You may have heard the term “Asperger’s Syndrome” used before in relation to autism.

This used to be the name for what’s now called high functioning autism or Autism Spectrum Disorder (ASD) Level 1.

It refers to individuals on the autism spectrum who have average to above-average intelligence and who possess competent to very competent language comprehension.

But here’s the thing – just because someone is “high functioning” doesn’t mean they don’t face major challenges.

The term can often be taken to mean that this milder presentation of autism is nothing to worry about. Those who live with it can, ‘just get on with it.’

However, the reality is that many individuals with high-functioning autism (HFA) would benefit greatly from support in navigating some of their core responsibilities relating to work, relationships as well as embracing their unique personality.

Despite having higher cognitive capacities, those with HFA can encounter difficulties in social interactions, sensory processing, adjusting to changes in routine, as well as exhibiting repetitive behaviours.

The “high functioning” label doesn’t mean these struggles are any less valid or real.

Recognising the Signs: Symptoms and Traits of High Functioning Autism in Adults

Problems with executive functioning can make it difficult to manage day-to-day life, leading to fatigue and burnout. The effort of camouflaging autistic traits and conforming to neurotypical standards can cause social exhaustion and sometimes lead to self-rejection and self-esteem issues.

Receiving a diagnosis of high-functioning autism as an adult can often feel like a relief, providing a framework that can make sense of — and offer a roadmap for — all the ways your brain works differently from the norm, that contribute to cycles of dysfunctional behaviours.

This can help you release the feelings of shame or unworthiness that can be rooted in pathology-based terminology, instead allowing you to lean into the language of neurodiversity and take a more behavioural-based approach as opposed to accepting a clinical label for life.

Receiving a diagnosis can empower you to advocate for your particular needs, be ok with walking to the rhythm of your own drum, embracing a more authentic means of self-expression, and letting go of the facade of being what society deems ‘normal.’

Let’s take a closer look at some of the symptoms associated with high functioning autism in adults:

Social Communication Challenges

• Difficulty Initiating Conversations: You might find it difficult to notice signs of romantic interest, such as when people flirt with you across the room. This can lead to social paralysis – awkwardness – and indecision about how to reciprocate and form relationships.
• Challenges Ending Conversations: You may find yourself speaking like an open book in a constant stream of consciousness narrative. This might lead you to be unable to pick up on cues that the other person is ready to change the subject you’re on, or even end the conversation entirely.
• Oversharing in Conversations: You might begin a conversation with some of your most revealing, vulnerable, challenging experiences you’re moving through in your personal life. This might place the other person in a difficult situation, leaving them not knowing how to receive or respond to what you’re sharing.
• Literal Interpretation of Humour: Understanding humour, especially when it’s rooted in more abstract or metaphorical language, can sometimes be difficult. You might take certain jokes or sarcasm too literally, which can lead to awkward misunderstandings in social interactions.

Restricted Interests and Repetitive Behaviours

• Intense Specialised Interests: You might experience an intense fascination with a subject – or multiple subjects – which you do incredible deep dives into becoming an expert in. But this can often come at the expense of socialising or your other personal responsibilities.
• Adherence to Routine: There might be a great need to adhere to a routine in order to feel emotionally regulated and like you’re able to cope with the demands of your personal and professional life.
• Repetitive Physical Behaviours: These can be very subtle in those with high functioning autism. They might include things such as fiddling with togs on clothes, fidgeting with pens, stationary at work, or repetitive tapping of the body or on a hard surface.
• Verbal Repetition (Echolalia): If you engage in echolalia, it may be for multiple reasons. It might be to confirm that you’ve received a piece of information, or it could be part of a greater coping mechanism or ‘scripting.’
• Difficulty with Transitions: Unless there is a clear structure in place, it could be very difficult for you to transition from one part of your day to another, or perhaps from task to task in a work-based/productivity environment.

Sensory Sensitivities

• Hypersensitivity and Hyposensitivity: Adults with functioning autism often encounter a combination of heightened sensitivity (hypersensitivity). Reduced sensitivity (hyposensitivity) to different sensory inputs such as visual cues, auditory signals, tactile sensations and scents.
• Sensory Seeking Behaviours: Hyposensitivity can lead to sensory seeking behaviours, such as touching objects, staring at spinning objects, or craving deep pressure, as a way to obtain more sensory input and stimulation.
• Sensory Avoidance Behaviours: Hypersensitivity may result in sensory avoidance behaviours, like covering ears to block out noise, wearing sunglasses indoors to reduce visual input, or having a restricted diet due to texture aversions.
• Sensory Overload and Meltdowns: When sensory input becomes too overwhelming, adults with high functioning autism may experience sensory overload, leading to meltdowns, shutdowns, or intense anxiety as a coping mechanism.

Real-World Examples of High-Functioning Autism in Different Demographics

Autism, like all mental health conditions, doesn’t affect people within specific demographics more than another. It can – and does – affect people from across all walks of life.

However, while there is a core set of behavioural tendencies associated with autism, the way in which they present will vary greatly. There is a saying within the autism community which goes ‘if you’ve met one person with autism, you’ve met one person with autism.’

And while that does speak positively to the uniqueness of HFA, this diversity of presentation can often lead to difficulties in diagnosis, which is why so many children can slip under the radar. As a result, this is why so many adults seek a diagnosis in later life after realising something isn’t quite clicking.

Something just isn’t quite right within their life, despite being successful, despite seeming to have it all. Or, at least mostly have it all.

Adults vs. Children

Since autism is generally considered to be a genetic condition, this means the symptoms can be picked up in childhood. In certain cases, it can sometimes be a useful exercise to contrast childhood behaviours with those in adulthood.

If you’re unsure of whether you’re on the spectrum of HFA, having an awareness of how certain tendencies in childhood might be manifestations of your HFA in adulthood can help discern how you might make positive improvements in your life.

This understanding not only provides validation and clarity, but also opens doors to accessing appropriate accommodations, developing self-advocacy skills, and embracing a positive identity as a neurodivergent individual.

Let’s take a look:

Children with high functioning autism:

• Display more obvious repetitive behaviours: Younger HFA children can show more prominent repetitive behaviours like hand flapping or spinning objects, because such behaviours are less likely to have been repressed due their lack of social conditioning and instilled etiquette.
• Have strong, narrow interests: Young children often have a single highly focused interest that means everything to them, monopolising attention, leading them to talk about nothing else. As a result they also have difficulty conversing about other children’s interests, or entering into reciprocal relationships.
• Struggle with peer relationships and social interaction: HFA children may find social cues puzzling, they do not try to make friends, nor do they approach other children as potential playmates. Often preferring solitary activities they drift into the periphery of children’s social play to watch. They might play when approached, but struggle to initiate.
• Have emotional outbursts when routines are disrupted: If a child with HFA’s routine is disrupted, which is something they’ve come to rely on for emotional security, this sense of ungroundedness might lead to emotional outbursts or breakdowns due to a lack of coping skills.

Adults with high functioning autism:

• Mask symptoms with coping strategies: Adults may learn to repress repetitive behaviours in public, using coping skills to fit in and avoid calling attention to their idiosyncrasies.
• Navigate social situations with scripts and strategies: Adults often develop memorised scripts, rules, and strategies that help them get through social interactions with better confidence, hiding their underlying afflictions.
• Turn obsessive interests into successful careers or hobbies: Adults might also funnel their narrow fascinations and strengths into successful pursuits in technology, science, or the arts, enjoying the opportunity to make a positive channel for their passions.
• Experience burnout, anxiety, and depression from masking: The conditioning of anti-inclusivity rules and social expectations can force an individual with mild autism to wear a mask – ‘camouflaging,’ – which can lead to major stress, fatigue, and mood issues.

Men vs. Women

It can also be very helpful to talk about the differences in presentation of HFA symptoms between men and women. For a long time autism was considered to be a ‘male only’ disorder. But in mental health, this type of thinking is something of a fallacy.

By acknowledging this, it lays the ground for greater inclusivity across the gender gap. It also opens up the conversation about differing accommodations that might be needed in relation to differing challenges which might be faced in relation to gender.

We still live in a world where there is a great divide in certain social expectations between men and women. Not to mention, the physiological and emotional differences that can also affect the way that HFA presents across various individuals.

Let’s take a closer look:

High Functioning Autism Tendencies in Men:

• More noticeable repetitive behaviours: Males with high functioning autism may display more noticeable repetitive behaviours, such continuous body movements, appearing to never to be to sit still.
• Intense, narrow interests in objects or systems: Males often possess highly focused interests in specific areas, which might conform to what we typically think of as autism related obsession, those which are less conventionally appealing as a passion.
• Social interaction and communication challenges: This preoccupation with collecting and categorising objects or facts can dominate conversations and impact their ability to engage in reciprocal social interactions, leading to oversharing and dominating conversations.
• Greater likelihood of additional conditions: Males with high functioning autism may be at greater risk for additional conditions such as ADHD or oppositional defiant disorder, which can further impact their daily functioning.

Further Reading: What is the Relationship Between Autism and ADHD?

High Functioning Autism Tendencies in Women:

• Masking and camouflaging behaviours: Women with high-functioning autism often develop a repertoire of techniques to conceal their autistic traits. This might include copying social behaviours, scripting conversations, copying facial expressions and mimicking gestures.
• Special interests in people or animals: Women’s special interests might centre on people, relationships, or pop culture which may be perceived as more socially acceptable and result in missed or delayed diagnosis.
• Internalising emotional challenges: Women with high-functioning autism might be more prone to internalising their difficulties, resulting in higher rates of anxiety, depression and further mental health conditions.
• Struggling with social expectations and gender roles: As women are socialised from a very early age to be nurturing, empathetic and attuned to the emotional needs of others, the difficulty in reading social cues and responding to emotions in a neural typical way might be incredibly difficult in a presentation of HFA.

Workplace

If you’ve found yourself struggling in the workspace in relation to any of the pieces which have been talked about so far, here are some specific examples which might allow you to make connections between some of your perceived HFA tendencies:

• Social Communication Difficulties in the Workplace: You might have found it difficult to build consistent relationships in the workplace and interpret nonverbal cues. There can also be a difficulty in maintaining eye contact and participating in reciprocal conversations with co-workers. This might have led you to misread social norms and Express your emotions awkwardly and have limited friendships. Over time this might lead to difficulties which can lead to isolation and being looked over for promotions.
• Sensory Overload in the Work Environment: You may have found your work environment particularly challenging. If you’re someone who experiences sensory overload and works in a busy office environment, the constant overlapping of sounds such as key typing, conversations, and other stimuli can lead to underlying agitation and stress which can lead to fatigue and a lack of concentration and a lack of output.
• Inflexibility and Resistance to Change in the Workplace: It could be that you really thrive on routine and predictability. That means whenever there are changes made at your place of work, they could cause extreme agitation manifesting in inflexibility. You may have difficulty adapting to new tasks, responsibilities, or team dynamics which might cause anxiety and frustration.

Relationships

Relationships are challenging at the best of times for neurotypical people. And so, there are bound to be unique challenges for those on the spectrum of ASD. Here are some specific relational pieces, which haven’t been talked about thus far:

• Emotional Reciprocity and Intimacy in Relationships: Since one of the core symptoms of autism is an inability to engage with abstract thinking this can often make it difficult to understand the emotions of other people. So when you enter into relationships, whether they be interpersonal or romantic, you could fail to read emotional cues, not knowing or realising what’s required. This may lead to a lack of emotional intimacy and inability to deepen interconnections in a way that more neural typical people find almost second nature.
• Sensory Sensitivities and Physical Intimacy: Certain sensory sensitivities such as physical sensitivity might make physical intimacy more of a challenge than It is for neurotypical people. This sensitivity might necessitate moving very slowly through the sexual experience and also taking great care when it comes to engaging with the genitalia wherever you are a man or woman.\

Further Reading: AuDHD: Could This Explain Your Ongoing Struggles?

Supporting High-Functioning Autism: Therapeutic Approaches

While autism spectrum disorder (ASD) is a lifelong condition, there are various therapies and modalities that can significantly improve an individual’s quality of life. These interventions can help address core challenges associated with HFA, such as social communication difficulties, sensory processing issues, and repetitive behaviours.

Here are some of the major therapies that can be beneficial for adults with high-functioning autism:

Cognitive Behavioral Therapy (CBT):

Focuses on: Cognitive Behavioral Therapy (CBT) helps individuals with HFA identify and adjust negative thought patterns that contribute to anxiety, depression, and social difficulties. Through CBT, individuals can learn coping mechanisms and develop more effective communication skills.

Social Skills Training:

Focuses on: Social skills training equips individuals with practical strategies for initiating conversations, maintaining eye contact, reading social cues, and navigating social situations with greater confidence.

Applied Behavior Analysis (ABA):

Focuses on: ABA therapy uses positive reinforcement and structured learning environments to improve communication, social interaction, and daily living skills. While often used with children, ABA principles can be adapted for adults with HFA.

Occupational Therapy (OT):

Focuses on: Occupational therapists help individuals with HFA develop skills for independent living, including managing sensory sensitivities, improving motor skills, and participating in meaningful activities.

Speech-Language Therapy:

Focuses on: Speech-language therapy can address communication challenges in HFA, such as difficulty with verbal expression, nonverbal communication, and pragmatic language skills (using language appropriately in different contexts).

It’s important to note that the most effective treatment approach for HFA is often individualised. A combination of therapies tailored to the specific needs and goals of the person can yield the most positive outcomes.