4 Challenges and 4 Strengths in High-Functioning Autism

High-Functioning Autism

Autism Spectrum Disorder (ASD) is characterized by the presence and degree of symptoms that affect how a person communicates, interacts with others, learns, and engages in repetitive and restricted behaviors. The 2020 Community Report on Autism, funded by the CDC, found that 1 in 54 children were diagnosed with Autism Spectrum Disorder in 2016, which is an increase from the 1 in 59 cases found in previous years.

Children and adults with more severe ASD usually have intellectual impairments and difficulty functioning independently. Those on the other end of the spectrum—high-functioning autism (HFA), which used to be referred to as Asperger’s syndrome—tend to have milder symptoms. As children, they may be integrated into some mainstream classes at school, and into the workforce as adults.

Most cases of ASD are diagnosed around age 3 when certain milestones, such as speech and social development, haven’t been met or have regressed. However, with HFA, research has found that most are diagnosed later in childhood, between the ages of 7 and 9. While it is often thought that the greater awareness about ASD we now have contributes to early detection, decades ago that was not the case. At that time, the kids and adults with HFA might have just been thought of as quirky, awkward, or eccentric—but now we know so much more.

4 Common Challenges in High-Functioning Autism

While symptoms can manifest in varying degrees, the more common challenges in HFA are:

  1. Deficits in social interactions: This can include discomfort with eye contact, lack of reciprocal conversation, and difficulty with non-verbal communication such as understanding body language and social cues. They may also have a harder time making friends due to these challenges.
  2. Dislike of change: Those with HFA like predictability and routine and tend to develop repetitive habits. Consequently, they can become very upset when unexpected change happens, or something interferes with their preferred set pattern of behavior.
  3. Restricted areas of interest: They tend to be very focused—even fixated—on specific ideas or subjects. While the narrowness of their interests can be limiting, their ability to focus on a particular topic can be extraordinary.
  4. Sensory sensitivities: It’s not unusual for people with any form of ASD to be sensitive to sensory input. They may find certain smells, noises, tastes, light, and touch to be overwhelming or uncomfortable. When exposed to them, it can be very stressful and upsetting.

4 Awesome Strengths in High-Functioning Autism

Despite the challenges, people with high-functioning autism often have several identifiable strengths too. Among them are:

  1. Strong ability to concentrate: Those with HFA tend to develop special interests and can devote long periods of time to learning about them. They can stay very focused to the point that their knowledge can be channeled into vocations that they enjoy and that benefits others.
  2. Higher intelligence: Many people with HFA are really smart and have a great memory along with a strong vocabulary and ability to think visually. This helps them to think outside the box and be creative problem solvers.
  3. Honest and accepting: They’ll be honest and tell you the truth. Those with HFA see through pretense. They are not judgmental, prejudiced, or manipulative, and they accept others just as they are.
  4. Very reliable: They tend to have a lot of integrity and be very conscientious. People with HFA are very dependable, and their uncanny focus helps them follow-through with commitments and promises.

These strengths—and others—can be very helpful in finding meaningful work in specialized fields. Consider, for example, the contributions of these 3 high-functioning people who were diagnosed with autism in childhood:

  • Satoshi Tajiri was fixated on arcade games and became the creator of POKEMON.
  • Comedian Dan Aykroyd’s obsession with the paranormal led him to write and star in the blockbuster movie,
  • Temple Grandin, Ph.D., author and professor of Animal Science at Colorado State University, whose ability to “think in pictures” and empathy for animals led to the development of more humane livestock equipment.

Co-existing Conditions with High-Functioning Autism

As with all mental health disorders, the earlier a person with HFA (or anywhere on the autism spectrum) is diagnosed and begins treatment, the better the opportunity for living a more fulfilling life. Because the repetitive, sensory, and social issues are often the focus of early interventions, it’s important to know that these folks may also have other conditions that might be contributing to their symptoms and behavior. It is not unusual for them to also have ADHD, anxiety, obsessive-compulsive tendencies, inflammation, or abnormal activity in certain areas of the brain.

As with all mental health disorders, the earlier a person with autism spectrum disorder is diagnosed and begins treatment, the better the opportunity for living a more fulfilling life. Click To Tweet

SPECT imaging is very useful for assessing overall brain function and identifying the blood flow patterns related to a person’s symptoms. So, even if there is already a diagnosis of HFA or ASD, knowing what else is going in in the brain can lead to recommendations for issues that might otherwise be overlooked. By including this technology in an evaluation, a more comprehensive treatment plan can be created that optimizes a person’s brain to improve function so they can minimize their HFA-related challenges and capitalize on their strengths to be even more awesome.

Autism spectrum disorder and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever, and waiting until life gets back to “normal” is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.


  1. How to deal with when you appear to have 2 in class. One loves to sing at a low tone consistently.

    Comment by Janet — April 5, 2021 @ 3:08 AM

  2. I work with autism everyday and this information is priceless for adults with these challenges. I can see how many children have been wrongly treated just as dificilt without the right tools. This information must be shared. I did in my FB page

    Comment by DEBBIE M TORRELLAS — April 5, 2021 @ 3:44 AM

  3. Thank you, Dr. Amen and team. Do you have any insight into a developing cluster of symptoms on the autism spectrum defined by some as Pathological Demand Avoidance? We are trying to support a family member with this cluster of symptoms. Thank you.

    Comment by Sharon D — April 5, 2021 @ 4:31 AM

  4. You guys are v expensive:(

    Comment by Nermeen — April 5, 2021 @ 5:11 AM

  5. Good information

    Comment by Bob Foster — April 5, 2021 @ 6:54 AM

  6. My 23 year old son who has HFA is a patient at the Costa Mesa Amen Clinic and we’ve had a positive experience. My son has grown over these last 10 months! We have talked with his Amen doctor about my son receiving the Covid vaccine. His doctor shared that he “does not know of any credible evidence that it will have a negative impact on the brain.” My son and I accept this, and we understand that there is much to still learn about the effects of the vaccine — no one can offer any absolutes — an we will continue to read and weight the risks against the benefits. Can Dr. Amen offer additional input to address our concerns, specifically the risks of getting vaccinated or not versus the benefits of getting vaccinated or not? Thank you for your continued support! We are grateful for our Amen doctor and experience!

    Comment by Michelle Vergara — April 5, 2021 @ 9:00 AM

  7. Although it is important to provide non-enabling guidance to even people labeled as “High Functioning Autistics” for their own good and for those around them. It is good to provide accurate information so as not to give HFA’s a false sense of their skills, intelligence and “truthfulness” (they are NOT known to tell the truth – they are Blunt- there is a HUGE difference between the two; they do not have insight in which to tell the “truth” due to Theory of Mind where they think Everyone thinks exactly like they do, in which their brains have a very Big filter. Our societies while Well Meaning, want to provide an Awesome report or research results, we do a HUGE disservice to this community by Not telling the TRUTH of what we know, and worst yet, we teach/train this community to where Masks to conform to our view of what is valuable. Ask an adult HFA about “the Mask” and how detrimental it is to them. They cannot be who they are. It is very Psychologically damaging.

    Comment by jo brown — April 5, 2021 @ 9:03 AM

  8. Whomever wrote this article for Amen Clinics missed the mark. “HFA’s”, due to their Autism are Not reliable. They are offensive, judgmental and not accepting in their social interactions. They have Brain moderate to severe Brain Dysfunction.

    Comment by Ann Rose — April 5, 2021 @ 9:50 AM

  9. Thanks for this great article. Do you have sample SPECT images of an ASD brain vs. a typical brain? I have seen these images for dyslexia and ADHD students.

    Comment by Dianne Silver — April 5, 2021 @ 11:00 AM

  10. Hello Michelle, thanks for reaching out. Dr. Amen and Tana both have received the COVID vaccine. There is video on our YouTube channel where they address why they decided to get which might help answer some of your questions: https://youtu.be/u9ZhS_v6Az4

    Comment by Amen Clinics — April 5, 2021 @ 2:06 PM

  11. Hi Rose Ann, I am truly sorry for your encounters from those who have given you cause for your experiences. I Assure you would not have anything like those negative encounters with me being an HFA. I have my own business for most of my adult working life, have saved eight lives,fixed two different PTSD issues, shut down 78 drug houses selling drugs to children, and my business has operated for 23 1/2 years without one single complaint filed for any reason to any HOA,state agencies or to my insurance by a customer. I am not perfect but I resolve my life from every aspect possible by being conscious.

    Comment by Christopher — April 7, 2021 @ 6:07 PM

  12. Functioning levels are no longer used. Your terminology of High Functioning autism is outdated and problematic. When you label someone “High Functioning” they are then often denied the support they might need because you said that they function just fine. It is a spectrum and we all often move up and down that spectrum depending on circumstances, sensory loads, and the amount of masking we are required to do. There are many times when I am functioning at say a level 1 autism, but due to stuff in my world and the pressures of living in a neurotypical world I may slide up to a level 2 and need more support. Then there are times when the energy it costs me to mask and function in that neurotypical world pushes me to level 3 where I go into shut down and just don’t function or communicate well or meltdown. Therefore, if you see me when I am either masking really well or in a great spot in my life, you could label me as high functioning, limit the support I am allowed, and convincing family and my support circle I don’t need their help, but then the shit hits the fan and I need a lot more support and you have cut me off from my support because no one will believe me.
    You are also, passing judgment on those who have higher support needs as being “Low Functioning” and unable to learn or do anything. The thing is that I have had encounters with such individuals labeled as non-verbal, and they are able to communicate verbally with me as a fellow autistic. Neurodivergent people speak a different language and yet we are expected to conform to neurotypical speech and social patterns. When you put neurodivergent people in a room with no NTs, we all communicate perfectly fine. We also socialize comfortably and in our own way. It is only when you put NTs into our midst do we struggle with socialization and communication. There have been some awesome studies done in the UK showing this to be true also. Maybe the only thing that is a disability for us is living in a neurotypical society that keeps telling us we are broken! Please remove the FUNCTIONING LABELS as they are offensive and problematic!

    Comment by Sally — June 2, 2022 @ 2:18 PM

  13. Hey! I really find this article interesting. I'm on the high end of the spectrum and I've been learning to live with my autism ever since I found out about the diagnosis. I've been doing well, but it has been challenging at times. I've had good people teach me how to overcome some of the barriers people on my end of the spectrum face, and it's been doing me a lot of good. I don't really feel the need to "mask" much, since all the people in my life are very honest and accepting. I hope I don't ever need to mask who I am, because I want to live a fulfilling life just like everyone else on this planet.

    Comment by Cassy — January 12, 2023 @ 5:25 PM

  14. I am deeply saddened by the ableist comments made here. And whether the commenter is ND or NT is irrelevant.

    No ND person speaks for any other ND person, and the NTs need to maybe hush up and listen. We have pattern recognition, we already know what you are going to say. 🤣

    I am AuDHD. I'm not a genius, but my IQ is 142.

    I am a territory sales executive, working either in the field or from my home office. Im DAMN good at my job. I live alone and have been supporting myself for 38 years.

    I am honest, I am loyal. I bring a unique perspective to my company. I make good money.

    Do NOT suggest that ASD and ADHD people are somehow less than. That would be a terrible mistake. And maybe watch your back, a unicorn with a skill set you can only imagine may be coming to replace you. 😘

    TBH, I would 100% prefer be my AuDHD self, than any of the so called neurotypicals commenting here. You all need an education. And grammar lessons. 🙄

    Comment by Talie Rosa — June 27, 2023 @ 8:01 PM

  15. So many hateful, judgmental comments, ironically from neurotypical individuals labeling all HFAs as this or that. First of all, please stop calling autism a mental health disorder. That implies that brain could somehow be healed and a person somehow less or no longer autistic. That kind of language does not help the stigma you seem to otherwise wish to diminish.

    Comment by Dana Catherine — September 28, 2023 @ 4:09 AM

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