High functioning autism, also known as high functioning autism spectrum disorder (HFASD), refers to individuals who have autism but have average or above average intelligence and relatively good language and cognitive skills. HFASD is not a formal diagnosis, but a term used to describe individuals on the higher end of the autism spectrum. Whether high functioning autism is considered a disability is a complex question with varied perspectives.
Definition of Disability
According to the Americans with Disabilities Act (ADA), a person with a disability is defined as someone who has a physical or mental impairment that substantially limits one or more major life activities, has a record of such an impairment, or is regarded as having such an impairment. Major life activities include, but are not limited to, caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.
So whether high functioning autism is considered a disability depends on the degree to which it substantially limits major life activities for that individual. There is a wide spectrum of challenges and abilities within HFASD. Some individuals may have no significant limitations, while others may be profoundly challenged in their ability to communicate, socialize, or care for themselves independently.
Perspectives on HFASD and Disability
There are several major perspectives on whether high functioning autism constitutes a disability:
Medical Perspective
The medical community generally views HFASD as a developmental disability. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies autism spectrum disorder (ASD) as a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction across multiple contexts. Even for those without intellectual impairments or language deficits, these social communication challenges may substantially limit major life activities under the ADA definition.
Social Perspective
From a social model perspective, disability arises from barriers created by society, not solely from a medical condition. While autism presents certain innate challenges, many of the limitations faced by autistic individuals come from lack of acceptance, discrimination, inaccessible environments, and lack of accommodations. Proponents argue that identifying HFASD unconditionally as a disability perpetuates stigma and fails to recognize societal barriers.
Identity-First Perspective
Many autistic self-advocates and allies prefer identity-first language such as “autistic person” rather than “person with autism.” This grounds autism as an inherent part of their identity, not anconditional trait. From this viewpoint, HFASD may confer challenges but is not considered a disability.
Legal Perspective
Legally, HFASD may be considered a disability if it substantially limits major life activities, enabling access to accommodations and services under disability laws like the ADA or IDEA. However, some argue broader autism rights issues are sometimes overlooked by focusing solely on legal definitions and qualifications.
Factors Impacting Disability Classification
Several factors influence whether HFASD is disabling for a given individual:
| Factor | Description |
|---|---|
| Functional abilities | Abilities related to communication, social skills, self-care, and living independently. Significant deficits may indicate disability. |
| Co-occurring conditions | Many have additional conditions like ADHD, anxiety, OCD that compound challenges. |
| Cognitive abilities | Some have intellectual disability, while others have normal to high IQ. |
| Sensory issues | Sensitivities to light, sound, etc. may limit activities. |
| Life stage | Needs and challenges often change over one’s lifespan. |
Generalizations about disability are difficult, given this heterogeneity within the HFASD population. The same individual may be disabled in some settings or life stages, but not others, based on the interactions between their abilities and environment.
Social Communication Challenges
Core deficits in social communication and interaction are hallmarks of ASD at all points on the spectrum. For those with HFASD, these may manifest as:
Difficulty with Social Cues
Reading subtle verbal and nonverbal social cues like facial expressions, body language, and tones of voice may be challenging. As a result, individuals may struggle to understand others’ perspectives.
Trouble Building Friendships
Many autistic individuals have difficulty making age-appropriate friendships and communicating reciprocally. They may have few friends or prefer solitary activities.
Problems with Conversation Skills
Conversational abilities vary, but some have trouble initiating or maintaining back-and-forth exchanges. One-sided conversations focused on special interests are common.
Difficulty Empathizing
Reading and responding to others’ emotions in socially expected ways may be challenging and contribute to relationship difficulties.
Discomfort with Eye Contact
Sustained eye contact often feels uncomfortable. Lack of eye contact may be perceived as odd or rude by others.
For some higher functioning individuals, these social struggles are significant enough to impact relationships, academics, employment, and other areas—potentially rising to the level of disability if they substantially limit major activities.
Behavioral and Emotional Challenges
In addition to social difficulties, common behavioral and emotional features associated with HFASD include:
Fixated Interests
Many autistic individuals have special interests they focus on intently. These affinities provide enjoyment but can be all-consuming.
Rigid Routines
Devotion to daily rituals and resistance to change is common. Interruptions can cause significant anxiety or tantrums.
Repetitive Behaviors
Repetitive motor behaviors like hand flapping, lining up objects, and echolalia provide comfort. But they may be misunderstood by others.
Sensory Sensitivity
Irritation to certain sounds, textures, smells, etc. is common. Public settings with noise and crowds may be overwhelming.
Emotional Dysregulation
Some struggle to identify and regulate their own emotions appropriately. This can manifest as emotional outbursts.
Coping with these behavioral challenges day-to-day places extra demands on individuals and families. In some cases, behaviors significantly disrupt home, school, or work life.
Assessment of Disability
There is no single way to conclusively categorize HFASD as a disability or not. Each individual’s skills and challenges are unique. Reputable diagnosticians assess disability on a case-by-case basis through:
Developmental History
Reviewing one’s developmental and medical history helps establish symptom patterns.
Interviews
Speaking to the individual and close contacts (parents, teachers, etc.) provides insights on functioning.
Observations
Directly observing social interactions and behaviors in natural settings provides diagnosticians context.
Standardized Testing
Tests help evaluate cognitive skills, adaptive functioning, communication abilities, and more.
These tools help determine specific areas of difficulty that may qualify as substantially limiting under the law and require accommodation and services.
Treatment and Therapy Options
Regardless of disability classification, individuals with HFASD have options to help maximize strengths while minimizing challenges. These include:
Behavioral Interventions
Applied behavior analysis uses positive reinforcement to improve behaviors and communication. Social skills groups also help.
Assistive Technology
Devices like tablets can provide visual schedules, communication aids, and tools for emotional regulation.
Targeted Therapies
Physical, occupational and speech therapies address needs like motor skills and sensory issues.
Medications
Medicines may help manage co-occurring anxiety, depression, OCD, ADHD, sleep disturbances or aggression.
Educational Support
Individualized instruction, aides, speech services, and positive behavior support can provide help at school.
Workplace Accommodations
Adjustments to environments, schedules, communication, and sensory inputs help employees succeed.
Implementing personalized therapies, services, and supports—whether at home, school, or work—allows those with HFASD to thrive.
Legal Rights and Disability Status
Understanding the legal rights afforded individuals with disabilities helps clarify what is at stake in designating HFASD as a disability. Laws like the Americans with Disabilities Act (ADA) and the Individuals with Disabilities Education Act (IDEA) provide certain protections and entitlements to services for those with a diagnosed disability that substantially impacts functioning.
Qualifying individuals have the right to:
- Access free and appropriate special education services at school
- Receive early intervention services for ages 0-3
- Get reasonable accommodations at work
- Gain physical access to buildings and transportation through mandated accessibility
- Be free from discrimination in employment, education, and access to services
- Access government services and programs for people with disabilities
For those with HFASD who face substantial challenges in major life activities, securing appropriate accommodations and services often hinges on having their disability legally recognized. But diagnosis and eligibility processes can be complex.
Challenges Accessing Services
Some report difficulty getting schools, workplaces, and government agencies to provide legally mandated accommodations. Reasons include:
- Normal or high IQ scores reducing perceived need
- Lack of self-advocacy skills
- Poor understanding of HFASD by institutions
- Communication difficulties proving challenges
- Spotty access to knowledgeable diagnosticians
Advocacy by individuals, family members, and care providers helps ensure services are delivered appropriately.
Controversy Around Autism as a Disability
There are conflicting opinions within the autism community about whether autism should be framed as a disability requiring cure or accommodation, or simply a natural human variation.
Arguments Against Disability Model
Opponents of the disability narrative argue:
- It promotes stigma around autism
- Interventions try to make autistic people “normal” rather than accepting differences
- It overlooks barriers created by lack of societal acceptance and accommodation
- Autism confers positives as well challenges
- Language should reflect identity, not medical condition
Arguments for Disability Model
Proponents of the disability model contend:
- It’s a medical fact that autism causes disability for many people
- Services and support systems depend on recognizing disability
- Acknowledging disability does not negate individual strengths
- Everyone has a right to access tools needed to thrive in society
- It’s a matter of access, not identity
In practice, most believe a balance is needed between honoring neurodiversity and providing resources based on individual needs.
Conclusion
Whether high functioning autism is considered a disability rests on individual factors like cognitive skills, functional abilities, and co-occurring conditions. While autism confers social, communication, and behavioral challenges for all, the extent to which these pose substantial limitations varies greatly. A personalized approach is needed for each person.
For those significantly impacted in major life activities, framing HFASD as a disability can help ensure appropriate accommodations and access to services. But for those more mildly affected, the disability label risks promoting harmful stigma. Perspectives from the medical community, disability advocates, educators, and self-advocates each provide important insights on how to best support individuals across the spectrum.
The autism community remains divided on many complex issues related to autism as an identity versus disability. But most agree that respecting each individual’s strengths, needs, and desires—regardless of functioning level or formal diagnosis—is paramount. With the right supports, the vast majority of those with HFASD can live happy, fulfilled lives integrated in their communities.