ABA for High-Functioning Autism

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Autism Spectrum Disorder (ASD), as the name implies, exists on a scale. Learners along the spectrum differ in the levels of support they need to reach their highest potential and lead fulfilling lives. On one end are those who require “very substantial” support, and on the other are those who require a lesser degree of support. 

Previously, learners on the latter end of the spectrum were diagnosed with Asperger’s Syndrome, which was often referred to as “high-functioning autism” or HFA. The term “high-functioning autism” is being used less and less within the autism community these days, but those new to an ASD diagnosis or to the community tend to still use it frequently. 

In this article, we will define high-functioning autism, address why HFA is generally not preferred language today, and answer some questions we get often, including: “What level of autism needs Applied Behavior Analysis (ABA) therapy?” and “Does ABA help high-functioning autism?” 

What is “High-Functioning” Autism?

“High-functioning” autism is not an official medical diagnosis but a term often used to describe learners on the spectrum who exhibit fewer or less pronounced challenges with language, cognition, behavior, and/or daily functioning. HFA is commonly associated with individuals who might meet the criteria for ASD as outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), but who do not have significant intellectual disabilities.

The DSM was first published in 1952 by the American Psychiatric Association (APA) to provide a standardized framework for diagnosing mental health conditions. The goals of the DSM are to ensure consistency in diagnoses across practitioners; facilitate research on mental health conditions; and guide treatment approaches by creating a common language for clinicians. The most recent edition was published in 2022. 

Why “High Functioning” Isn’t Generally Used Anymore

Autistic learners today generally prefer to use terminology that focuses on specific needs and strengths, instead of vague and potentially misleading or even harmful labels that classify one’s ability to function. Why? Because “high-functioning” as a classification term:

  • Oversimplifies the spectrum
    Labeling someone with HFA can imply that their struggles are minimal or non-existent, which is often not the case. 
  • Ignores hidden challenges
    Many “high-functioning” individuals face significant difficulties with sensory sensitivities, executive functioning, emotional regulation, and social interactions. These challenges might not be visible but can have a profound impact on daily life. 
  • Creates a false hierarchy
    Perpetuating a “ranking” within the autism spectrum, with HFA seen as “better” or more acceptable than “low-functioning,” is not reflective of the diverse experiences of autistic learners and can contribute to stigma. 
  • Minimizes the need for support
    Individuals labeled with HFA may struggle to access accommodations or support because their needs are underestimated. This can lead to misunderstandings in education, workplace settings, and healthcare. 
  • Dismisses personal experiences
    Some individuals report that being labeled as “high-functioning” makes others invalidate their challenges or assume they don’t need help, leading to feelings of frustration or being misunderstood.

What Level of Autism Needs ABA Therapy?

This is a bit of a trick question because all learners with autism can benefit from engaging in ABA therapy! By design, ABA therapy is highly individualized, collaborative, and effective across ages. ABA is generally most helpful for individuals who:

  • Face challenges in specific areas such as communication, behavior, or daily living skills.
  • Require structured, evidence-based interventions to meet their developmental goals.

Who may benefit is not determined by the diagnostic level alone but by the learner’s specific needs and challenges and the amount of support needed to address their goals. A younger learner who doesn’t yet have a communication system in place, for example, will always benefit from a higher level of support. This level can change over time as they learn skills and their support needs are not as high.

Here’s how ABA therapy aligns with different levels of ASD:

Level 1: Requiring Support

Previously referred to as “high-functioning” autism, Level 1 learners tend to express mild challenges with social communication, demonstrate some difficulty adapting to change or regulating emotions, and may need help with executive functioning skills like planning and organization.

Level 2: Requiring Substantial Support

Level 2 learners tend to have more pronounced challenges with verbal and nonverbal communication, significant difficulty coping with changes or new environments, and restricted or repetitive behaviors may interfere with daily functioning.

Level 3: Requiring Very Substantial Support

Level 3 learners typically exhibit significant communication challenges, including the possibility of being nonspeaking, demonstrate intense difficulty adapting to change or transitioning between activities, and are highly reliant on caregivers for daily needs.

ABA Therapy For “High-Functioning” Autism

Developing an ABA therapy plan by considering the support needs of individual learners is a far more effective treatment strategy than considering their degree of “functioning.” For example, some learners have very high support in only a few areas, while others have lower support needs, but in several areas. And of course, there can be any combination therein. By focusing on support needs, we maintain our focus on the individual instead of their category.

ABA therapy can help learners with lower support needs to:

  • Improve social skills
    • Teaches nuanced social interactions, such as understanding body language, maintaining conversations, or building friendships.
    • Focuses on learning how to navigate complex social environments, which can be a significant challenge for Level 1 learners. 
  • Enhance communication
    • Addresses pragmatic language skills, such as understanding sarcasm, idioms, or conversational turn-taking.
    • Helps individuals tailor their communication to different social settings. 
  • Build independence
    • Focuses on executive functioning skills like planning, organization, and time management.
    • Supports self-regulation strategies to handle sensory sensitivities or emotional challenges. 
  • Reduce challenging behaviors
    • If behaviors like meltdowns, rigidity, or resistance to change interfere with daily life, ABA can help develop alternative coping mechanisms. 
  • Strengthen adaptive skills
    • Teaches life skills, such as managing routines, self-care, and navigating work or school environments.
    • ABA therapy for teens can prepare learners for transitions, such as moving to college or entering the workforce.

Is ABA the Best Therapy for “High-Functioning” Autism?

While ABA has proven to be beneficial for autistic learners, it’s not the only option for supporting individuals with lower support needs. Alternative or complementary therapies, such as speech therapy, occupational therapy, social skills groups, or cognitive-behavioral therapy, may also be effective, depending on the individual.

It’s essential to work with qualified providers to assess whether ABA therapy aligns with the individual’s needs and preferences.

ABtA Programming for Learners with Lower Support Needs

At A Bridge to Achievement, we practice a neuro-affirming, assent-based approach to ABA therapy. All of our programs and services are tailored to each individual learner, with ABA therapy sessions, Social Skills Groups, and Vocational Skills Groups being most popular with our learners with lower support needs. 

If you are interested in having your learner assessed for ASD or exploring our offerings to see if they are right for you and your family, reach out or request services. Support starts here.