What Is High-Functioning Autism?

High-functioning autism is a term sometimes used to refer to autistic people with an average-to-high IQ and low support needs. The flip side of this is low-functioning autism, which may refer to an autistic person whose daily life is severely impacted. But high-functioning autism and low-functioning autism are not official diagnoses, and experts prefer that these outdated terms not be used as they find them misleading and, often, offensive.

Autism is a neurodevelopmental disorder that impacts how a person processes information and communicates. It is officially called autism spectrum disorder (ASD) because autistic people have a wide range of social skills and behaviors.

The term high-functioning autism is often used to describe what was previously called Asperger’s syndrome. This earlier diagnosis was categorized separately from autism and referred to children who have some markers of autism but do not have language or intellectual impairment. Kids who fell under this umbrella may have had above-average intelligence while struggling with sensory sensitivities, social communication difficulties, or behavioral challenges.

Asperger’s syndrome was an official diagnosis in the DSM until the release of the DSM-5 in 2013, when it was removed as a diagnosis separate from autism spectrum disorder. The idea of a spectrum is that it includes people with a wide range of symptoms and needs for support. In its wake, the term “high-functioning autism” was popularized as shorthand for autistic people who are not severely impacted.

The basic diagnostic criteria for autism are the same whether someone is considered to have high-functioning autism or not. In order to receive an autism diagnosis, a child must meet certain behavioral criteria. These fit into two categories: social communication and restricted or repetitive behaviors.

Signs of social communication differences include:

In younger kids (under 3 years)

• Failure to respond to their own name
• Disinterest in giving, sharing, or showing objects of interest
• Aversion to displays of affection
• Preference for solitary play

In older children

• Difficulty carrying on a reciprocal or back-and-forth conversation
• Lack of eye contact
• Difficulty reading body language in others
• Difficulty recognizing others’ emotions, responding to social situations, and understanding social relationships
• Aversion to displays of affection
• Preference for solitary play

Children with restricted or repetitive behaviors repeat certain actions and rituals and can become fixated on minute details to the point of distraction. In addition, they may:

• Become upset by minor changes in daily routine
• Line up, sort, or organize toys or objects instead of playing with them
• Show a consuming interest in a specific topic or object
• Have unusual sensory sensitivities

There are now officially three levels of autism, which are supposed to indicate the extent of support that a child needs. High-functioning autism is often equated with “level one autism,” which refers to someone with low support needs. However, even these levels are subjective and can be problematic.

Many experts and autistic self-advocates argue that the terms “high- and low-functioning” lead to assumptions about a person that can be inaccurate and even offensive. It is also based on the premise that one’s support needs remain static, when in reality they can shift depending on the environment, the number of stressors, sleep quality, and more. Intelligence or verbal ability doesn’t equate to ease of daily life. An autistic child may have high verbal ability yet require assistance getting dressed, or they may be able to tolerate an environment one day but not the next.

Instead of using overgeneralized labels, it’s best to talk specifically about what supports each autistic individual needs and when. When in doubt, ask whether someone prefers person-first language (person with autism) or identity-first terminology (autistic). An older child or a child’s parent will also be able to shed light on their specific support needs. This tends to come up most commonly in the context of school and individual education program (IEP) meetings. Being as specific as possible will ensure that the child receives the accommodations that will best support them.

“High-functioning autism” or “low-functioning autism” can feel like convenient shorthand to indicate the extent to which someone is impacted. But it is an oversimplification that can feel judgmental and can lead to misleading assumptions about an individual.