High Functioning Autism vs Asperger's: Understanding the Diagnostic Evolution
Dr. Matt Miceli is a licensed clinical psychologist with over 8 years of experience helping teens and adults better understand their minds. He specializes in autism and ADHD assessments and has guided many individuals through the often-confusing process of diagnosis and self-discovery.
In recent years, the way autism is diagnosed and discussed has changed significantly. Terms like Asperger’s syndrome and high functioning autism are still widely used, but they no longer appear in today’s diagnostic manuals.
If you’ve ever felt unsure about what these labels mean—or whether they still apply—this guide will walk you through the shift in diagnostic language and why it matters. With expert insight from Dr. Miceli, you’ll gain a clearer understanding of the autism spectrum and how these changes impact teens, adults, and their families.
Core Autism Symptoms (All Levels)
These are traits shared across the autism spectrum:
Difficulty with back-and-forth conversation
Challenges understanding social cues (e.g., tone, facial expressions, body language)
Preference for routines and resistance to change
Repetitive behaviors (e.g., hand-flapping, lining up objects, repeating phrases)
Intense focus on specific interests
Sensory sensitivities (e.g., to sound, light, textures, or smells)
Difficulty with emotional regulation
Trouble forming or maintaining peer relationships
Delayed or unusual language development (in some cases)
High Functioning Autism (HFA) Traits
Often seen in higher functioning individuals with ASD Level 1 or those previously diagnosed with Asperger’s:
Strong verbal skills with little or no early language delay
Average to high intelligence
Deep, narrow interests (e.g., specific topics or hobbies explored in detail)
Monologues or one-sided conversations about preferred topics
Social awkwardness or difficulty reading unspoken social rules
Rigid thinking or black-and-white perspectives
May mask or “camouflage” symptoms in certain settings
Exhaustion or shutdowns after social interaction
Executive functioning challenges (e.g., planning, time management, organization)
Often aware of being “different” but unsure why
As you can see those with asperger symptoms have a lot of overlap with those with high functioning autism symptoms, but we’ll learn, asperger’s is no longer used as an official diagnosis. Keep reading to learn why.
The Historical Journey of Asperger's Syndrome and Autism
Asperger's syndrome was first identified in 1944 by Austrian pediatrician Hans Asperger. He observed children with average intelligence and language development but significant social challenges and restricted interests. However, it wasn't until 1994 that Asperger's syndrome was officially included in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-4) as a separate diagnostic category.
During this period (1994-2013), Asperger's syndrome was distinguished from autism by several key features:
Children diagnosed with Asperger's demonstrated no significant delays in early language development
They showed typical cognitive development
They had age-appropriate self-help skills and adaptive behavior
They maintained environmental curiosity
This contrasted with autism, which typically involved language impairments and potential delays in cognitive development. The condition was often described as a "mild" or "high-functioning" form of autism, though these terms were never officially recognized in diagnostic manuals.
The Historical Journey of Asperger's Syndrome and Autism
Asperger's syndrome was first identified in 1944 by Austrian pediatrician Hans Asperger. He observed children with average intelligence and language development but significant social challenges and restricted interests. However, it wasn't until 1994 that Asperger's syndrome was officially included in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-4) as a separate diagnostic category.
During this period (1994-2013), Asperger's syndrome was distinguished from autism by several key features:
Children diagnosed with Asperger's demonstrated no significant delays in early language development
They showed typical cognitive development
They had age-appropriate self-help skills and adaptive behavior
They maintained environmental curiosity
This contrasted with autism, which typically involved language impairments and potential delays in cognitive development. The condition was often described as a "mild" or "high-functioning" form of autism, though these terms were never officially recognized in diagnostic manuals.
The DSM-5 Consolidation: A Major Shift in Diagnosis
In May 2013, the publication of the DSM-5 dramatically changed the diagnostic landscape. Asperger's syndrome was eliminated as a separate diagnosis and incorporated into the broader category of Autism Spectrum Disorder (ASD). This consolidation also absorbed other previously separate conditions, including:
Autistic Disorder
Childhood Disintegrative Disorder
Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)
The rationale behind this change was the growing recognition that these conditions represented variations of a single spectrum rather than fundamentally different disorders.
Under the current DSM-5 framework, individuals who would have previously received an Asperger's diagnosis now receive an ASD diagnosis, typically specified by support level rather than subtype. The DSM-5 established three levels of autism spectrum disorder based on required support:
Level 1: Requiring support
Level 2: Requiring substantial support
Level 3: Requiring very substantial support
Individuals formerly diagnosed with Asperger's would generally fall into the Level 1 category, though this is not universally true, as support needs can vary across different domains.
DSM-5 Support Levels for Autism Spectrum Disorder
Here is a chart that breaks down the 3 levels of ASD:
Level 1: Requiring support
Noticeable difficulties initiating social interactions; may seem to have decreased interest in social interactions
Rituals and restricted behaviors cause significant interference with functioning in one or more contexts; resists attempts by others to interrupt or redirect
Support with social situations, flexibility, and organization/planning
Level 2: Requiring substantial support
Marked deficits in verbal and nonverbal communication; social impairments apparent even with supports in place
Inflexibility of behavior, difficulty coping with change, or restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer
Regular support for daily functioning, specialized teaching for social skills, structured environment
Level 3: Requiring very substantial support
Severe deficits in verbal and nonverbal communication; very limited initiation of social interactions
Extreme difficulty coping with change, marked distress when routines are disrupted; restricted/repetitive behaviors markedly interfere with functioning
Constant support, high level of structured environment, intensive intervention
Autism Level 1 is often considered the modern equivalent of high-functioning autism, and many people who were previously diagnosed with Asperger’s now fall under this category.
Distinguishing Characteristics: Why the Historical Differences Matter
Even though Asperger's is no longer a separate clinical diagnosis, understanding the historical distinctions helps explain why many people still identify with the term and find it meaningful.
Language and Communication Development
The most significant historical distinction between Asperger's syndrome and autism was in language development. Children with Asperger's syndrome typically acquired language capabilities at a time appropriate for their age, showing no clinically significant delay in verbal development.
However, they often exhibited subtler language differences, including:
Difficulties with pragmatic aspects of communication
Challenges understanding figurative language
Problems applying appropriate conversational conventions
In contrast, other forms of autism commonly featured delayed language acquisition, with some individuals developing verbal skills later than expected and others experiencing more persistent and pronounced communication challenges.
Cognitive Profile and Intelligence
Another distinguishing feature was cognitive functioning and intelligence. Individuals diagnosed with Asperger's syndrome typically demonstrated average or above-average intellectual functioning, with no significant cognitive delays. Many excelled in specific areas of interest, showing remarkable abilities to absorb and retain information about their preferred subjects.
This cognitive profile contributed to the perception of Asperger's as "high-functioning" autism, though this terminology has fallen out of favor due to its potentially misleading implications. Intellectual ability alone does not determine functional outcomes, and many individuals with strong cognitive skills may still experience significant challenges in everyday functioning, particularly in social contexts or when dealing with sensory sensitivities.
Social Interaction Patterns
Both Asperger's syndrome and other forms of autism share challenges with social interaction, but subtle differences were sometimes noted. Individuals with Asperger's often demonstrated a desire for social connection but struggled with understanding and applying social norms and cues. They might engage in one-sided conversations about topics of special interest without recognizing their conversation partner's waning interest.
In some cases, autism presentations not classified as Asperger's were characterized by less apparent social motivation or a more pronounced withdrawal from social interaction. However, these distinctions were not universally applicable, and considerable overlap existed in the social challenges experienced across different autism presentations, further supporting the eventual diagnostic consolidation.
Navigating the Spectrum with Understanding
Asperger’s syndrome is no longer a standalone diagnosis. Since the release of the DSM-5 in 2013, what was once labeled Asperger’s now falls under the broader umbrella of Autism Spectrum Disorder (ASD).
This shift reflects a deeper understanding: autism isn’t a set of separate conditions — it’s a spectrum. Traits that were once used to define Asperger’s, like strong verbal skills and narrow interests, are now seen as part of the natural variation within autism itself.
Still, for many people who received an Asperger’s diagnosis before the change, the term remains deeply meaningful. It gave language to their experiences and a sense of identity they don’t want to lose. And for some, the new system feels less personal — more clinical, less descriptive of who they are.
At the same time, this unified approach has helped push the conversation forward. It’s allowed for a wider, more inclusive understanding of autism — one that makes space for different abilities, support needs, and ways of engaging with the world.
But challenges remain.
Support systems often struggle to meet the diverse needs of autistic individuals, especially adults who may appear “high functioning” but still face real barriers in daily life. And disparities in who gets diagnosed — and when — continue to impact underserved groups.
Moving forward, the focus needs to stay on what matters most: providing respectful, responsive support that recognizes the full spectrum of autistic experience — whether someone still identifies with the term Asperger’s or not.
Key Takeaways on High Functioning Autism vs Asperger's
Remember that while diagnostic terminology has changed, the experiences and identities of autistic individuals remain uniquely personal. The most important approach is one that respects individual preferences while providing appropriate, needs-based support.
Ready to Better Understand Yourself or Your Child?
Dr. Miceli has spent over a decade helping teens and adults gain clarity around autism, ADHD, and other neurodevelopmental differences. Whether you're exploring a diagnosis for the first time or looking to better understand how your brain works, you're not alone.
Schedule an assessment today and take the next step toward greater self-understanding and support.
Frequently Asked Questions
What is high-functioning autism ?
High-functioning autism isn’t an official diagnosis, but it’s often used to describe autistic people who have average or above-average intelligence and fewer challenges with verbal communication. These individuals may still struggle with social skills, sensory sensitivities, or executive functioning. Today, this presentation is typically diagnosed as Autism Spectrum Disorder (ASD) Level 1.
What happened to the term "Asperger’s syndrome"?
Asperger’s syndrome was once a separate diagnosis used for people with strong language and cognitive skills but clear social and behavioral differences. Since the DSM-5 was released in 2013, the Asperger diagnosis has been folded into the broader category of Autism Spectrum Disorder. Many people still identify with the term “Asperger’s,” even though it’s no longer used clinically.
Is Asperger’s syndrome the same as high-functioning ASD?
In many cases, yes. What was once called Asperger’s syndrome would now be considered high-functioning ASD or ASD Level 1. These individuals are often highly verbal, curious, and capable in many areas—but they may still need support with social interactions, flexibility, or emotional regulation.
How is an autism diagnosis made?
An autism diagnosis is typically made through a combination of interviews, observation, developmental history, and sometimes standardized testing. A psychologist or other licensed specialist will assess social communication, repetitive behaviors, and how these patterns affect daily life and learning.
Can autistic people or those with Asperger’s live independent lives?
Absolutely. Many autistic people and those previously diagnosed with Asperger syndrome lead full, independent lives. Some may need support in specific areas—like planning, social situations, or work transitions—but they often develop routines that work well for them. Everyone’s experience is different, and independence looks different for each person.
What treatments are available for people on the spectrum?
Treatment depends on the individual's needs. For some, Applied Behavior Analysis (ABA) is recommended—especially in early childhood. Others benefit more from therapy focused on social skills, executive functioning, or emotional support. Occupational therapy, speech therapy, and parent coaching can also be part of a well-rounded treatment plan.
What are the challenges with learning for people with autism or Asperger’s?
People with autism high-functioning or Asperger syndrome often have uneven learning profiles. They may excel in one area (like math or memorization) but struggle with flexible thinking, abstract reasoning, or following multi-step instructions. Support tailored to how someone learns best is key.
Are these conditions still being studied and reviewed?
Yes. The understanding of autism, high-functioning ASD, and related diagnoses is always evolving. New research is being constantly reviewed to improve support, increase early identification, and reduce stigma around neurodivergent experiences.
