There’s an overwhelming amount of information about autism on the internet, we get it. A lot of new terms, new vocabulary, new controversy – it’s easy to get it wrong sometimes, even when we mean well. It’s understandable that you might be confused, “What’s wrong with ‘high functioning autism’?”
We at ONE Intervention are happy to help clear up any questions you have! In this article, we’re breaking down for you:
- What is ‘high functioning autism’ (and why it’s offensive to some in the autistic community)
- What’s preferred to ‘high functioning autism’?
- Why can autism go undiagnosed?
- What are some more resources I can refer to?
We’ve compiled the above information from various credible, expert sources all over the internet. We know it can be a bit intimidating, but trust us – let’s go through each topic one by one.
What Is ‘High Functioning Autism?’
What is autism?
First things first, some of us might be a little confused as to what autism is in the first place, and why it can be called ‘high functioning autism.’
Basically, autism is a neurodevelopmental disorder. According to the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), there are two particular characteristics of autism.
The first is a lack of social communication and interaction skills. The second is repeated, repetitive behaviour. A child must have ‘a persistent deficit in each of the three areas of social communication and interaction’, and ‘at least two of the four types of repeated, repetitive behaviour’ to be diagnosed with ASD.
If that still sounds a bit complicated, we recommend that you check out our article on Empowering People With Autism: Causes, Symptoms And Your Community!, or this thoughtful insight into autism by our Founder.
What Is ‘High Functioning Autism’?
But to be clear, ‘high functioning autism’ isn’t an official medical diagnosis. In fact, it shouldn’t be used in a professional healthcare setting, because it’s not a unique type of autism. It doesn’t have its own treatment or symptoms.
‘High functioning autism’ is a casual term used to describe what is generally understood as a milder form of autism. It implies that people with this milder form are minimally impacted by their diagnosis, and still able to go about their daily life similar to most people without an ASD diagnosis.
However, this implication isn’t quite true. All people with autism do face the social and emotional challenges associated with ASD – each to their individual extent.
People tend to think ‘high functioning autism’ refers to Asperger’s Syndrome, or savant syndrome. In both of the above cases, the individuals have average to above-average IQ and have exceptional talent in a particular skill set.
But that line of thinking isn’t completely accurate, either. Actually, most people with autism have an average IQ. They may be extremely talented in a specific skill, but that could be a result of hard work or individual passion, rather than their diagnosis.
Why Is ‘High Functioning Autism’ Controversial?
So, we now understand what autism is. We’re also aware of the fact that autism is a spectrum. It’s understandable that people may believe that autistic people who need less support can be labelled as ‘high functioning autism.’
However, this label can be quite hurtful to those in the autistic community.
Firstly, it creates the misconception that such individuals have no need of support for their diagnosis. That’s patently untrue – if such were the case, there would be no need for a diagnosis in the first place.
Secondly, ‘high functioning autism’ can imply that other individuals who require more support are ‘low-functioning’. Put simply: That’s insulting at best, dehumanizing at worst.
In short, ‘high functioning autism’ is a rather vague label that can minimise the struggle that the autistic community goes through. This matters because it may give the misconception that autistic people are able to handle themselves, and require no support.
What Is Preferred to ‘High Functioning Autism?’
The DSM-5 (the most recent edition) classifies autism as a spectrum disorder. Basically, there are three levels to this spectrum:
- Level 1 Autism – Requires some support.
- Level 2 Autism – Requires substantial support.
- Level 3 Autism – Requires very substantial support.
Level 1 autism is a much more appropriate term to use than ‘high level autism.’ Let’s briefly go through what each of the levels mean, and their support needs.
Level 1 Autism
A person with level one autism is able to perform daily tasks without much (if any) assistance. This means that they can manage their health, money and household as well as any person without a diagnosis for ASD.
However, a person with level one autism can still struggle with social interaction and communication. They may have difficulty reading social cues, or starting and maintaining a conversation. Alternatively, they may still experience extreme sensory sensitivity. They still require some support.
For example, a child with level one autism may struggle to make eye contact when talking with their peers. They might prefer to adhere to a rigid schedule for their daily activities. Also, they might still be sensorily overwhelmed by certain lights, sounds or textures.
People with level one autism may benefit from therapies such as speech and language therapy, and they may also require support plans tailored to their individual needs.
Level 2 Autism
People with level two autism require ‘substantial support’, in the sense that they exhibit more significant challenges in social communications and interactions.
For example, a child with level two autism may find it difficult to express themsleves verbally, or may have limited speech ability. They may display more pronounced repetitive behaviours, such as full-body stims, or may have a severe reaction if there is a change in routine.
It’s true that people with level two autism struggle in ways that tend to be more visible than those of level one autism. But, it’s important to note that the challenges faced by people on both levels are equally frustrating and valid.
Some forms of support provided to people with level two autism could be educational institutions that cater to their diagnosis. This could be in the form of individualised education plans and therapies catering to more fundamental skills, such as hygiene and self-care.
Level 3 Autism
At level three autism, individuals require the most amount of support. Out of all three levels, a child with level three autism faces the most severe challenges in social communication and interaction.
For example, the child may be nonverbal or use minimal speech. They may rely on alternative forms of communication, such as a speech generating device. In social situations, they might appear to be ‘in their own world’ and unresponsive to their peers.
This stage of autism may require extensive support from caregivers to perform daily activities, such as bathing and feeding themselves. At the same time, their occupational therapy may focus on the most basic tasks, such as physical coordination.
For more information on each level of autism, this article by Medical News proves enormously helpful.
Why Can Autism Go Undiagnosed?
With us, so far? Going by the above levels, an ASD diagnosis may appear quite cut-and-dry. However, that’s not always the case. This could be due to a variety of factors:
Autism in females can be expressed in different traits
Traditionally, experts assumed that autism occurs more frequently in males than in females. This is because certain autistic traits in females still follow the social norms associated with femininity.
For example, females generally report more difficulties with sensory input than males do. They may be able to form friendships more easily, and be more motivated to continue conversations than boys. This could give the misimpression that they face fewer social difficulties.
Also, females tend to internalise their symptoms of autism. For example, a child with autism may become quite emotionally distressed when faced with a change in routine. Boys may express this through physical aggression, while girls may suppress their emotion.
The latter could lead to the autistic girls developing other underlying conditions, such as anxiety and depression.
As a result, autism is diagnosed less frequently in girls than in boys. This could give the impression that autism is a “male” condition – when in fact, it affects both males and females equally.
For more information about autism in girls and why autism can go undiagnosed in females, ONE recommends this informative article by UCLA Health.
Masking
Autism is usually diagnosed at childhood. However, some children learn to mask their behaviours. That means that they cope with neurotypical social norms by concealing their true thoughts and behaviours.
For example, a person with autism may feel quite overwhelmed by the constant flow of conversation with strangers throughout the day. However, they might mask and instead pretend that they like such conversations, in order to fit in and enjoy the acceptance of others.
Autistic people who mask well thus appear to not display the usual symptoms of autism. This of course makes it harder for them to be diagnosed.
That being said, this is quite a simplified explanation of masking. For a more in-depth article about masking in autism, we recommend this piece by the National Autistic Society.
What Are Some More Resources I Can Refer To?
Now, we know what ‘high level autism’ is. We know that it can be a deeply hurtful label, and we understand why. Also, we’ve gone through each level of autism and what they refer to. We then elaborated a little bit on why autism can go undiagnosed even after each level seems to be clearly demarcated.
If you’re curious for even more resources and support, we’ve got you!
St Andrew’s Autism Centre
St Andrew’s Autism Centre aims to serve people with autism through professional services. These include a special education school, day activity centres, and Singapore’s first autism home.
Autism Association Singapore
Autism Association Singapore is a social service agency in Singapore that aims to support and serve people with ASD. Their services include Centres that cater for both children and adults, as well as a school for autistic children.
ONE Intervention
And of course, ONE Intervention is always here to provide you with our expert services. We’re a special needs school catering to children with ASD, ADHD, dyslexia and other learning needs. We pride ourselves on our play-oriented, individualised education programmes and our evidence-based intervention process.
Contact us here 🗣️, or if you’ve any other experiences or questions that you’d like to share, drop us a comment below! 💬