World Autism Awareness Day: What Is High-Functioning Autism? Its Causes And Diagnosis

What Is High-functioning Autism?

High-functioning autism (HFA) is not an official medical diagnosis but a common term used to refer to people with autism spectrum disorder who speak, read, write and manage life skills without much assistance [1].

It is characterized by features similar to those of Asperger syndrome or Asperger's, a developmental disorder characterised by difficulties in social interaction and nonverbal communication, along with restricted and repetitive patterns of behaviour and interests [2].

The specific defining characteristic recognized by psychologists in high functioning autism is the delay in the development of early speech and language skills, before the age of three years.

Asperger Syndrome & High-Functioning Autism

Asperger's and high-functioning autism differs from each other in ways that is, diagnostic criteria of Asperger syndrome exclude a general language delay whereas, in high-functioning autism, there is a significant delay before the age of three years [3].

Some of the other differing characteristics of high-functioning autism from Asperger's are as follows [4]:

• People with Asperger syndrome are better at empathizing with another than ones with HFA.
• People with HFA more often have problems with functioning independently.
• People with HFA have a lower verbal reasoning ability.
• People with HFA have better visual/spatial skills (higher performance IQ) than people with Asperger syndrome.
• People with HFA face low levels of deviating locomotion or clumsiness than people with Asperger syndrome.

Reports also point out that the male to female ratio of 4:1 for HFA is much smaller than that of Asperger syndrome [5].

What Are The Symptoms Of High-functioning Autism?

HFA does not cause nor include intellectual disabilities, distinguishing HFA from low-functioning autism. Individuals with high-functioning autism, are at a higher risk of developing symptoms of anxiety [6].

Also, the presence of one or more disorders in addition to the primary disorder (HFA) is reported, which includes bipolar disorder and obsessive-compulsive disorder (OCD). Some complications or disorders associated with HFA include ADHD and Tourette syndrome.

What Are The Causes Of High-functioning Autism?

Information regarding the biological basis of autism is limited and studies have linked the cause to structural abnormalities in specific brain regions [7].

The claim that some vaccinations cause autism has not been proven and several countries and studies do not support this assertion.

How Is High-functioning Autism Diagnosed?

HFA, initially, was not included in the official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. However, HFA came under the DSM-4 classification for individuals with the autistic disorder but do not have an intellectual disability (an IQ of 70 or more) [8].

However, the present diagnostic standards of the classification of HFA is no longer used and has been replaced by 3 support levels for autism spectrum disorders. That is, cases of HFA are diagnosed by 35 months of age, much earlier than those of Asperger syndrome [9].

How Is High-functioning Autism Treated?

There is no single treatment or medicine for people with autism but a number of measures that can help manage the condition and ease the symptoms. The treatment measures for HFA are as follows [10]:

• Augmentative and alternative communication, used for autistic patients who cannot communicate orally.
• Applied behavioural analysis (ABA) focuses on teaching adaptive behaviours like social, play skills or communication skills.
• Occupational therapy helps autistic children and adults learn everyday skills that help them with daily tasks, such as personal hygiene and movement.
• Speech-language therapy, to help those with autism who need to develop or improve communication skills.
• Sensory integration therapy helps people with autism adapt to different kinds of sensory stimuli such as lights or sounds.

Medication: Medication is usually used for symptoms associated with autism, such as depression, anxiety, or behavioural problems.