This checklist lists the various differences in function often associated with high functioning autism. That said, the term “high functioning” is one that now considered problematic for a variety of reasons. This is what you need to know to get started.
Is The Term High Functioning Autism Offensive?
When my son was first diagnosed as being on the autism spectrum, the term “high functioning” was used to describe him. This was just after the DSM-V eliminated the Asperger’s diagnosis entirely and instead diagnosed all children meeting the criteria as having Autism Spectrum Disorder.
The high functioning label was used by his developmental pediatrician to demonstrate that he was well within normal range for intellectual function and was also verbal. We used it ourselves for the first few years, until members of our autism community began to express concerns over it’s validity.
The general concern is that once given the correct support and accommodations (often a keyboard or another means of communication), many people described as “low-functioning” on the autism spectrum become able to communicate quite effectively.
Just as the abilities of someone classified as “low-functioning” have been drastically underestimated, the reality is that so-called “high-functioning” autistics have also been underestimated and therefore under-supported.
While we no longer use the label “high functioning” in my home, I do understand the need to better understand if you, or your child, may be headed for an autism diagnosis. With this in mind, I have put together the following checklist of what are typically considered to be traits of autistic individuals within the realm of “high functioning.”
Autistic people, including those considered high-functioning, often display a wide range of differences across a variety of circumstances. In order to receive an autism diagnosis, a person must have difficulties with each of the following:
Differences In Nonverbal Communication
An autistic person may struggle with understanding another’s body language, identifying nonverbal cues, eye contact, or making “typical” facial expressions.
Differences with social and emotional reciprocity
Autistic people typically display differences in social and emotional reciprocity. This means they may struggle to initiate or respond to communication. Reciprocal communication (i.e. going back and forth in conversation) can be a struggle. They may also face challenges in speaking about non-preferred topics.
Contrary to unfortunate popular belief, this has nothing to do with empathy or the ability to empathize! Research has shown that austic individuals may even be hyper-empathtic.
These differences in communication have to do with the neurodiversaity of the autistic brain and not a lack of concern for others.
Social and Relational Challenges
Autistic children may show little interest in imaginary play. Autistics of all ages may have great difficulty fitting in with others and forming lasting friendships/relationships.
In order to be diagnosed as on the autism spectrum a person must also have at least two of the following four differences:
- Stereotyped or repetitive behaviors or interests: Intensely fascinated with certain objects or topics, repeat things people say, have verbal or motor tics, or engage in repetitive movements.
- An intense need for routine and consistency: Engage in rituals that seem obsessive or compulsive, struggle with change and transitions more than is typical for someone their age, and struggle to manage even minor adjustments.
- Restricted and intensely focused interests in specific topics: Avid collectors, ability to memorize long strings of facts, and be unable to stop talking about a very specified range of subjects.
- Differences in sensory processing: Sensitive to sensory input, such as loud noises or scratchy clothing textures. Or displays muted sensory reactions, not noticing when things are very loud or distracting.
While this is the overall criteria, the following checklist has practical examples of these things in practice to help you better understand whether or not an autism diagnosis may be appropriate.
High Functioning Autism Checklist (underlying characteristics)
1. Visual Differences
- Avoids eye contact
- Displays discomfort/anxiety when looking at certain pictures (e.g., the child feels as if the visual experience is closing in on him)
- May engage in intense staring
2. Auditory Differences
- Covers ears when certain sounds are made
- Seems unable to focus when surrounded by multiple sounds
- May display extreme fear or discomfort when unexpected noises occur
- Purposely withdraws to avoid noises
- Conversely, may seek loud, consistent noises as a calming technique (i.e. child falls asleep with the vacuum noise)
3. Differences In Smell
- Recognizes smells before others
- Has a good memory of past smells
- May easily become nauseated over overpowering or unpleasant smells
- Smells foods before eating them
- Smells materials before using them
4. Tactile Differences:
- May refuse to wear shoes or socks
- Complains of clothing being “scratchy”
- Does not respond well to unexpected touch
- Differences in response to temperature
- Does not respond to temperature appropriately
- Difficulty with clothing seams or tags
- May seemingly overreacts to pain
- May seemingly underreact to pain
- May display shower avoidance or avoid bathing (due to feel of water on skin, changes in temperature before during and after, etc..)
5. Food Rigidity And Aversions
- May not allow foods to touch each other on the plate
- Easily gags
- Rigid food preferences
- May make limited food choices
6. May display self-stimulatory behaviors including rocking, hand movements, facial grimaces
Differences in Cognition Checklist
1. Executive Function
- Difficulty with task completion
- Difficulty with initiating tasks
- May have difficulty when novel material is presented without visual support
- May experience issues with following directions
- Difficulty with organizational skills and sequencing (i.e. the order needed to complete a task)
2. Cognitive flexibility
- May display rigid thinking
- May show intense restricted interests
Differences in Gross Motor Skills
- May display an awkward gait
- Difficulty throwing or catching a ball
- Difficulty coordinating different extremities inlcuding shoe tying and bike riding
- Poor balance
Fine Motor Skills Differences
- Difficulty with handwriting/cutting/coloring skills
- May have an unusual pencil/pen grasp
- Difficulty applying sufficient pressure when writing, drawing, or coloring
- May be prone to intense anxiety
- May be more likely to struggle with mental health
- May show emotional responses that seem out of proportion to the situation,
- Inability to prevent or lessen extreme behavioral reactions
- Perseverative/rigid/ritualistic behaviors or preoccupation with area of special interest
- Meltdowns, including crying, aggression, and even property destruction
After looking over this checklist, if you find many of the signs and symptoms listed apply to your situation, please, let me encourage you. This list of differences is an overview and intended only to help inform your next steps.
The beauty of neurodiversity is that no one checklist could possibly list everything you need to know about an individual, no matter what their differences. Moreover, this checklist does nothing to list the overwhelmingly wonderful qualities every single autistic person possesses.
That list would be far longer and much more beautiful.