What is a High Functioning Autistic Disorder?

High-Functioning Autism, Asperger's Syndrome, Semantic Pragmatic Disorder, Attention Deficit Disorder etc.

Contrary to popular belief most people within the autistic spectrum are high-functioning individuals of average to high intelligence. All have varying levels of difficulty with instinctive social interaction, perfunctory communication and the processing of nonverbal communication, such as gestures and facial expressions, and sensory inputs, such as background noise and bright lights which many find hard to filter out.

The spectrum encompasses a wide range of diagnoses with multiple variables. Collectively they are often called Pervasive Developmental Disorders or PDDs and may be classed as:

• High Functioning Autism: HFA is the traditional diagnosis for individuals with severe social interaction and communication deficits. Although the distinction with AS is blurred and indeed AS is often considered a subset of HFA, people diagnosed with HFA tend to have a much higher Performance IQ (P-IQ) than Verbal IQ (V-IQ). HFAers tend to avoid social contact more, but are less likely to feel embarrassed in social situations, being relatively unconcerned by other people's opinions. Read the DSM-IV diagnostic criteria for autism.
• Asperger's Syndrome: This is currently the commonest diagnosis for individuals with relatively well-developed language skills but with deficits in instinctive social interaction. AS individuals find it hard to respond to nonverbal signals and social stimuli in the expected way and are often hypersensitive to some shrill sounds, bright lights or textures. Read the DSM-IV diagnostic criteria;
• Attention Deficit Hyperactivity Disorder: Often co-diagnosed with Asperger's Syndrome, ADHDers share hypersensitivity to many sensory inputs and social problems at school with AS indviduals. The condition is characterised by short attention spans and short bursts of overactivity. This contrasts with AS individuals who can, when indisturbed, concentrate on a single task for a considerable length of time. As ADHD individuals tend to exhibit greater interest in social interaction, many psychologists do not class it in the autistic spectrum. Learn more;
• Semantic Pragmatic Disorder: SPD is often considered a close relative of Asperger's Syndrome, but is often accompanied by hyperlexia and is usually diagnosed in people with high IQs who may be prone to pedanticism, have difficulties in processing figurative speech, but generally have less-pronounced social deficits than other high-functioning autistics. Learn more!.

Symptoms vary considerably too. Relative social skill deficits, resulting from an inability to glean information from the behaviour and gestures of others, often leading to difficult situations. High-functioning autistics may appear socially naïve and lack common sense. People with high-functioning autistic phenomena display varying levels of:

• Impairment of social interaction
• Impairment of communication
• Impairment of social imagination and understanding
• Difficulties in filtering out unwanted sensory inputs, such as background noise and bright lights.
• Often, but not always, difficulties with fine motor co-ordination, classed as dyspraxia or clumsiness.

These symptoms may become more pronounced, especially with the onset of adolescence. Failure to fit in with peer groups leads to further withdrawal and feelings of rejection.

There is a wide range of intellect and language skills, but even those with a good vocabulary are greatly hampered by their lack of misinterpretation of everyday social situations. The condition appears to be more common in boys than girls, although recent research suggests it may simply be easier to detect in males.

Often parents may suspect their child's unusual behaviour is casued by neurological difference, but diagnosis may be delayed as routine screening tests do not check social behaviour and nonverbal communication. Initially children may be thought to have a development language delay or hearing impairment.

The following professionals may be involved in assessment and assist in making a diagnosis or providing therapy: Health Visitor - General Practitioner - Clinical Medical Officer - Paediatrician - Psychiatrist, Psychologist (Clinical / Educational) - Speech and Language Therapist - Occupational, Therapist - Education Personnel - Music Therapist - Art Therapist.

What does this mean for those affected?

These difficulties can be both frustrating for those affected and potentially harmful. Their impaired social understanding often means they fail to understand the intricacies of everyday life, which in turn places enormous strain on carers, parents and family.

The level of impairment and its effect on everyday life varies with each individual. Progress can be made, but everyone is different and success can be intermittent.

Schooling

A referral should be made to a pre-school educational home visitor, who is a trained teacher. They will visit at home and make arrangements for play group attendance with the help of a play friend, if required.

Attendance at mainstream nursery is usual - often with time assistance of an auxiliarv. This is also arranged through the Educational Psychology Service. At nursery progress will be monitored and meetings with the professionals involved, and parents. will be held to decide on time most appropriate school placement. This mav be in a mainstream setting.

The educational service is now more aware of the special educational needs of children with ASDs and a working party and Fife Action on Autism has drawn up guidelines for teachers. Copies are available through the Auchterderran Centre. Please contact Liz Stewart on 01592 414684 or send her an e-mail.

However, alongside these social difficulties, many display an extraordinary in-depth learned knowledge of a particular subject or activity. While this is a tremendous talent, people closest to them are often frustrated to find that these interests often take over everyday life and may hinder the development of acceptable communication skills. However, with love and care many high-functioning autistic people have made valuable contributions to society, married, had kids and pursued careers based on their lifelong special interests. Read what psychologist and renowned autism specialist Tony Attwood has to say in his article The Discovery of Aspie and just consider that many historical figures such as Albert Einstein exhibited aspie-like traits (Aspie is a familiar term for a person with Asperger's Syndrome used by many diagnosed with this phenomenon).

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