High Functioning Autism
High functioning autism (formerly known as Asperger’s Syndrome) describes individuals at the most able end of the autistic spectrum who are verbal, have higher IQ’s and have the most hidden form of this disorder. As a result, these individuals are often the most disadvantaged in terms of getting a diagnosis. Because they have higher IQs, this population is able to work out ways to compensate for their limitations in communication or in social functioning that are based on logical reasoning. What makes these higher functioning individuals very difficult to identify is that their features are VERY SUBTLE so they tend to blend in pretty well and often get missed by parents, teachers and most medical professionals. Their difficulty reading and/or responding adequately to social situations is often interpreted as being “quirky”, “rude”, “selfish”, “antisocial”, “defiant”, “obnoxious” and even as “sociopathic”. Therefore, these individuals end up being marginalized and experience on-going interpersonal problems at school or in the work place. Many of these adults have difficulty maintaining long-term romantic relationships.
Recognizing these subtle tell-tale signs is important, because once they are identified we can educate people who interact with them. Awareness is key in our efforts to ensure equal rights for this population.
Here are some of the common characteristics I’ve observed in my interactions with the higher functioning autism population throughout FL (I’ve used the pronouns he or she interchangeably as an example):
1- Conversations are mostly “one-sided”. When engaging them in a conversation, notice their responses. Are they able to consistently respond to a direct question? Does their answer seem to veer off into another topic? Is their response usually off-timing? Is the conversation mostly one-sided or a “rambling” about one topic without a conversational back and forth? Does it seem like they aren’t really understanding what you’re saying or asking (poor receptive communication)? Notice the way the conversation ends. Do they drift off while you’re still talking? Is there a natural pause after their sentences or does it seem abrupt?
2- Unusual focus on a particular topic or interest. When interacting with them, do you notice that most of their conversation surrounds one particular theme or topic, i.e. planetary systems, a kind of machinery/technology, a movie or a character (often speaks like a movie character or recites movie lines verbatim), or shows other narrowed interests? Are they “experts” in a particular subject without exclusion of other topics? Another example, if you ask them to look at a photograph do they zoom in on something unusual, like an unmatching button or something out of place that most people would oversee?
3- Repetitive and idiosyncratic patterns of behavior. Is their a particular movement (i.e tapping, spinning of an object or snapping of fingers) vocal stim, utterance, grimace or posture that is predictable about the individual? Do they often do this particular behavior when engaged in a particular activity?
4- Unusual eye-contact during conversation. When speaking directly to them, are they able to engage in a normal eye-contact during conversation? Do their eyes drift off or dart around while speaking directly to them? Do they seem to not be listening to you? Do you notice a flat gaze (no emotion) while they are talking?
5- Hyper-focus and zoning out behavior. Do they often seem excessively engrossed in a particular activity to the point of appearing completely zoned out from their surroundings and environment? For instance, they are so engaged in what they’re doing they ignored a fire drill alarm or an accident nearby? If you ask them about their day, they have trouble recalling details about their day outside of what they are interested in.
6- Unusual personal hygiene. This area can be tricky, because I’ve seen both extremes. Either excessively concerned about their hygiene to an extent that is borderline OCD (spends an inordinate amount of time flossing, brushing teeth or grooming), or those who are not concerned at all. For example, wearing the same clothes for an entire week and/or go days without bathing or brushing teeth if they don’t have someone reminding them to do so. Because a high percentage of this population have sensitivity issues, many avoid new fabrics and smells and prefer the familiar feel of the same “broken in” shirt, underwear, socks, shoes and jeans. Some may dislike the smell of laundry detergent so they avoid using freshly washed clothing altogether.
7- Rigidness with routines. Does he show a dislike or aversion to any sudden changes to their environment or usual routine? Does introducing a new piece of furniture, paint color, decoration, or change in their environment produce visible anxiety or preoccupation? Do you notice or expect an “adjustment period” to new changes? Many young children respond with meltdowns or ‘tantrums’ when confronted with changes they aren’t ready for (meltdowns are typically outgrown as they get older).
8- Social anxiety or avoidance. Does she seem to not be interested at all towards interacting with others, like avoiding sleep overs, meeting new people, going to a party or social gathering? When they do attend a function, do they seem to keep to themselves? This trait seems to be less common among the more independent higher functioning population, since they have learned early on to conform and blend in, in order to maintain jobs or romantic relationships. But if given a choice, they are perfectly fine avoiding social interaction for long periods of time.
9- Flat affect. This feature is particularly difficult to pin-point for an untrained person. Especially, if the individual is higher IQ and has learned to adjust their behavior by imitation. But take a close look at their affect. It will almost always seem unnatural. The range of their facial expressions are usually very limited. Some describe it as “the eyes do not match the rest of the face”, “their expression does not match the situation”, “there is a lack of connection”, or they may appear flat or completely unemotional.
The above features are some of the most common traits I’ve observed, however this list is not exhaustive. There are many more idiosyncrasies displayed by this population and can vary greatly among gender, culture and families. If you suspect your child might be in this end of the spectrum, have them evaluated. The problem with not being identified is that the lack of knowledge from others regarding this condition can promote unnecessary prejudice and social stigma along with continuous friction at school, the work place and interpersonal relationships. This population deserves to be understood and treated equally. Call us with any questions or concerns (813) 468-6528.
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