Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social communication, restricted interests, and repetitive behaviours. When it comes to individuals with what was once referred to as “high-functioning autism,” the signs can be more subtle, leading to delayed diagnoses or misdiagnoses altogether. This article explores high-functioning autism symptoms that are often overlooked, focusing on early detection, the importance of intervention, and how professional support, such as VMA Psych’s counselling, ASD coaching, and behavioural services, can make a meaningful difference.

Understanding High Functioning Autism: What Does It Mean?

Although the term “high-functioning autism” is not formally recognized in the DSM-5, it is often used colloquially to describe individuals diagnosed with Autism Spectrum Disorder Level 1. This level refers to those who require support but may not present with intellectual or language impairments. As a result, their challenges can be misinterpreted as behavioural issues, mental health concerns, or simply “quirky” personality traits.

Because these individuals often excel in certain areas - such as academics, special interests, or rote memory - they can "mask" their social, emotional, and sensory difficulties, missing their needs or making them misunderstood.

High-Functioning Autism Symptoms That Are Often Overlooked

1. Subtle Social Communication Differences

While individuals with ASD-1 may appear sociable or verbally fluent, they often struggle with the nuances of social interaction. Overlooked symptoms can include:

• Difficulty understanding sarcasm, tone, or metaphor

• Literal interpretation of language

• Challenges with back-and-forth conversation or maintaining topic relevance

• Speaking in a formal or monotone voice

• Trouble recognizing unwritten social rules (e.g., personal space or appropriate eye contact)

These challenges can be mistaken for shyness, awkwardness, or anxiety. Over time, however, they can result in social isolation, especially during adolescence when peer interactions become increasingly complex.

2. Masking and Camouflaging Behaviours

Especially common among girls and women, masking refers to the effort made to mimic socially accepted behaviours to "fit in." This may include:

• Rehearsing conversations before speaking

• Mimicking others’ facial expressions or gestures

• Hiding stimming behaviours (e.g., tapping, rocking, fidgeting)

• Forcing eye contact despite discomfort

While masking may help individuals blend into social environments, it can come at a significant emotional cost, including exhaustion, anxiety, and identity confusion.

3. Sensory Sensitivities

Many individuals with high-functioning autism experience sensory processing challenges. These might not be as overt as sensory meltdowns, but still impact daily functioning. Examples include:

• Discomfort with certain fabrics, sounds, or lighting

• Being a “picky eater” due to texture or taste sensitivities

• Avoidance of crowded spaces or social events

• Overreactions to smells or noise levels

Parents and teachers may misinterpret these symptoms as being fussy or overly sensitive rather than indicators of a sensory processing issue.

4. Intense or Niche Interests

A hallmark of ASD, restricted and repetitive interests, is often overlooked in high-functioning individuals because they may present as talents or passions. Signs include:

• Intense focus on one topic (e.g., trains, coding, mythology) to the exclusion of other interests

• Accumulating detailed facts without a clear social purpose

• Talking at length about special interests without recognizing whether the listener is engaged

• Becoming distressed when unable to engage in the preferred topic

These behaviours can be mistaken for giftedness or eccentricity without recognizing their roots in autism spectrum differences.

5. Executive Functioning Challenges

Though intelligent and capable, many individuals with ASD-1 struggle with executive functioning—mental skills related to planning, organizing, emotional regulation, and task completion. Overlooked signs include:

• Chronic forgetfulness or losing things

• Difficulty initiating tasks, especially non-preferred ones

• Trouble managing time or prioritizing activities

• Becoming overwhelmed by changes in routine

These symptoms may be misattributed to ADHD (a common co-morbidity), laziness, or oppositional behaviour when they stem from neurological differences.

6. Emotional Regulation and Mental Health

One of the most overlooked aspects of high-functioning autism is emotional dysregulation. Individuals may have:

• Intense emotional reactions to minor changes or setbacks

• Difficulty identifying or articulating their own emotions

• High levels of anxiety, especially in social situations

• Co-existing conditions such as depression, OCD, or ADHD

These emotional challenges often lead individuals to seek help later in life, sometimes after years of undiagnosed struggles.

The Importance of Early Detection

Identifying high-functioning autism symptoms early can lead to interventions that significantly improve quality of life. In Ontario, assessments typically involve a multidisciplinary approach, including standardized tools such as the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) and a comprehensive developmental history.

Private Autism Assessments at VMA Psych

At VMA Psych, we provide accessible, high-quality private assessments for Autism Spectrum Disorder using gold-standard tools like the ADOS-2. Our experienced team - including psychologists and Child and Youth Care Practitioners (CYCP) - takes a strengths-based approach that supports each individual’s unique profile, ensuring tailored recommendations that are practical for home and school settings.

Common Misdiagnoses or Missed Diagnoses

Because many high-functioning individuals develop coping strategies to navigate daily life, their symptoms may be missed or misdiagnosed. Conditions that frequently overlap or are confused with ASD include:

• Social Anxiety Disorder

• Generalized Anxiety Disorder

• Obsessive Compulsive Disorder (OCD)

• Attention-Deficit/Hyperactivity Disorder (ADHD)

• Borderline Personality Disorder (BPD) in older adolescents and adults

While co-occurring conditions are common, a proper differential diagnosis is key to ensuring individuals get the right support at the right time.

Why Support Is Still Necessary

Even when individuals with ASD-1 appear to function well in school or work settings, support is often still needed to navigate transitions, relationships, and emotional well-being. Areas of ongoing support include:

• Counselling and Psychotherapy: Helps individuals process emotions, navigate relationships, and build coping strategies

• Behavioural Services and CYCP Support: Assists children and teens in developing regulation skills, understanding social cues, and handling stress

• ASD Coaching: Supports teens and adults in navigating executive functioning, goal setting, time management, and independent living

How VMA Psych Can Help

At VMA Psych, we offer a full suite of services to support individuals with Autism Spectrum Disorder, including:

• Comprehensive ASD Assessments using the ADOS-2 and other validated tools

• Child and Youth Care Practitioners (CYCP) who provide in-home, in-school, and community support

• Individual Counselling for children, teens, and adults with ASD

• ASD Coaching for developing independent living and executive functioning skills

Whether you are a parent seeking clarity for your child, an educator looking for resources, or an adult seeking to understand yourself better, our team is here to help.

If you or someone you love is showing signs of high-functioning autism, don’t wait. Early understanding and the proper support can change the course of development and well-being. Contact VMA Psych to book an ASD assessment or to learn more about our counselling, behavioural services, and ASD coaching.