High-functioning autism explained

High-functioning autism
Synonyms:Sukhareva syndrome[1]
Field:Psychiatry
Symptoms:Trouble with social interaction, impaired communication, restricted interests, repetitive behavior
Complications:Social isolation, employment problems, family stress, bullying, self-harm[2]
Onset:By age two or three[3] [4]
Duration:Lifelong
Causes:Genetic and environmental factors
Diagnosis:Based on behavior and developmental history
Differential:Asperger syndrome, ADHD, Tourette syndrome, anxiety, bipolar disorder, obsessive–compulsive disorder
Treatment:Behavioral therapy, speech therapy, psychotropic medication[5] [6] [7]
Medication:Antipsychotics, antidepressants, stimulants (associated symptoms)[8] [9] [10]

High-functioning autism (HFA) was historically an autism classification where a person exhibits no intellectual disability, but may experience difficulty in communication, emotion recognition, expression, and social interaction.[11] [12] [13]

HFA has never been included in either the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) or the World Health Organization's International Classification of Diseases (ICD), the two major classification and diagnostic guidelines for psychiatric conditions.

Characterization

High-functioning autism is characterized by features similar to those of Asperger syndrome. The defining characteristic recognized by psychologists is a significant delay in the development of early speech and language skills, before the age of three years. The diagnostic criteria of Asperger syndrome exclude a general language delay.[14]

Further differences in features of people with high-functioning autism from those with Asperger syndrome include the following:[15] [16] [17]

Comorbidities

Individuals with autism spectrum disorders, including high-functioning autism, risk developing symptoms of anxiety. While anxiety is one of the most commonly occurring mental health symptoms, children and adolescents with high functioning autism are at an even greater risk of developing symptoms.[18]

There are other comorbidities, the presence of one or more disorders in addition to the primary disorder, associated with high-functioning autism. Some of these include bipolar disorder and obsessive–compulsive disorder (OCD). In particular the link between HFA and OCD, has been studied; both have abnormalities associated with serotonin.[19]

Observable comorbidities associated with HFA include ADHD and Tourette syndrome. HFA does not cause, nor include, intellectual disabilities. This characteristic distinguishes HFA from low-functioning autism; between 40 and 55% of individuals with autism also have an intellectual disability.[20]

Behavior

An association between HFA and criminal behavior is not completely characterized. Several studies have shown that the features associated with HFA may increase the probability of engaging in criminal behavior. While there is still a great deal of research that needs to be done in this area, recent studies on the correlation between HFA and criminal actions suggest that there is a need to understand the attributes of HFA that may lead to violent behavior. There have been several case studies that link the lack of empathy and social naïveté associated with HFA to criminal actions.[21]

There is still a need for more research on the link between HFA and crimes, because many other studies point out that most people with ASD are more likely to be victims and less likely to commit crimes than the general population. But there are also small-subgroups of people with autism that commit crimes because they lack understanding of the laws they have broken.[22] Misunderstandings are especially common regarding autism and sex offenses, since many people with autism do not receive sex education.[23]

Cause

See main article: Causes of autism. Although little is known about the biological basis of autism, studies have revealed structural abnormalities in specific brain regions. Regions identified in the "social" brain include the amygdala, superior temporal sulcus, fusiform gyrus area and orbitofrontal cortex. Further abnormalities have been observed in the caudate nucleus, believed to be involved in restrictive behaviors, as well as in a significant increase in the amount of cortical grey matter and atypical connectivity between brain regions.[24]

Diagnosis and IQ

HFA is not a recognised diagnosis by the American Psychiatric Association or the World Health Organization. HFA is often, however, used in clinical settings to describe a set of symptoms related to an autism spectrum disorder whereby they exhibit standard autism indicators although have an intelligence quotient (IQ) of 70 or greater.[25]

Treatment

While there exists no single treatment or medicine for people with autism, there exists several strategies to help lessen the symptoms and effects of the condition. There is however no one size fits all solution, so that the best treatment course is different for each individual. Furthermore, research shows that earlier diagnosis and interventions are more likely to have significant beneficial effects later in life.[26]

Augmentative and alternative communication

Augmentative and alternative communication (AAC) is used for autistic people who cannot communicate orally. People who have problems speaking may be taught to use other forms of communication, such as body language, computers, interactive devices, and pictures.[27] The Picture Exchange Communication System (PECS) is a commonly used form of augmentative and alternative communication with children and adults who cannot communicate well orally. People are taught how to link pictures and symbols to their feelings, desires and observation, and may be able to link sentences together with the vocabulary that they form.[28]

Speech–language pathologists

Speech–language pathologists (SLPs) can help those with autism who need to develop or improve communication skills.[29] People with autism may have issues with communication, or speaking spoken words. According to the ASHA, SLPs can help diagnosing autism as they often are among the earliest practitioners that children with autism see, and help with finding means of communication that better suit the child.[30] They can also counsel caretakers, and accompany people with autism when they transition into adulthood and a work environment, such as help in writing an adequate CV. SLPs may teach someone how to communicate more effectively with others or work on starting to develop speech patterns.[31] SLPs use a variety of therapies depending on the child's needs and practitioner's preferences, usually a mix composed in majority of promising therapies and a few unestablished therapies according to evidence-based guidelines.[32]

Occupational therapy

Occupational therapy helps autistic children and adults learn everyday skills that help them with daily tasks, such as personal hygiene and movement. These skills are then integrated into their home, school, and work environments. Therapists will oftentimes help people learn to adapt their environment to their skill level.[33] This type of therapy could help autistic people become more engaged in their environment. An occupational therapist will create a plan based on a person's needs and desires and work with them to achieve their set goals.

Applied behavioral analysis (ABA)

Applied behavior analysis (ABA) is considered the most effective therapy for autism spectrum disorders by the American Academy of Pediatrics.[34] ABA focuses on teaching adaptive behaviors like social skills, play skills, or communication skills[35] [36] and diminishing problematic behaviors such as self-injury[37] by creating a specialized plan that uses behavioral therapy techniques, such as positive or negative reinforcement, to encourage or discourage certain behaviors over-time.[38] However, ABA has been strongly criticised by the autistic community, who view it as abusive and detrimental to autistic children's growth.[39] [40] [41]

Sensory integration therapy

Sensory integration therapy helps people with autism adapt to different kinds of sensory stimuli. Many with autism can be oversensitive to certain stimuli, such as lights or sounds, causing them to overreact. Others may not react to certain stimuli, such as someone speaking to them.[42] Many types of therapy activities involve a form of play, such as using swings, toys and trampolines to help engage people with sensory stimuli. Therapists will create a plan that focuses on the type of stimulation the person needs integration with.

Medication

There are no medications specifically designed to treat autism. Medication is usually used for symptoms associated with autism, such as depression, anxiety, or behavioral problems.[43] Medicines are usually used after other alternative forms of treatment have failed.[44]

See also

Further reading

Notes and References

  1. Manouilenko I, Bejerot S . Sukhareva – Prior to Asperger and Kanner . Nordic Journal of Psychiatry . 69 . 6 . 479–82 . August 2015 . 25826582 . 10.3109/08039488.2015.1005022 . 207473133 . 31 March 2015 . Report .
  2. Web site: Autism spectrum disorder - Symptoms and causes . Mayo Clinic . 13 July 2019 . en . https://web.archive.org/web/20190714024941/https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928 . 14 July 2019 . live.
  3. Web site: NIMH " Autism Spectrum Disorder . nimh.nih.gov . 20 April 2017 . October 2016 . https://web.archive.org/web/20170421093226/https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml . 21 April 2017 . live.
  4. Book: American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) . Autism Spectrum Disorder. 299.00 (F84.0) . 2013 . 50–59 . Arlington, VA . American Psychiatric Publishing . 978-0-89042-559-6 . 10.1176/appi.books.9780890425596 . 2027.42/138395.
  5. Management of children with autism spectrum disorders . Myers SM, Johnson CP . Pediatrics . 120 . 5 . 1162–82 . November 2007 . 17967921 . 10.1542/peds.2007-2362 . free . 2019-05-24 . https://web.archive.org/web/20190323092305/https://pediatrics.aappublications.org/content/120/5/1162 . 2019-03-23 . live.
  6. Sanchack . KE . Thomas . CA . Autism Spectrum Disorder: Primary Care Principles. . American Family Physician . 15 December 2016 . 94 . 12 . 972–79 . 28075089.
  7. Sukhodolsky . DG . Bloch . MH . Panza . KE . Reichow . B . Cognitive-behavioral therapy for anxiety in children with high-functioning autism: a meta-analysis. . Pediatrics . November 2013 . 132 . 5 . e1341–50 . 10.1542/peds.2013-1193 . 24167175. 3813396.
  8. Ji N, Findling RL . An update on pharmacotherapy for autism spectrum disorder in children and adolescents . Current Opinion in Psychiatry . 28 . 2 . 91–101 . March 2015 . 25602248 . 10.1097/YCO.0000000000000132 . 206141453.
  9. Oswald DP, Sonenklar NA . Medication use among children with autism spectrum disorders . Journal of Child and Adolescent Psychopharmacology . 17 . 3 . 348–55 . June 2007 . 17630868 . 10.1089/cap.2006.17303.
  10. Jaeggi . S. M. . Buschkuehl . M. . Jonides . J. . Perrig . W. J. . From the Cover: Improving fluid intelligence with training on working memory . Proceedings of the National Academy of Sciences . 105 . 19 . 6829–33 . 2008 . 10.1073/pnas.0801268105 . 2383929 . 18443283. 2008PNAS..105.6829J . free.
  11. Sanders. James Ladell. Qualitative or Quantitative Differences Between Asperger's Disorder and Autism? Historical Considerations. Journal of Autism and Developmental Disorders. 39. 11. 2009. 1560–1567. 0162-3257. 10.1007/s10803-009-0798-0. 19548078. 26351778.
  12. Carpenter . Laura Arnstein . Soorya . Latha . Halpern . Danielle . Asperger's Syndrome and High-Functioning Autism . Pediatric Annals . 2009 . 38 . 1 . 30–5 . 10.3928/00904481-20090101-01. 19213291.
  13. Andari. Elissar. Duhamel. Jean-René. Zalla. Tiziana. Herbrecht. Evelyn. Leboyer. Marion. Sirigu. Angela. 2 March 2019. Promoting social behavior with oxytocin in highfunctioning autism spectrum disorders. PNAS. 107. 9. 4389–4394. 10.1073/pnas.0910249107. 20160081. 2840168. free.
  14. http://behavenet.com/aspergers-disorder Asperger's Disorder
  15. Web site: News and general information | Finance, High tech, Health, .... https://web.archive.org/web/20070809090928/http://www.sacramentoasis.com/docs/8-22-03/as_%26_hfa.pdf. March 14, 2022. August 9, 2007.
  16. 12199137 . 2002 . Rinehart . NJ . Bradshaw . JL . Brereton . AV . Tonge . BJ . Lateralization in individuals with high-functioning autism and Asperger's disorder: A frontostriatal model . 32 . 4 . 321–331 . Journal of Autism and Developmental Disorders . 10.1023/A:1016387020095. 23067447.
  17. 10.1007/s10803-006-0251-6 . Emotion Perception in Asperger's Syndrome and High-functioning Autism: The Importance of Diagnostic Criteria and Cue Intensity . 2006 . Mazefsky . Carla A. . Oswald . Donald P. . Journal of Autism and Developmental Disorders . 37 . 6 . 1086–95 . 17180461. 12094187 .
  18. 10.1016/j.brainres.2010.09.075 . The treatment of anxiety symptoms in youth with high-functioning autism spectrum disorders: Developmental considerations for parents . 2011 . Reaven . Judy . Brain Research . 1380 . 255–63 . 20875799. 5226904.
  19. 10.1186/1744-859X-11-16 . Psychiatric comorbidities in asperger syndrome and high functioning autism: Diagnostic challenges . 2012 . Mazzone . Luigi . Ruta . Liliana . Reale . Laura . Annals of General Psychiatry . 11 . 16 . 22731684 . 1 . 3416662 . free.
  20. Newschaffer. Craig J.. Croen. Lisa A.. Daniels. Julie. Giarelli. Ellen. Grether. Judith K.. Levy. Susan E.. Mandell. David S.. Miller. Lisa A.. Pinto-Martin. Jennifer. Reaven. Judy. Reynolds. Ann M.. Rice. Catherine E.. Schendel. Diana. Windham. Gayle C.. The Epidemiology of Autism Spectrum Disorders*. Annual Review of Public Health. 28. 1. 2007. 235–258. 0163-7525. 10.1146/annurev.publhealth.28.021406.144007. 17367287. free.
  21. Matthew D. . Lerner . Omar Sultan . Haque . Eli C. . Northrup . Lindsay . Lawer . Harold J. . Bursztajn . Emerging Perspectives on Adolescents and Young Adults With High-Functioning Autism Spectrum Disorders, Violence, and Criminal Law . Journal of the American Academy of Psychiatry and the Law . 22635288 . 2012 . 40 . 2 . 177–90 . 2013-03-24 . 2019-12-11 . https://web.archive.org/web/20191211055002/http://jaapl.org/content/40/2/177.long . dead.
  22. Web site: Autism Myths & Misconceptions . 2021-08-05.
  23. News: Moyer . Melinda Wenner . When autistic people commit sexual crimes . Spectrum News . 2019-07-09 . 2021-08-05.
  24. Book: 10.1017/CBO9780511973918.006 . Brain imaging and the neuroanatomical correlates of autism . Researching the Autism Spectrum . limited . 2011 . Spencer . Michael . Stanfield . Andrew . Johnstone . Eve . Roth . Ilona . Rezaie . Payam . 978-0-511-97391-8 . 112–55.
  25. de Giambattista. Concetta. 2019. Subtyping the Autism Spectrum Disorder: Comparison of Children with High Functioning Autism and Asperger Syndrome. Journal of Autism and Developmental Disorders. 49. 1. 138–150. 10.1007/s10803-018-3689-4. 30043350. 6331497.
  26. Web site: 2021-04-19 . What are the treatments for autism? NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development . 2023-06-10 . www.nichd.nih.gov . en.
  27. Web site: Augmentative and Alternative Communication (AAC). American Speech-Language-Hearing Association. 2019-08-20. https://web.archive.org/web/20190815210201/https://www.asha.org/public/speech/disorders/aac/. 2019-08-15. live.
  28. Web site: What Treatments are Available for Speech, Language and Motor Issues?. Autism Speaks. 2015-12-16. https://web.archive.org/web/20151222074105/https://www.autismspeaks.org/what-autism/treatment/what-treatments-are-available-speech-language-and-motor-impairments. 2015-12-22. live.
  29. Web site: What is Autism, Asperger Syndrome, and Pervasive Developmental Disorders?. US Autism and Asperger Association. 16 December 2015. https://web.archive.org/web/20151228125601/http://www.usautism.org/definitions.htm. 28 December 2015. live.
  30. Web site: Autism (Autism Spectrum Disorder) . 2023-06-11 . American Speech-Language-Hearing Association . en.
  31. Web site: Speech and Language Therapy. Autism Education Trust. https://web.archive.org/web/20180626141543/http://www.autismeducationtrust.org.uk/good-practice/written%20for%20you/parents-and-cares/pc%20speech%20and%20language%20therapy.aspx. June 26, 2018.
  32. Hsieh . Ming-Yeh . Lynch . Georgina . Madison . Charles . 2018-08-06 . Intervention Techniques Used With Autism Spectrum Disorder by Speech-Language Pathologists in the United States and Taiwan: A Descriptive Analysis of Practice in Clinical Settings . American Journal of Speech-Language Pathology . en . 27 . 3 . 1091–1104 . 10.1044/2018_AJSLP-17-0039 . 29710283 . 206169358 . 1058-0360.
  33. Web site: Occupational Therapy's Role with Autism. American Occupational Therapy Association. April 3, 2022.
  34. Myers. Scott M.. Johnson. Chris Plauché. 1 November 2007. Management of Children With Autism Spectrum Disorders. Pediatrics. 120. 5. 1162–1182. 10.1542/peds.2007-2362. 0031-4005. 17967921. 20 August 2019. https://web.archive.org/web/20191009024902/https://pediatrics.aappublications.org/content/120/5/1162. 9 October 2019. live. free.
  35. Web site: Applied Behavioral Analysis (ABA): What is ABA?. Autism partnership. 16 June 2011 . 2019-08-20. https://web.archive.org/web/20190103173916/https://www.autismpartnership.com/applied-behavior-analysis. 2019-01-03. live.
  36. Matson . Johnny . Hattier . Megan . Belva . Brian . Treating adaptive living skills of persons with autism using applied behavior analysis: A review . Research in Autism Spectrum Disorders . January–March 2012 . 6 . 1 . 271–276 . 10.1016/j.rasd.2011.05.008.
  37. Summers . Jane . Sharami . Ali . Cali . Stefanie . D'Mello . Chantelle . Kako . Milena . Palikucin-Reljin . Andjelka . Savage . Melissa . Shaw . Olivia . Lunsky . Yona . Self-Injury in Autism Spectrum Disorder and Intellectual Disability: Exploring the Role of Reactivity to Pain and Sensory Input . Brain Sci . November 2017 . 7 . 11 . 140 . 10.3390/brainsci7110140 . 29072583 . 5704147 . free.
  38. Web site: Applied Behavioral Strategies - Getting to Know ABA. 2015-12-16. https://web.archive.org/web/20151007100326/http://www.appliedbehavioralstrategies.com/what-is-aba.html. 2015-10-07. live.
  39. Web site: Invisible Abuse: ABA and the things only autistic people can see. 28 March 2019.
  40. Web site: The Controversy Around ABA. Child Mind Institute.
  41. Web site: The controversy over autism's most common therapy. 10 August 2016.
  42. Web site: Smith . M . Segal . J . Hutman . T . Autism Spectrum Disorders . helpguide.org . https://web.archive.org/web/20150107003731/http://www.helpguide.org/articles/autism/autism-symptoms-and-early-signs.htm . 7 January 2015.
  43. Web site: National Institute of Mental Health. Medications for Autism. Psych Central. 2015-12-16. https://web.archive.org/web/20151213211732/http://psychcentral.com/lib/medications-for-autism. 2015-12-13. live.
  44. Web site: Pope . J . Volkmar . F . Medicines for Autism . November 14, 2014 . WebMD . 3 April 2012 . https://web.archive.org/web/20141217120946/https://www.webmd.com/brain/autism/medications-for-autism . 17 December 2014.

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