What Is High-Functioning Autism?

Medically Reviewed by Jabeen Begum, MD on July 04, 2023
6 min read

“High-functioning autism” isn’t an official medical term or diagnosis. It’s an informal one some people use when they talk about people with autism spectrum disorder, or ASD, who can speak, read, write, and handle basic life skills like eating and getting dressed. They can live independently.

Autism is a developmental brain disorder that includes many symptoms with a broad range of severity. People with the disorder fall somewhere along the "autism spectrum." Some are severely disabled, but others may only exhibit mild symptoms. IQ levels can also vary significantly.

For a long time, however, only people with very severe symptoms were diagnosed with autism. Starting in the 1990s, milder forms were recognized, including Asperger's syndrome (now called high-functioning autism).

Then in 2013, the American Psychiatric Association grouped all autism-related disorders together as ASD.

Still, you may hear some people who aren’t doctors continue to use terms like Asperger’s. It may be that they’re not familiar with the spectrum, or they may be referring to a diagnosis made before the conditions were renamed autism spectrum disorder.

Like all people on the autism spectrum, people who are high functioning have a hard time with social interaction and communication. They don’t naturally read social cues and might find it difficult to make friends. They can get so stressed by a social situation that they shut down. They don’t make much eye contact or small talk.

People on the spectrum who are high-functioning can also be very devoted to routine and order. They might have repetitive and restrictive habits that seem odd to others.

There’s a wide range of how they do with school and work. Some do very well in school, while others get overwhelmed and can’t concentrate.

Some can hold a job, and others find that really hard to do. It all depends on the person and the situation. But even for someone on the spectrum who can do a lot, the commonality among those diagnosed with ASD is underdeveloped social skills.

There aren't any specific medical tests to diagnose ASD. Doctors will usually look at a child's development and behavior through time to officially diagnose them.

A doctor can find traits of ASD in children 18 months or younger. By the time a child is 2 years old, an expert will usually be able to make a formal diagnosis. But sometimes, people get a diagnosis much later. They might find that they have high-functioning autism as an older child, a teenager, or as an adult. 

There are three main parts to the diagnosis process for ASD:

Developmental monitoring.Parents and doctors will continue to watch a child grow. They'll see if the child shows the usual signs and skills of development for their age. During well checks with your doctor, they might ask you about your child's development. They may also interact and talk to your child to understand their level of development.

Developmental screening. This takes an even deeper look at how a child is developing. This is a normal part of well checks, even if your kid has no concern for ASD. Experts recommend that children get developmental and behavioral screenings at 9 months, 18 months, and 30 months. They also suggest that they get specific ASD screenings during their well checks at 18 months and 24 months.

Your doctor might also suggest screenings for your child at other times, if there's a concern. These screenings will focus on your child's movement, thinking skills, behaviors, emotions, and language.

Developmental diagnosis. Your doctor will give your child a test to help figure out if they show any areas of concern that might be related to ASD. If so, they'll see a specialist. This may include a child psychologist, speech-language pathologist, developmental pediatrician, occupational therapist, or another doctor. 

This expert may give your child a formal developmental evaluation. During this, a doctor may give your child another test, ask you questions, or have you finish a questionnaire to better understand your child's strengths and areas they have trouble in. The results will help your doctor figure out if your child has a developmental condition.

For adults, the diagnosis for ASD is a little different. You'll want to find an expert who is trained to analyze and diagnose older people. The way a doctor diagnoses each adult may be slightly different.

Most of the time, your doctor will ask you about your life today. They may talk to you about how you interact with other people, if you have any repetitive behaviors, what your interests are, and if you struggle with anything. 

They may also ask about how you were as a child. Some doctors may want to speak with one of your parents or siblings to get a better idea of what you were like as a kid.

You can find a test for ASD online. The Autism-Spectrum Quotient (AQ) is a screening tool that can help you find out if you have traits of autism. It was published in 2001 by Simon Baron-Cohen, PhD, a psychology professor and director of the Autism Research Centre at the University of Cambridge, England. While it can help you understand more about where you might be on the spectrum, Baron-Cohen doesn't suggest the test as an official diagnosis.

Before all autism-related conditions were grouped at ASD, doctors used to call high-functioning autism Asperger's syndrome. It was originally named in 1944 by Viennese psychologist Hans Asperger. But it wasn't officially classified as its own disorder until 1994.

Previously, doctors set Asperger's syndrome apart from other autism-related conditions because people with the condition had average or higher than average language and intelligence skills. But once doctors defined these conditions on a spectrum, there was no need for a separate name.

Autism used to be considered a rare disorder, but the CDC states that about 1 in 36 children have autism spectrum disorder. ASD cases have continued to go up each year. 

The rise may be because doctors have better screening tools and awareness of the condition. Some experts think it also has to do with many different genetic and environmental factors. Research to understand what causes ASD and why it's on the rise continues.

Studies have found that young adults with ASD are most likely to choose a STEM (science, technology, engineering, and math) major over other majors. They're also more likely to choose these majors compared to other people without ASD or those with a different disability.

Children with ASD and average IQ levels also tend to show higher success levels in math compared to kids without ASD who are in the same IQ range. Experts think this is because people with ASD have special organizational patterns and skills that tend to make them great at problem-solving. 

But people with an autism-related condition also have the lowest overall rate of enrollment in college.

Unemployment rates for people with ASD are also very high. In 2021, 85% of adults with the condition were unemployed.

Despite their many gifts and talents, people with high-functioning autism tend to face barriers as they apply to jobs. ASD affects your social skills, your ability to communicate, and how you manage your behaviors and reactions. This can have a big impact on the job interview process.

A person may have all of the skills for a job. But if they lack conversation skills during an interview, the job hirer might form a bias against them. While interviewers might not even realize they've done this, it can greatly affect a person with ASD's ability to get a job.

But despite this, many people with the condition thrive in their careers. One of the best-known ASD success stories is that of Temple Grandin, PhD, who carved out a unique career path designing systems for managing livestock.

In a normal corporate setting, she may not have had the same opportunities. While some jobs might require communications and social skills, other more technical careers don't. If these jobs were less interview and conversation-based, people with ASD may have a better chance to showcase their skills.

There are countless jobs -- not just in technology -- that people with high-functioning autism can excel at if they're given the chance.