Definition of High Functioning Autism
Autism is defined by a triad of symptoms that includes impaired communication, difficulty with social interaction and restricted interests. But beyond this basic definition, the symptoms of autism vary from one child to the next. Autism is not one neat label -- it represents a spectrum of issues ranging from low to high functioning.
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Autism Spectrum Disorders
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The Diagnostic and Statistical Manual of Mental Health Disorders (DSM) classifies the autism spectrum disorders under the umbrella heading of pervasive developmental disorders (PDD). Under PDD there are six classifications: Autistic Disorder, Rett's Disorder, Childhood Disintegrative Disorder, Asperger's Disorder, PDD-NOS and Fragile X Syndrome. High functioning autism (HFA) is not included in that list because it is not an official diagnosis. In spite of that, HFA is widely used by professionals to indicate the higher functioning end of the autism spectrum.
High Functioning Autism
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The key issues that differentiate one end of the spectrum from the other are language and intelligence. Children diagnosed with what is often called "classic" autism fall at the "low functioning" end with severe deficits in verbal and nonverbal communication. They may have an average IQ but many have low IQs. On the opposite end of the spectrum, high functioning autism describes individuals whose language develops normally and who have average to above average IQs. HFA is often used interchangeably with Asperger's Syndrome (AS), but professionals disagree about whether the two are the same. Some differentiate HFA by saying that these children have an early language delay while those with AS hit all the developmental milestones.
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Symptoms
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Children with HFA are challenged by autism's core deficits but with variations. They may have a great vocabulary and can talk, but they can't truly share experiences through give-and-take conversation. They tend to interrupt and, oblivious to what others were chatting about, dominate the conversation by talking non-stop about the one topic that interests them. Unable to intuitively learn the social skills that come as second nature to neurotypical children, they struggle to socialize with peers. The slightest change in routine results in extreme anxiety that is not alleviated by IQ or verbal ability. Children with HFA often have extreme sensitivities to sounds (unexpected or loud sounds can trigger anger, fear or withdrawal), touch, temperature, and the smell and texture of food. Their visual sensitivity may cause them to be distracted by the slight flickering in lights that most people don't notice. Because of their neurological differences, children with HFA do not easily grasp the concept that people have their own unique thoughts. They are unable to generalize, learning rules in one setting but not understanding that the same rules apply in a different circumstance.
Challenges
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Since they are so high functioning, it is easy for teachers, friends and relatives to underestimate their daily struggle. Negative behaviors are often interpreted as willful disobedience. It is important to realize that navigating everyday tasks results in high levels of stress. The "high functioning" nature of HFA makes it hard to remember that these children need to be taught -- step-by-detailed-step -- how to do so much of what comes naturally for most people.
Behind the Behavior
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Imagine feeling that if you had to memorize one more fact your head might explode and genuinely believing that your head may burst open because you don't comprehend the nuance of figures of speech. What if the seams of your pants felt like pins sticking into your legs, or you couldn't tune out the hum of an air conditioning unit outside while trying to take a test. Or think about anticipating lunch time only to involuntarily gag from the smell of broccoli cooking in the cafeteria. Now you've entered the world of high functioning autism. In spite of their challenges, children with HFA are highly motivated to meet expectations. But sometimes the stress and anxiety win. The result is loss of control, a burst of anger, or a meltdown. The reason behind the behavior needs to be assessed in order to understand, teach the necessary skills, and facilitate successful daily living for those with HFA.
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