Table of ContentsView AllTable of ContentsHFA vs. Asperger’s SyndromeHFA and Level 1 AutismDetermining Support NeedsNavigating a Neurotypical World
Table of ContentsView All
View All
Table of Contents
HFA vs. Asperger’s Syndrome
HFA and Level 1 Autism
Determining Support Needs
Navigating a Neurotypical World
High-functioning autism(HFA) is neither an official diagnosis nor is there an agreed-upon definition of what the term means. In the broadest sense of the term, high-functioning autism may mean any of the following:
Adding to the confusion is the fact that many autistic people are bright and accomplished yet simultaneously have a high need for support (related to anxiety andsensory sensitivity issues, for example, that significantly impact their daily functioning).
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Until 2013, many people who might be said to have high-functioning autism were diagnosed with either Asperger’s syndrome orPDD-NOS(pervasive developmental disorder not otherwise specified).
But, there are differences that set those two diagnoses apart:
As of 2013, with the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), neither PDD-NOS nor Asperger’s syndrome is an official diagnostic category in the United States. Both are now included under the diagnosis of autism spectrum disorder (ASD).People who would have been classified as “high-functioning” are now described as being “Level 1 ASD.”
HFA and Level 1 Autism
Autism spectrum disorder is a single diagnosis that encompasses many people who are very different from one another. So, to clarify these differences, the DSM-5 also includes functional levels. People who are bright and verbal are generally given the diagnosis of Level 1 ASD.
Autistic self-advocates and some experts problematize the use of functioning labels and levels because of the way those distinctions materially separate people into “good/useful” autistics versus “bad/not worth living” autistics; this claim is based in truth due to the popularity of eugenicist movements in the autistic community’s history.
Asperger’s and Eugenics
Still, the distinction in the DSM-5 doesn’t offer a clear characterization of what Level 1 ASD actually is. For example:
With any ASD diagnosis, including Level 1, the possible combinations of traits, strengths, and challenges are almost endless. This not only makes the characterization of behaviors difficult but also can leave you confused as to what kind and level of support is needed.
Autistic people labeled as being high-functioning may excel in school or be very skilled at their job, but may have difficulty completing hygiene tasks, like showering and brushing, on a daily basis. A “high-functioning” skilled professional may have severe sensory sensitivities, anxiety, and perseveration and might actually have a more difficult time in the workplace than an individual labelled as “low-functioning” who has less anxiety and fewer sensory issues.
What’s more, a “low-functioning” autistic person might spend most of their day in a supported setting where the possibility of dangerous interactions is almost zero. Meanwhile, the “high-functioning” individual may need to navigate a world full of complex and hazardous situations.
High-functioning autistic people often need many supports, but might not need another person to facilitate those supports. They may need to keep disposable, travel toothbrushes at their bedside rather than needing someone to brush their teeth for them. They might need reminders/alarms to remember to eat and primarily eat foods that are quick and easy to make, but may not need to be hand-fed. The cost and time associated with creating these secondary support systems, often alone, is a burden not oft talked about.
While it may be easy to think that autistic people labelled as being high-functioning need less support, they are actually just faced with different challenges. They may have academic success and marketable skills, but may deal with emotional dysregulation (and the associated depression and anxiety), inconsistent hygiene practices, and the symptoms of masking and autistic burnout.
The ever-changing definitions of autism can lead to a lack of clarity. Technology and cultural change are also modifying social expectations. In the past, face-to-face communication was what neurotypical society saw as the key to personal success for an autistic person; today, many autistic people can interact with others online, make friends through social media, and even hold down remote jobs. These built-in forms of support have enabled more autistic people to thrive in a neurotypical society.
Some businesses are giving autistic workers a chance,while others are not yet doing that work. Even in spaces where marginalized people are specifically recruited, they may not have the infrastructural and work-cultural support they need to survive or thrive.
Comparing High- and Low-Functioning Autism
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Neggers YH.Increasing prevalence, changes in diagnostic criteria, and nutritional risk factors for autism spectrum disorders.ISRN Nutr. 2014;2014:514026. doi: 10.1155/2014/514026American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5.Philadelphia, PA: APA; 2013.Chen JL, Leader G, Sung C, et al.Trends in employment for individuals with autism spectrum disorder: A review of the research literature.Rev J Autism Dev Disord.2015;2:115. doi:10.1007/s40489-014-0041-6
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Neggers YH.Increasing prevalence, changes in diagnostic criteria, and nutritional risk factors for autism spectrum disorders.ISRN Nutr. 2014;2014:514026. doi: 10.1155/2014/514026American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5.Philadelphia, PA: APA; 2013.Chen JL, Leader G, Sung C, et al.Trends in employment for individuals with autism spectrum disorder: A review of the research literature.Rev J Autism Dev Disord.2015;2:115. doi:10.1007/s40489-014-0041-6
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Neggers YH.Increasing prevalence, changes in diagnostic criteria, and nutritional risk factors for autism spectrum disorders.ISRN Nutr. 2014;2014:514026. doi: 10.1155/2014/514026American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5.Philadelphia, PA: APA; 2013.Chen JL, Leader G, Sung C, et al.Trends in employment for individuals with autism spectrum disorder: A review of the research literature.Rev J Autism Dev Disord.2015;2:115. doi:10.1007/s40489-014-0041-6
Neggers YH.Increasing prevalence, changes in diagnostic criteria, and nutritional risk factors for autism spectrum disorders.ISRN Nutr. 2014;2014:514026. doi: 10.1155/2014/514026
American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5.Philadelphia, PA: APA; 2013.
Chen JL, Leader G, Sung C, et al.Trends in employment for individuals with autism spectrum disorder: A review of the research literature.Rev J Autism Dev Disord.2015;2:115. doi:10.1007/s40489-014-0041-6
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