What is high-functioning autism?

High-functioning autism is not an official medical diagnosis. It’s often used to refer to people with autism spectrum disorder who read, write, speak, and manage life skills without much assistance.

Autism is a neurodevelopmental disorder that’s characterized by difficulties with social interaction and communication. Its symptoms range from mild to severe. This is why autism is now referred to as autism spectrum disorder (ASD). High-functioning autism is often used to refer to those on the milder end of the spectrum.

Read on to learn more about high-functioning autism and the official levels of autism.

Until the current revisions to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a condition known as Asperger’s syndrome used to be recognized as a distinct condition. People diagnosed with Asperger’s syndrome had several symptoms similar to autism without delays in the use of language, cognitive development, development of age-appropriate self-help skills, adaptive behavior, and curiosity about the environment. Their symptoms were also often milder and less likely to affect their daily life.

Some people consider the two conditions to be the same thing, though high-functioning autism is not a formally recognized condition. When autism became ASD, other neurodevelopmental disorders, including Asperger’s syndrome, were eliminated from the DSM-5. Instead, autism is now categorized by severity and may be accompanied by other impairments.

The American Psychiatric Association (APA) maintains a catalog of identified disorders and conditions. The Diagnostic and Statistical Manual of Mental Disorders has been used for decades to help doctors compare symptoms and make diagnoses. The newest version, the DSM-5, was released in 2013. This version combined all autism-related conditions under one umbrella term — ASD.

Today, ASD is divided into three levels that reflect severity:

  • Level 1. This is the mildest level of ASD. People at this level generally have mild symptoms that don’t interfere too much with work, school, or relationships. This is what most people are referring to when they use the terms high-functioning autism or Asperger’s syndrome.
  • Level 2. People at this level require more support, such as speech therapy or social skills training.
  • Level 3. This is the most severe level of ASD. People at this level require the most support, including full-time aides or intensive therapy in some cases.

There’s no single test for determining ASD levels. Instead, a doctor or psychologist will spend a lot of time talking to someone and observing their behaviors to get a better idea of their:

  • verbal and emotional development
  • social and emotional capabilities
  • nonverbal communication abilities

They’ll also try to gauge how well someone is able to create or maintain meaningful relationships with others.

ASD can be diagnosed as early as 18 months. However, many children, and even some adults, may not be diagnosed until much later. Being diagnosed at a later age can make treatment more difficult. If you or your child’s pediatrician think they may have ASD, consider making an appointment with an ASD specialist. The nonprofit organization Autism Speaks has a tool that can help you find resources in your state.

There aren’t any standardized treatment recommendations for different levels of ASD. Treatment depends on each person’s unique symptoms. People with different levels of ASD may all need the same kinds of treatment, but those with level 2 or level 3 ASD will likely need more intensive, long-term treatment than those with level 1 ASD.

Potential ASD treatments include:

  • Speech therapy. ASD can cause a variety of speech issues. Some people with ASD might not be able to speak at all, while others might have trouble engaging in conversations with others. Speech therapy can help to address a range of speech problems.
  • Physical therapy. Some people with ASD have trouble with motor skills. This can make things like jumping, walking, or running difficult. Individuals with ASD may experience difficulties with some motor skills. Physical therapy can help to strengthen muscles and improve motor skills.
  • Occupational therapy. Occupational therapy can help you learn how to use your hands, legs, or other body parts more efficiently. This can make daily tasks and working easier.
  • Sensory training. People with ASD are often sensitive to sounds, lights, and touch. Sensory training helps people become more comfortable with sensory input.
  • Applied behavioral analysis. This is a technique that encourages positive behaviors. There are several types of applied behavioral analysis, but most use a reward system.
  • Medication. While there aren’t any medications designed to treat ASD, certain types can help to manage specific symptoms, such as depression or high energy.

Learn more about the different types of treatment available for ASD.

High-functioning autism isn’t a medical term, and it doesn’t have a clear definition. But people using this term are likely referring to something similar to level 1 ASD. It may also be comparable to Asperger’s syndrome, a condition no longer recognized by the APA.