship with their friends and family. Although it doesn’t usually impact the person’s language skills and intelligence, it causes difficulty reading social cues, inability to understand other people’s emotions, and subsequent social withdrawal in general. Neurotypical peers and family members may misinterpret these behaviours.
Multidisciplinary In-House Support with Leaf Complex Care
At Leaf Complex Care, we take a person-centred approach to supporting autistic children and adults in their own homes. For our dedicated specialists, delivering proactive care to the people we serve is the utmost priority.
How do we do it?
Each specialist contributes their expertise to create a personalised care plan that addresses the unique needs and strengths of the autistic people we support. The team works together to ensure that interventions are consistent and coordinated across different areas of the person’s life. The multidisciplinary approach allows for a wide range of support, covering everything from behavioural and emotional issues to academic and social challenges. Specialists often work with the family, the person, and other stakeholders, providing integrated planning for better outcomes and improved quality of life in their homes and communities.
The team regularly reviews the effectiveness of the interventions and makes necessary adjustments to the care plan.
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Contact us today, and we will create a tailored care plan meeting your unique needs. Find us at the following locations: Bristol, South East, Birmingham and Somerset. We deliver our services across the UK.
