High- and Low-Functioning Asperger’s Explained

Elemy
Updated: January 11, 2021

⁠In the past, people might have been diagnosed as high-functioning or low-functioning Asperger’s. But Asperger’s is no longer a standalone diagnosis. What was formerly diagnosed as Asperger’s is now simply diagnosed as autism.

It’s been said that meeting one person with autism means understanding just one type of autism. Each person is different with symptoms that set them apart from the rest.

Someone with a high-functioning form of autism or Asperger’s may not display outward symptoms. Someone on the low-functioning side may show more.

No matter where you land on this spectrum, therapy can help. But the type you’ll need depends on the symptoms you show and the severity with which they alter your life.

What Difference Does a Diagnosis Make?

Asperger’s syndrome is typically associated with high-functioning autism. People with traditional Asperger’s symptoms can sometimes fit in with their peers. Sometimes, it’s difficult to tell if people with Asperger’s have autism or if they’re simply a little quirky or unusual.

For some families, looking for an autism diagnosis doesn’t make sense. They would prefer to emphasize a person’s similarities rather than pointing out the differences.

A diagnosis of autism or Asperger’s can come with real benefits, including:

Inclusion. A diagnosis can help a person come to a deeper understanding of preferences and tendencies. Sharing that could lead to less discrimination and snap judgments.
Benefits. People with low-functioning autism may qualify for special programs at school, at home, or both. They may also get clearance from insurance to participate in covered therapies.
Community. Families that understand autism are in a better position to offer meaningful support and care. A diagnosis makes that level of understanding possible.

Autism is diagnosed via observations, questionnaires, and tests. Children as young as 3 years old can be reliably diagnosed, but some people don’t find out they have Asperger’s until they are adults.

Asperger’s: Breaking Down High-Functioning & Low-Functioning Terms

It’s important to understand that no doctor will use the term Asperger’s during a diagnostic conversation. The rules have changed, and now doctors use autism spectrum disorder to discuss anyone with symptoms, including those with Asperger’s. Similarly, no doctor will use terms like high-functioning or low-functioning autism.

But families don’t always use the same terms doctors do. We use shorthand to chat with each other and make sense of technical terms that don’t come naturally. Most families know that autism occurs on a spectrum, and they know that includes a high and a low.

Asperger’s symptoms typically involve:

Limited social interactions or connections that aren’t appropriate.
Speech that seems robotic, repetitive, too loud, or too soft.
Conversations that center on one specific item and that are one-sided.
Inability to respond to body language and emotional outbursts.
Awkward or repeated movements.

The more symptoms a person has, and the more severe they are, the lower the level of functioning. The reverse is true too.

Some researchers say people with Asperger’s are different than their autistic counterparts. Those with high-functioning autism, for example, need more help with recognizing emotion than those with Asperger’s do.

It’s fine to use terms like high-functioning and low-functioning at home. It’s also fine to use Asperger’s instead of autism (plenty of other parents prefer this term). The important thing is to recognize that the person does have differences and that treatment can and often does help.

Asperger’s Therapy Options

Whether people have high or low levels of Asperger’s functioning, treatment may help. Practitioners tailor their approaches to ensure that their clients get help to overcome deficits while building up skills they lack.

Autism Speaks reports that Asperger’s therapy options include:

Cognitive behavioral therapy (CBT). Actions develop from thoughts. Changing negative ideas into positive affirmations is the goal of a CBT program. When your thoughts change, your actions quickly follow.
Social skills training. Boost conversational skills and learn how to read subtle cues like body language in these classes.
Speech therapy. Learn to control the sound and pace of your speech, and practice listening to others when they share their thoughts.
Physical therapy. Improve coordination and reduce clumsiness with the help of a professional. Sessions can also help you improve fine motor skills so you can type and write clearly.

The American Academy of Family Physicians says occupational therapy may also help people with Asperger’s syndrome. A therapist could help clients to:

Improve motor skills.
Deal with sensory overload.
Improve the ability to tackle activities of daily living.
Build school-based or work-based skills.

Psychiatric medications may also be helpful for some people with Asperger’s syndrome. They are generally used in conjunction with other therapies. A person may need medications to address:

Hyperactivity or impulsivity.
Irritability or aggression.
Ritualized behavior or compulsive thoughts.
Anxiety.

Many people with Asperger’s syndrome benefit from applied behavior analysis (ABA) therapy. Of all treatments for autism, this is the most studied option, and it’s widely considered the most effective.

ABA practitioners start with a therapeutic goal. Clients may focus on something simple, such as leaving the house properly dressed and groomed. Or they may tackle a bigger goal, such as walking into a noisy grocery store to buy food without feeling overwhelmed.

In each session, practitioners identify what trigger seems to spark unhealthy behavior. It could be loud noises, strong emotions, fatigue, hunger, or something else altogether. Then, they identify a new act to replace the malformed behavior. Drills help to practice the new action until it becomes routine and commonplace.

ABA therapy is intensive, and often, people dedicate many hours each week to sessions with their therapists. With time and practice, people with Asperger’s can make great strides with ABA techniques.

As people age, their therapeutic needs often change. For example, some people with Asperger’s develop an unusual reaction to a loved one’s emotion. They may over-celebrate a success or overlook a moment of grief. These communication difficulties can wrench relationships apart.

ABA therapy could help people to spot those emotional moments and practice appropriate responses. Kids may not need this help, but adults might. It’s important for the goals of therapy to change as the person ages and progresses in treatment.

Other Support for People With Asperger’s

Therapists, doctors, and counselors can help people with Asperger’s live a healthy and adjusted life. Sometimes, families need to add more people to the team. That’s especially true for people with low-functioning Asperger’s syndrome. They may need help to live independently.

Additional help can come via:

School. Children with high-functioning Asperger’s may not qualify for an Individualized Education Plan (IEP) and special considerations in class, but those on the low-functioning side of the spectrum might. The assistance they get in school could help lay the foundation for their ongoing education.
Work. Activists write meaningfully about the importance of a career for people with Asperger’s. A job is more than a place to visit each day. An important, rewarding career can lead to a sense of accomplishment and self-fulfillment. Colleagues can also become friends and additional sources of support. Career counselors can help to match people to the right position for their strengths.
Peers. Joining an Asperger’s support group can offer critical help. People with Asperger’s often feel alone, misunderstood, and stressed. They may feel as though they can’t be themselves without facing criticism. Talking with peers who understand them can be freeing.

Seek out all the supports that help, but avoid being formulaic. Just because one person with autism benefits from a form of therapy doesn’t mean that everyone will.

The best programs are tailored to strengths and weaknesses. Don’t follow a plan that isn’t customized.

Can Asperger’s Be Cured?

Asperger’s and other autism spectrum disorders are lifelong conditions. They start well before birth, and they persist throughout the lifespan.

The goal of Asperger’s therapy isn’t to cure the condition. That isn’t possible. Instead, therapists and technicians use their skills to ease troublesome symptoms and help people lead better lives.

The disorder will always be present, but with care, it can be easier than ever to live with. People with Asperger’s can learn to control the troubling symptoms of the disorder so they can thrive in life.