Introduction
High-functioning autism (HFA) is a subcategory of autism spectrum disorder (ASD) characterized by high levels of preserved cognition and language skills. Although not formally recognized as a distinct nosological entity in classifications such as DSM-5 and ICD-11, HFA represents 10% of ASD diagnoses, according to international studies. Understanding the psychological and neurophysiological specificities of HFA is essential to improve diagnostic accuracy, avoid therapeutic errors and optimize clinical support.
Methods
A systematic literature review was conducted using databases such as PubMed, MedLine, and the Scientific Electronic Library. The main search terms included “HFA,” “Asperger syndrome,” “ASD,” “diagnosis,” and “speech disorders.” In total, 42 relevant articles were analyzed, covering national and international research. The study evaluated differences between HFA, Asperger syndrome, and other ASD subgroups.
Results
Individuals with HFA have distinct developmental profiles. They have peculiar social interactions, often formal and limited to specific interests. Despite greater cognitive and linguistic abilities, difficulties in understanding social norms and in empathic communication are common. Neurophysiologically, accelerated maturation of brain electrical activity is observed in children with HFA, with distinct patterns in alpha frequency and increased beta-2 activity, indicative of possible alterations in the excitatory-inhibitory balance. In addition, sensitivity to environmental changes and resistance to flexibility are striking behavioral characteristics.
Discussion
The diagnostic challenges of HFA arise, in part, from the lack of specific tools for early identification of social deficits. Widely used methods, such as ADOS-2 and ADI-R, although effective for ASD in general, have limitations in detecting HFA peculiarities. More sensitive instruments, such as scales for Asperger syndrome (e.g., ASDS, GADS, KADI), have demonstrated greater diagnostic accuracy. The absence of cognitive and linguistic delays and greater social adaptability distinguish HFA from other forms of ASD, but also hinder its early clinical recognition.
Integrated Conclusion
Although HFA is not considered a formal subcategory of ASD, its psychological, behavioral, and neurophysiological particularities justify greater attention in clinical assessment and management. The development of specific diagnostic tools and adapted interventions is essential to optimize therapeutic and pedagogical support, promoting better outcomes for individuals with HFA.
Reference :
Danilina, KK, & Salimova, KR (2024). High-Functioning Autism and its Understanding in Modern Literature. Autism and Developmental Disorders, 22(4), 4–12. DOI: 10.17759/autdd.2024220401.
