Those with high functioning autism (HFA) were once diagnosed with Asperger's Syndrome, but this diagnosis was removed with the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Now all those on the spectrum are diagnosed with Autism Spectrum Disorder, but there are specific symptoms associated with higher functioning.
Limited Eye Contact
Limited eye contact is one of the first signs of autism in toddlers, and it also affects children and adults on the spectrum. While a person with severe autism might make no eye contact at all, a person with mild autism may have a fleeting eye gaze. This means that he or she might look you in the eye for just a moment or two before looking away.
Difficult to Read Socially
When people interact with one another, they often use nonverbal cues to gauge the other person's mood, interest level, and intentions. While people on the spectrum often struggle to interpret these nonverbal cues, this may not be something other people notice. Instead, observers may notice their own difficulty interpreting the social cues of the person on the spectrum. The affected individual may have a flat affect or lack of facial expression and may speak without a lot of vocal inflection to show emotion. He or she may turn or look away in the middle of a conversation but still be listening.
Seeks Social Interaction in Unusual Ways
Many people think that those on the spectrum seem to take no notice of other people. However, people with mild autism often seek out social interaction, even if they may not know how to connect with other people in traditional ways or at their developmental level. Children may be comfortable interacting with adults, who may find them precocious and endearing, but they may struggle for topics of conversation on the playground. Adults with HFA may talk too much or too little, or they may not notice if their topic of conversation is uninteresting to conversational partners.
Gestures can be difficult for people with any level of autism. In severe cases, gestures may be completely absent. People with high functioning autism may use gestures inconsistently or awkwardly and may need to be directly taught about the meaning of gestures like pointing, nodding the head, or waving. This symptom may not be present in adults, who have learned how to use gestures appropriately over the years.
Limited Spontaneous Sharing of Perspective
Limited or absent sharing of perspective is a classic sign of autism. In severe cases, the person may not make any attempt to share his or her world with other people. For those with mild autism, this characteristic may be more subtle. You may notice that a child with high functioning autism does not spontaneously show you things or tell you about his or her day. If asked or prompted, an older child or adult with mild autism may show or describe his or her experiences.
In severe autism, a person may be completely nonverbal or communicate only through sign language or a communication board. In mild autism, individuals may have normal or even advanced language skills. They may simply have difficulty using language in a functional way to get what they want. This means they may be able to talk at length about a subject, but they might have trouble asking a question to get more information.
Struggles to Maintain a Conversation
In mild autism, an individual may struggle with some finer points of initiating a conversation and keeping it going. There could be silences or awkward starts. However, they can learn about asking questions, taking turns talking, and starting up an interaction. With therapy, these challenges may not even be apparent to the casual observer.
Subtle Repetitive Behaviors
For high functioning individuals, repetitive behaviors may not take the form of hand flapping or head banging, as is sometimes the case in more severe autism. Instead, these behaviors may take the form of a verbal tic, a need to chew on something, a tendency to shift their weight back and forth, or another subtle behavior. Typically, individuals can redirect this behavior in a more socially appropriate way.
Strong Preference for Routine
In mild autism, a disruption of the routine may not bother the individual to the point of shutting down or being unable to function, but it can definitely cause a disruption in mood and behavior. Many older kids and adults have learned to cope with this, and they can typically find ways to recover. However, they often prefer to stick to routines and avoid deviations from planned schedules.
Non-Standard Pretend Play
Not engaging in pretend play is an early sign of autism; however, children with mild autism may have non-standard pretend play routines. For instance, instead of pretending to be a person mowing the lawn, a child with high functioning autism may pretend to be the lawnmower.
Likely to Be Anxious
There is a correlation between high levels of anxiety and high functioning autism. In fact, researchers estimate that at least 40 percent of people on the autism spectrum have also been diagnosed with an anxiety disorder. Whether the disorder has been formally diagnosed or not, someone with high functioning autism may have a tendency to worry more than their neurotypical peers.
Knowing the Symptoms Can Help
Because of their high level of functioning, individuals with mild autism can often go undiagnosed. Knowing the symptoms of HFA at various ages can help parents, teachers, and the individuals themselves get the help they need to be at ease in a mostly neurotypical world.