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High-functioning autism

Historical autism classification

Field	Value
name	High-functioning autism
synonyms	Sukhareva syndrome
field	Psychiatry
symptoms	Trouble with social interaction, impaired communication, restricted interests, repetitive behavior
complications	Social isolation, employment problems, family stress, bullying, self-harm
onset	By age two or three
duration	Lifelong
causes	Genetic and environmental factors
diagnosis	Based on behavior and developmental history
differential	Asperger syndrome, attention deficit hyperactivity disorder, Tourette syndrome, anxiety disorder, bipolar disorder, obsessive–compulsive disorder, major depressive disorder
management	Behavioral therapy, speech therapy, psychotropic medication

High-functioning autism (HFA) was historically an autism classification to describe a person who exhibited no intellectual disability but otherwise showed autistic traits, such as difficulty in social interaction and communication. The term was often applied to verbal autistic people of at least average intelligence. However, many in medical and autistic communities have called to stop using the term, finding it simplistic and unindicative of the difficulties some autistic people face.

HFA has never been included in either the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) or the World Health Organization's International Classification of Diseases (ICD), the two major classification and diagnostic guidelines for psychiatric conditions. The DSM-5-TR subtypes autism into three levels based on support needs. Autism Level 1 has the least support needs and corresponds most closely with the "high-functioning" identifier.

Characterization

The term "high-functioning autism" was used in a manner similar to Asperger syndrome, another outdated classification. The defining characteristic recognized by psychologists was a significant delay in the development of early speech and language skills, before the age of three years. The term Asperger syndrome typically excluded a general language delay. Other differences were noted in features of high-functioning autism and Asperger syndrome in a study of 112 children in Germany.

HFA is not a recognised diagnosis by the American Psychiatric Association or the World Health Organization; however, HFA was previously used in clinical settings to describe cases of autism spectrum disorder where indicators suggested an intelligence quotient (IQ) of 70 or greater.

Comorbidities

Main article: Conditions comorbid to autism

With the notable exception of intellectual disabilities, which were not part of HFA, comorbidities found in HFA populations reflected those found in autism. (Between 40 and 55% of individuals with autism also have an intellectual disability.) Studies that looked specifically at HFA have examined anxiety, bipolar disorder, Tourette syndrome, attention deficit hyperactivity disorder (ADHD), and obsessive–compulsive disorder (OCD). Both HFA and OCD have abnormalities associated with serotonin.

References

(August 2015). "Sukhareva – Prior to Asperger and Kanner". Nordic Journal of Psychiatry.
"Autism spectrum disorder - Symptoms and causes".
(October 2016). "NIMH " Autism Spectrum Disorder".
American Psychiatric Association. (2013). "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)". American Psychiatric Publishing.
"“ Autism and depression are connected: A report of two complimentary network studies”".
(November 2007). "Management of children with autism spectrum disorders". Pediatrics.
(15 December 2016). "Autism Spectrum Disorder: Primary Care Principles.". American Family Physician.
(November 2013). "Cognitive-behavioral therapy for anxiety in children with high-functioning autism: a meta-analysis.". Pediatrics.
(2009). "Qualitative or Quantitative Differences Between Asperger's Disorder and Autism? Historical Considerations". Journal of Autism and Developmental Disorders.
(2009). "Asperger's Syndrome and High-Functioning Autism". Pediatric Annals.
(August 25, 2024). "Making information and the words we use accessible".
Price, Devon. (April 5, 2002). "Unmasking Autism: Discovering the New Faces of Neurodiversity". National Geographic Books.
Coffey, Laura T.. (August 13, 2021). "Autism glossary: What to say, and what not to say, when talking about autism".
(March 18, 2022). "The Diagnostic and Statistical Manual of Mental Disorders". American Psychiatric Association (APA).
[http://behavenet.com/aspergers-disorder Asperger's Disorder] {{webarchive. link. (2013-04-25 – ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' Fourth edition Text Revision (DSM-IV-TR) [[American Psychiatric Association]] (2000))
(2007). "The Epidemiology of Autism Spectrum Disorders*". Annual Review of Public Health.
(2011). "The treatment of anxiety symptoms in youth with high-functioning autism spectrum disorders: Developmental considerations for parents". Brain Research.
(2012). "Psychiatric comorbidities in asperger syndrome and high functioning autism: Diagnostic challenges". Annals of General Psychiatry.

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