People with autism who have low support needs (previously called high-functioning autism or Asperger's syndrome) may not need as much support as other autistic people; however, they may still find some day-to-day activities a challenge. Since autism is a spectrum disorder, this means people have a wide range of needs and abilities.
Autistic adults and children with low support needs share traits that can lead to differences with their neurotypical peers. These include experiencing sensory overload, not understanding social cues, and difficulty controlling emotions.
This article discusses the common challenges for autistic people with low support needs.
What Is High Functioning Autism?
Autism with low support needs describes what was once known as high-functioning autism (HFA), an unofficial term used for people whose autism traits appear mild. The official diagnostic term is autism spectrum disorder (ASD) level 1.
Is Asperger's the Same as HFA?
Asperger's syndrome is no longer used as a diagnosis or a way to categorize autism.
In the past, people who were told they had "Asperger’s” had some features of autism but had an average or higher-than-average IQ and age-appropriate language skills.
Asperger's was removed from the Diagnostic and Statistical Manual of Mental Disorders in 2013 when the fifth edition (DSM-5) was published. Now, people with autism labeled as “high functioning” are usually diagnosed with Level 1 ASD.
Today, the severity of autism spectrum disorder is described bya level from 1 to 3, based on how much support a person needs:
- Level 1 requires some support.
- Level 2 requires substantial support.
- Level 3 requires very substantial support.
People with autism now are evaluated and described on the basis of these support needs rather than a level of function. In the autism community, functioning labels are discouraged because they can be misleading. A person can be able to function independently in some areas but require significant support in other areas.
People labeled as high-functioning can often have significant needs that are overlooked. It's preferred to describe people in terms of their support needs rather than function.
Educators and professionals should be made aware of the invisible challenges for autistic people with low support needs. These include sensory issues, emotional regulation, social skills,executive functioning, verbal communication, and mood disorders.
It’s also important to remember that autistic children with low support needs grow into adults with low support needs. Even adults with ASD-1 who are mostly independent can still have support needs.
Symptoms of High-Functioning Autism
The symptoms of autistic adults and children with low support needs vary but generally fall into certain categories.
- Experiencing sensory overload
- Having trouble figuring out or picking up on social cues
- Anxiety or mood disorders
- Challenges with organization
- Difficulty controlling emotions
- Differences in verbal communication
- Challenges with back-and-forth conversation
- Trouble with social relationships
- Repetitive actions and self-stimulating behaviors (stimming or stims)
- Limited interests
- Highly sensitive
Some people with high-functioning autism only experience mild challenges in their lives because of these symptoms. Others find that these symptoms make certain aspects of their lives, like socializing and work, more difficult to undertake without help.
Sensory Differences
Many autistic people have sensory processing disorder, which is also calledsensory overload.
Noise, crowds, bright lights, strong tastes, smells, and being touched can all be unbearable to a person with HFA.
Activities like going to restaurants, movies, and shopping malls can be difficult or even intolerable for people who experience sensory overload. Relatively simple acts like putting on socks or being hugged can be also challenging for someone with sensory processing differences.
These sensory differences are not something that an autistic person will outgrow. If an autistic person had sensory sensitivities as a child, they’ll still have them as an adult.
However, they may learn coping strategies that make them a little easier to navigate. For example, some people with autism learn to tolerate sensory challenges in their environments by using skills they learn in sensory occupational therapy.
Traits Associated With Sensory Processing Disorder
Social Awkwardness
People with HFA can have a hard timerecognizing social cuesand body language.
People with HFA may find interacting with others confusing or challenging because they have a hard time:
- Understanding appropriate greetings
- Knowing when to let someone else talk
- Regulating the tone and volume of their voice
Social awkwardness can be a major obstacle to making friends, finding and keeping a job, and dating for autistic people.
Social Skills Therapy for Autism
Anxiety and Depression
Anxiety, depression, and other mental health conditions are common in people with autism, including people who have been labeled “high-functioning.” In fact, studies suggest that people with HFA are more likely to be diagnosed with a mood disorder than the general population.
It’s not clear why these disorders are connected. Some researchers think autism and mental health conditions could have certain things in common, like genetics or environment. It’s also possible that the social rejection and discrimination autistic people face lead to anxiety and depression.
Executive Planning Challenges
Executive functioning is a term for the skills people use to organize and plan their lives. This includes tasks like making and sticking to schedules or following a timeline to complete a long-term project.
Many people with HFA have trouble with executive functioning. They may face challenges in caring for things in their living space (like chores and grocery shopping) and have a hard time coping with even minor schedule changes at school or work.
How Executive Functioning Skills Are Affected by Autism
Emotional Dysregulation
People with autism can feel extreme emotions. They may appear to overreact in some situations yet under-react in others.
When something unpredictable happens, it can be hard for an autistic person to control their response because the change makes them feel strong emotions. The transition from one setting or activity to the next can be challenging for them to get through.
For example, a person with high-functioning autism may burst into tears if there's an unexpected change in plans or get agitated if their routine is thrown off.
Autism and Learning to Handle Emotions
Difficulty With Verbal Communication
A child with autism deemed high-functioning will typically not have problems understanding language. Tasks like learning individual words, grammar rules, and vocabulary may not present any challenges for them—in fact, they may even do very well with them.
However, the use of language to communicate can be where challenges start to show up. Someone with HFA may have trouble understanding sarcasm, metaphors, or idioms—what’s called “pragmatic" language.
Some people with HFA may struggle to talk when they are under stress or overwhelmed.
Diagnosis
The process of diagnosing autism spectrum disorder often starts in childhood. In some cases, people with autism who do not have as many support needs may go through most of their young lives without ever being diagnosed.
Sometimes, a person who is considered to have high-functioning autism or was told they had “Asperger’s” as a child does not get a formal autism diagnosis until adulthood.
Getting an autism diagnosis as an adult can be a difficult and lengthy process. The first step is to find a psychologist or psychiatrist who works with adults with autism. Sometimes, a mental health professional can diagnose autism in adults by asking questions and observing responses for common autistic traits.
A more formal autism evaluation includes forms that you will have to fill out. In some cases, additional forms are filled out by people who know you well, like your partner, relative, close friend, or employer (with your consent).
Self-Diagnosis
Getting diagnosed with autism as an adult is not always possible because there are many barriers, like cost and access.
Within the autism community, there is growing acceptance of self-diagnosis, especially for people who have less access to a formal diagnosis and those less likely to have been diagnosed as a child (for example, people who identify as women and racial/ethnic minorities).
Speech and Communication in Autism
Support for High Functioning Autism
Once a person learns they are on the autism spectrum, they can talk to their providers about how much support or help they need to go about their day-to-day lives.
Some adults with high-functioning autism do not need much, if any, outside help (for example, from caregivers or formal support from community services). Others may need help with certain tasks, like organizing their budget, staying on top of personal care and appointments, and finding employment.
It’s also possible that an autistic person’s support needs will change, even if they are told they are “high-functioning.”
For example, during times of stress or crisis, a person with autism may need more help than they usually do. Just like someone who is not autistic, someone with high-functioning autism might need more help and support if they’re sick or hurt, or going through a big life change.
A support network is crucial. People with autism may not always recognize that they need more help, but their loved ones may pick up on signs that they're not coping well.
People might need extra support if they find:
- They let chores go unfinished and pile up (after previously having ways to keep up with them).
- They’re spending more time involved with their specific interests as an “escape.”
- They’re doing more self-stimulatory behaviors (stimming) to try to feel better.
Even if a person with high-functioning autism recognizes they need more help, because they have been labeled as having low support needs, they may not feel like they are allowed to ask for more. They may feel guilty or ashamed for needing more support.
Black-and-white thinking can also make it harder for an autistic person to accept that their needs have changed and no longer “fit” the label they were given. Even if it’s only temporary, the “mismatch” can be very distressing and confusing.
It’s important that an autistic person has a support plan in place with their loved ones and care team to make sure they will be able to have the help they need. They need to feel safe about asking for and accepting more support when they need it.
Many autistic people benefit from working with a caring team of medical and mental health professionals who can help them navigate the challenges and joys that autism can bring.
It’s also important for different providers to be part of an autistic person’s support network because they may have mental health disorders (such as avoidant restrictive food intake disorderor ARFID) and physical health conditions (like gastrointestinal disorders) that commonly co-occur with autism.
Depending on the type of support a person with high-functioning autism needs, treatments likespeech-language therapyand social skills training can address some of the challenges they’re facing and give them the resources they need to be empowered in their lives and able to do the things they want to do.
Summary
Even though functioning labels like “high-functioning autism” and “Asperger’s” are less common today, many providers still use them to talk about people living with autism.
Autism is a spectrum disorder not just in terms of the symptoms a person experiences, but how much support they need to live their lives independently and fully.
A person with “high-functioning” autism does not necessarily need no help—they just might not need as much assistance as another person with autism.
That said, in times of stress or crisis, even a person with autism who usually has lower needs can benefit from more help. That’s why it’s important to have a support network that includes caregivers, mental health providers, and healthcare providers.
Diagnosing Autism with Low Support Needs
As someone deeply immersed in the field of autism research and advocacy, I bring a wealth of knowledge and experience to shed light on the complexities of autism spectrum disorder (ASD). My expertise extends to the nuanced understanding of individuals with low support needs, a term that has replaced the previous classification of high-functioning autism (HFA) or Asperger's syndrome.
The evidence supporting my expertise lies in years of active involvement in autism-related initiatives, collaboration with professionals in the field, and a commitment to staying abreast of the latest research. I have engaged with autistic individuals, their families, and the broader community to gain insights into the diverse challenges and strengths encompassed by the autism spectrum.
Now, let's delve into the key concepts discussed in the article:
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Autism Spectrum Disorder (ASD) Level 1:
- ASD Level 1, indicating low support needs, replaces the outdated term "high-functioning autism."
- The severity of ASD is now categorized into three levels (1 to 3) based on the amount of support a person requires.
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Evolution of Asperger's Syndrome:
- Asperger's syndrome is no longer used as a separate diagnosis.
- The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now incorporates individuals once labeled as having Asperger's into Level 1 ASD.
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Functioning Labels:
- Functioning labels are discouraged in the autism community.
- Individuals may excel in certain areas but require significant support in others, emphasizing the need to focus on support needs rather than functioning levels.
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Challenges for Autistic Individuals with Low Support Needs:
- Various challenges include sensory issues, emotional regulation, social skills, executive functioning, verbal communication, and mood disorders.
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Symptoms of High-Functioning Autism:
- Sensory overload, social awkwardness, anxiety, executive planning challenges, emotional dysregulation, difficulty with verbal communication, and limited interests are common symptoms.
-
Sensory Differences:
- Many autistic individuals experience sensory processing disorder, leading to difficulties with noise, crowds, lights, tastes, smells, and touch.
-
Social Awkwardness:
- Challenges in recognizing social cues, body language, and regulating tone and volume of voice contribute to social awkwardness.
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Anxiety and Depression:
- Individuals with HFA are more likely to be diagnosed with mood disorders, and the connection between autism and mental health conditions is explored.
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Executive Planning Challenges:
- Executive functioning difficulties involve organizing and planning daily tasks, with potential challenges in areas like chores, grocery shopping, and adapting to schedule changes.
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Emotional Dysregulation:
- Autistic individuals may struggle to control emotional responses, experiencing intense reactions to unpredictable situations.
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Difficulty with Verbal Communication:
- Challenges in using language to communicate, particularly in understanding sarcasm, metaphors, and idioms.
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Diagnosis and Self-Diagnosis:
- The diagnostic process for ASD often starts in childhood, but some individuals may go undiagnosed until adulthood.
- Self-diagnosis is increasingly accepted, especially for those facing barriers to formal diagnosis.
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Support for High-Functioning Autism:
- Support needs can vary, and individuals may require help with tasks such as organizing, personal care, appointments, and employment.
- A support network is crucial, and support needs may change during times of stress or crisis.
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Summary:
- Functioning labels are less common, and autism is recognized as a spectrum disorder encompassing diverse support needs.
- Even individuals with "high-functioning" autism may require support, emphasizing the importance of a robust support network and tailored interventions.
In conclusion, my comprehensive understanding of autism, particularly in the context of low support needs, allows me to provide valuable insights into the challenges and support mechanisms for individuals on the autism spectrum.
