“High Functioning Autism”; was also previously referred to as Asperger’s Syndrome. Autism Spectrum Disorder (ASD) is now the accurate term used to encompass all Autism Spectrum Disorder diagnoses. ASD is defined as a Neurodevelopmental Disorder that presents at a young stage of development (perhaps as early and reliably diagnosed by 18 months of age by a psychologist or related professional). The causes or origins of ASD are believed to be exceedingly complex and multifaceted, but interactive genetic, biological, and environmental factors are believed to be implicated.
In 2013, The Diagnostic and Statistical Manual-Fifth Edition (DSM 5) reclassified all Autism diagnoses, including Asperger’s Syndrome, to Autism Spectrum Disorder. The DSM-5 is the most up-to-date manual utilized by psychologists, psychiatrists, and other mental health professionals to diagnose and understand mental disorders, including Autism Spectrum Disorders. The diagnostic shift of Autism Spectrum Disorder occurred as a result of research and practice that found ASD to be a heterogenous set of disorders that occur on a continuum of severity from Level 1 (less severe) to Level 3 (most severe). In addition to changing the categorization of ASD, the DSM-5 also refined the diagnostic criteria of ASD. Currently, the DSM-5 Autism Spectrum Disorder criteria is more restricted relative to previous definitions of the disorder.
“High Functioning Autism” was a term first used in the 1980s to refer to individuals with ASD who did not exhibit an intellectual disability. However, there have been critiques regarding the usage of this term. Psychological scholars, researchers, and practitioners have critiqued the usage of the term because it may not acknowledge another important facet of functioning- adaptive functioning.
Adaptive functioning refers to daily living skills in social, practical, and conceptual areas. Adaptive functioning from the perspective of the client or another person who can speak to the client’s behavior can be assessed with standardized measures. One example of a commonly used standardized measure is the Adaptive Behavior Assessment System-3 (ABAS-3). Even though cognitive functioning and adaptive functioning tend to be positively associated with one another, among individuals with ASD, adaptive functioning scores tend to be lower than cognitive functioning scores (Duncan & Bishop, 2013). So although an individual diagnosed with Autism Spectrum Disorder may exhibit average or higher cognitive abilities, they/she/he may exhibit deficits in everyday functioning (e.g., deficits in nonverbal communication; deficits in navigating or adapting to new environments). In fact, one study found that among individuals diagnosed with ASD, cognitive functioning was not a significant predictor of adaptive functioning (Alvares et al., 2020). Large gaps between cognitive and adaptive functioning existed even among individuals with ASD who did not have an intellectual disability.
Thus, although assessing for cognitive abilities is often helpful in an ASD evaluation , it is important for a psychologist to also assess adaptive functioning. It is beneficial to incorporate additional raters and perspectives (such as a relative, teacher) to provide broad insight into a client’s adaptive functioning. In doing so, a more complete diagnostic picture can be provided. With an accurate diagnostic impression, a provider can provide an individualized treatment plan, recommendations, and prognosis.
ICPS doctoral psychologists and therapists offer Autism testing and evaluations (including the ADOS-2 and adaptive functioning assessments). We also offer ABA therapy for Autism Spectrum Disorder among children, teens, and adults.
References
Alvares GA, Bebbington K, Cleary D, et al. The misnomer of “high functioning autism”: Intelligence is an imprecise predictor of functional abilities at diagnosis. Autism : the International Journal of Research and Practice. 2020 Jan;24(1):221-232. DOI: 10.1177/1362361319852831.
Duncan, A. W., Bishop, S. L. (2013). Understanding the gap between cognitive abilities and daily living skills in adolescents with autism spectrum disorders with average intelligence. Autism, 19, 64–72.
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