Managing High-Functioning Autism: Challenges, Support, and Therapies

Autism is a complex disorder that presents differently in every individual. Those with high-functioning autism (HFA) often have significant support needs, despite the misleading label. While they may have average or above average intelligence, HFA comes with challenges in communication, social skills, sensory processing, and more. However, with the right support and therapies, individuals with HFA can find ways to manage their symptoms and thrive.

Managing High-Functioning Autism: Challenges, Support, and Therapies
Managing High-Functioning Autism: Challenges, Support, and Therapies

What is High-Functioning Autism?

HFA is an informal term previously used to describe people on the autism spectrum who have average or above average intelligence and language skills. It has now been replaced in the diagnostic manual with the term “Autism Spectrum Disorder – Level 1,” indicating the person requires some support.

The terminology changed because functioning labels like “high-functioning” can be misleading. Many assumed those with HFA did not need much support, but that is often untrue. Autism exists on a spectrum, with each individual experiencing different challenges and support needs. Just because someone has strong intellectual abilities does not mean they do not struggle in other ways.

Common Challenges with High-Functioning Autism

While symptoms vary, those with HFA often face difficulties in the following areas:

Sensory Processing Differences

  • Many have sensory processing disorder or sensory overload
  • Loud noises, bright lights, crowds, smells, textures can be intolerable
  • Simple tasks like wearing socks or being hugged may be challenging
  • Sensory issues persist from childhood into adulthood

Social Interaction Challenges

  • Difficulty recognizing social cues and body language
  • Struggle to understand appropriate greetings, taking turns talking, regulating voice tone
  • Leads to awkwardness making friends, dating, interviews, work meetings

Anxiety and Depression

  • Much higher rates of anxiety, depression than general population
  • Thought to be connected to social difficulties, feeling like an outsider

Executive Functioning Difficulties

  • Hard time with organization, planning, time management
  • Struggle with chores, schedules, grocery shopping, long-term projects

Emotional Regulation Issues

  • May overreact or underreact to situations
  • Difficulty coping with change, transitions, unpredictability
  • Outbursts or shutdowns when routine is disrupted

Communication Challenges

  • Issues with pragmatic language like metaphors, sarcasm
  • Trouble having back-and-forth conversations
  • May struggle to speak when overwhelmed

While some manage these issues well day-to-day, they can make school, work, and relationships more challenging for many. But with the right support, individuals can find ways to manage their symptoms and live full lives.

Getting Diagnosed With HFA

Diagnosis often begins in childhood, but many adults go undiagnosed into adulthood. Getting an autism assessment as an adult involves:

  • Finding a provider experienced in adult autism diagnoses
  • Filling out questionnaires about your traits and behaviors
  • Having someone who knows you well fill out additional forms

If formal diagnosis is inaccessible, self-diagnosis is becoming more accepted in the autism community.

Seeking Support for High-Functioning Autism

After an autism diagnosis, it’s important to determine what supports are needed for daily life. Some with HFA may not need much outside assistance. But many benefit from help with things like:

  • Budgeting and finances
  • Household chores and cleanliness
  • Hygiene and personal care
  • Appointments and schedules
  • Finding and maintaining employment

An autistic person’s support needs may also change over time. During major life changes or times of stress, they may benefit from increased support, even if they usually function well day-to-day.

It’s crucial that individuals with HFA have a care team involving medical, mental health, and other providers. Co-occurring conditions like anxiety, depression, and gastrointestinal disorders are common and need treatment. Therapies like speech and social skills training can also help manage HFA symptoms.

Most importantly, having loved ones provide support through the ups and downs of autism is invaluable. They can encourage the person to ask for help when needed and provide reassurance that needing more support temporarily does not negate their abilities.

Finding the Right Therapies for Managing HFA

Evidence-based therapies tailored to the individual’s needs are key to helping those with HFA manage challenges. Some options to consider include:

Applied Behavior Analysis (ABA) Therapy

ABA helps reinforce positive behaviors and skills. It can teach:

  • Communication and social skills
  • Coping strategies for anxiety
  • Organizational and planning abilities
  • Self-care and daily living skills

Speech Therapy

Improves verbal and nonverbal communication skills. Targets things like:

  • Conversation abilities
  • Understanding idioms, sarcasm
  • Regulating tone, volume of voice
  • Coping with speech difficulties when overwhelmed

Occupational Therapy

Helps with sensory issues, motor skills, organization:

  • Develops methods to deal with sensory overload
  • Works on fine/gross motor skills
  • Teaches organizational habits
  • Improves focus and emotional regulation

Social Skills Training

Teaches social interaction and behavior skills:

  • Making eye contact and reading body language
  • Understanding social etiquette
  • Building interpersonal skills
  • Learning coping strategies for social settings

Cognitive Behavioral Therapy (CBT)

Helps manage anxiety, depression, and build confidence:

  • Identifies negative thought patterns
  • Develops healthy coping strategies
  • Works through social anxiety sources
  • Builds self-esteem and self-advocacy

Finding the Right Therapies for Your Child

If your child has recently been diagnosed with high-functioning autism, finding the right therapies can seem overwhelming. But support and treatment can make a world of difference in helping them thrive.

In-Home ABA Therapy in Maryland

Jade ABA Therapy provides customized in-home ABA treatment in Maryland tailored to your child’s needs. Their experienced therapists focus on building communication, social, and life skills to set your child up for success.

Get started with world-class, compassionate ABA therapy that will help your child flourish. Jade ABA’s outstanding therapists are dedicated to empowering your child. Contact them today to learn more about how they can help your family.

Get In Touch

Phone: (410) 616-0901 Email:

With the right support, those with high-functioning autism can find ways to manage their challenges and live fulfilling lives. While symptoms may persist, therapies and treatment equip individuals and families with the tools to overcome obstacles. Each person’s needs are unique, but with compassion and encouragement, a bright future is possible.


  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington DC: 2013.
  2. National Institute of Mental Health. Autism Spectrum Disorder.
  3. Schevdt S, Needham I. Possible signs of sensory overload. Psychiatr Prax. 2017 Apr;44(3):181-183. doi:10.1055/s-0042-118988
  4. Lake JK, Perry A, Lunsky Y. Mental health services for individuals with high functioning autism spectrum disorder. Autism Res Treat. 2014;2014:502420. doi:10.1155/2014/502420
  5. The Adult Autism Center. Autism and executive function.
  6. Asperger/Autism Network (AANE). Asperger profiles: Emotions and empathy.
  7. National Institute on Deafness and Other Communication Disorders. Autism Spectrum Disorder: Communication Problems in Children.
  8. University of Washington. Self-diagnosis-friendly resources and communities.
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