14 Symptoms of High-Functioning Autism in Male Adults

14 Symptoms of High-Functioning Autism in Male Adults

14 Symptoms of High-Functioning Autism in Male Adults

High-Functioning Autism (HFA), a term often used to describe individuals with Autism Spectrum Disorder (ASD) who do not have intellectual disabilities, is a complex condition that presents in numerous ways and can often go unrecognized or undiagnosed in adults, particularly males. Although “high-functioning” is not officially recognized in diagnostic manuals, it’s frequently used to denote those who might have significant social difficulties but are intellectually and verbally skilled.

HFA can be particularly challenging to identify in the male adult population due to societal expectations and stereotypes around male behavior, as well as the historical focus on autism as a childhood condition. Yet, the recognition and diagnosis of HFA in adult males are critical, as they can open doors to resources and strategies that can improve the quality of life and social integration. This blog post will explore 14 symptoms of high-functioning autism in male adults, aiming to build understanding and awareness of this often misunderstood condition.

What is High-Functioning Autism?

High-Functioning Autism (HFA) is a term often used to describe individuals on the autism spectrum who can function relatively well in everyday life, particularly in the intellectual and verbal aspects. Although this term is not officially recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is widely used in informal contexts to denote people with Autism Spectrum Disorder (ASD) who do not have intellectual disabilities and can speak fluently.

Individuals with HFA often exhibit difficulties in social interaction and communication but might have average or above-average intelligence. They may excel in certain areas, like music, art, or mathematics while struggling with social cues, empathy, or non-verbal communication.

HFA is often compared to or mistaken for Asperger’s Syndrome, another part of the autism spectrum. The main distinction used to be that people with Asperger’s do not experience the language development delays often associated with autism. However, the term “Asperger’s Syndrome” was removed from the DSM-5 in 2013, and individuals previously diagnosed with Asperger’s are now considered on the autism spectrum. This change was made to create a more flexible and encompassing spectrum that better represents the diversity of experiences and symptoms among people with autism.

According to the DSM-5, to be diagnosed with ASD, individuals must experience persistent difficulties in social interaction and communication across multiple contexts, along with restrictive and repetitive patterns of behavior, interests, or activities. These symptoms must be present from early childhood and limit or impair everyday functioning. Therefore, while someone with HFA might have a higher degree of functionality, they still experience significant challenges related to autism.

What is borderline autism in adults?

Borderline autism, also called Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), is a term used to describe individuals who exhibit some, but not all, of the characteristics of Autism Spectrum Disorder (ASD). In earlier versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), PDD-NOS was a separate diagnosis, often used for people who didn’t fully meet the criteria for other specific conditions like classic autism or Asperger’s syndrome.

The term “borderline autism” can be somewhat misleading as it suggests that the individual is on the edge of being autistic. However, it often means that the individual exhibits some traits typically seen in ASD but not to the degree or extent that would lead to a full diagnosis. Symptoms might include difficulty with social interactions, repetitive behaviors, or challenges with changes in routine. Still, they might be less pronounced or pervasive than individuals with a complete ASD diagnosis.

However, in the most recent DSM-5, published by the American Psychiatric Association, the distinct categories of autistic disorder, Asperger’s disorder, and PDD-NOS have been replaced with the umbrella term “Autism Spectrum Disorder.” This was done to capture better the wide range of symptoms and levels of impairment that people with these conditions can have. The concept of borderline autism would now fall into the lower end of the spectrum under this new classification system.

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Significantly, regardless of whether an adult is diagnosed with ASD or is considered to have borderline autism, they may still benefit from various forms of support and treatment, including behavioral therapies, social skills training, and potentially medication for associated symptoms like anxiety or depression.

As always, if you suspect that you or someone you know may be on the autism spectrum, it’s essential to consult with a healthcare provider or a mental health professional for an evaluation. They can provide guidance and help establish a treatment plan tailored to the individual’s needs.

14 Symptoms of High-Functioning Autism in Male Adults

High-Functioning Autism (HFA) can present differently in every individual, with varying severity and combinations of symptoms. Here are 14 common symptoms often observed in male adults with HFA:

  1. Difficulty with Social Interactions: Adults with HFA may struggle with understanding social norms and expectations, leading to difficulties in social situations.
  2. Challenges with Non-Verbal Communication: Reading facial expressions, body language, or understanding the tone of voice can be challenging, making it hard to interpret others’ emotions or intentions.
  3. Unusual Speech Patterns or Monotonous Voice: Speech may be formal or pedantic, and the person may have a flat or monotonous tone.
  4. Specific and Narrow Interests: Adults with HFA often have one or a few specific interests they are deeply passionate about and focus on extensively.
  5. Need for Routine and Struggle with Change: Individuals may strongly prefer routine and become distressed if their routine is disrupted.
  6. Sensory Sensitivity: Over- or under-sensitivity to sensory input like lights, sounds, textures, or smells is common.
  7. Difficulty Understanding Others’ Emotions or Perspectives: Understanding and empathizing with others’ feelings or viewpoints can be a struggle, often referred to as difficulty with the “theory of mind.”
  8. Physical Clumsiness: There may be issues with motor skills, resulting in clumsiness or uncoordinated movements.
  9. Excessive Detail Orientation: Individuals may focus on details rather than the overall picture, often missing out on the broader context.
  10. Difficulty with Group Settings: Participating in group settings can be overwhelming and challenging due to the complex social dynamics.
  11. Challenges in Making or Maintaining Friendships: Forming and maintaining relationships can be difficult due to social and communication challenges.
  12. Anxiety and Depression: Co-occurring mental health conditions like anxiety and depression are common in individuals with HFA.
  13. Difficulty in Recognizing Social Cues: Understanding subtle social cues, such as sarcasm or body language, can be difficult.
  14. Lack of Eye Contact: Many adults with HFA may struggle with maintaining eye contact during conversations.

It’s important to remember that each person with HFA is unique, and the presence, absence, or severity of any of these symptoms can vary widely from person to person. Suppose you or someone you know is experiencing these symptoms and causing significant distress or difficulty. In that case, reaching out to a healthcare professional for a thorough evaluation is essential.

Can high-functioning autism be diagnosed later in life?

Yes, High-Functioning Autism (HFA) can be diagnosed later in life. While Autism Spectrum Disorder (ASD) is typically diagnosed in early childhood, some individuals, especially those with high-functioning autism, may not be diagnosed until adulthood.

Several factors contribute to this. For example, individuals with high-functioning autism often develop coping mechanisms to manage their symptoms, making them less obvious to others. Additionally, societal expectations and stereotypes can lead to missed diagnoses, particularly in males, who may be encouraged to suppress their emotions and behaviors from a young age.

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Moreover, our understanding of autism has evolved significantly over the years, and the criteria for diagnosis have expanded. It means that many adults who were not diagnosed as children now meet the criteria for a diagnosis.

It’s important to remember that a diagnosis at any age can be helpful. It can provide a framework for understanding past challenges, inform current needs, and help individuals access appropriate resources and support. If you suspect that you or someone you know may be on the autism spectrum, it’s never too late to seek help from a healthcare professional.

What happens if high-functioning autism goes undiagnosed?

If High-Functioning Autism (HFA) goes undiagnosed, it may lead to various challenges and difficulties for the individual. Here are a few potential outcomes:

  1. Struggles in Social Settings: Without a diagnosis, the individual may not understand why they struggle in social settings, leading to frustration and isolation.
  2. Emotional Distress: Unexplained difficulties in day-to-day functioning can lead to anxiety, depression, and low self-esteem. The individual may feel different or misunderstood, leading to emotional distress.
  3. Limited Access to Services and Support: Without a diagnosis, an individual may be unable to access specific therapeutic resources, accommodations, or support systems designed for those with ASD.
  4. Misdiagnosis: Sometimes, the symptoms of HFA may be misinterpreted as signs of other conditions, like ADHD, social anxiety disorder, or personality disorders, leading to inappropriate or ineffective treatment strategies.
  5. Difficulty in Personal Relationships: Undiagnosed HFA can make personal relationships challenging. Misunderstandings can arise from difficulties in communication or empathy, which may strain relationships with family members, partners, and friends.
  6. Career Difficulties: Individuals might struggle in the workplace due to social and communication challenges. A diagnosis can lead to better understanding and accommodations, making working more manageable and productive.
  7. Lack of Self-understanding: A diagnosis can provide a framework for understanding one’s experiences and challenges, which can be empowering and validating. With a diagnosis, this understanding may be present.

Despite these challenges, it’s worth noting that many undiagnosed adults develop effective coping strategies and lead successful lives. 

Understanding and Managing Symptoms

Understanding and managing the symptoms of High-Functioning Autism (HFA) symptoms in adulthood can be challenging. Still, it can become significantly more manageable with the right strategies and support. Here are some ways to understand and manage the symptoms of HFA:

1. Professional Diagnosis: The first step is getting a professional diagnosis. That provides a clear understanding of what you’re experiencing, which is critical for effective management.

2. Therapy and Counseling: Cognitive Behavioral Therapy (CBT) can be very helpful in managing symptoms of HFA. It can help individuals understand their behaviors and develop strategies to cope with social situations, manage anxiety, and deal with emotions.

3. Social Skills Training: Many adults with HFA benefit from social skills training, which can help with understanding social cues, improving communication skills, and building relationships.

4. Mindfulness and Stress Management: Mindfulness, meditation, and other stress management techniques can help manage sensory overload and anxiety.

5. Support Groups: Joining support groups for adults with autism can provide a sense of community and shared understanding. It’s an opportunity to learn from others’ experiences and coping strategies.

6. Medication: While no specific medication for HFA exists, medications can manage co-occurring conditions, such as anxiety or depression.

7. Accommodations at Work or School: If you’re studying or working, discussing potential accommodations with your institution or employer can be helpful. These include flexible working hours, a quiet workspace, or extra task time.

8. Regular Exercise: Regular physical activity can help manage stress, improve mood, and promote better sleep, which can benefit individuals with HFA.

9. Healthy Lifestyle: A balanced diet, good sleep hygiene, and regular exercise can support overall mental health.

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10. Education: Educate yourself, family, friends, and colleagues about HFA to promote understanding and support.

Everyone is unique, so what works for one person might not work for another. Exploring different strategies and finding what works best for you is crucial. 

Life with High-Functioning Autism: Perspective from Adults with HFA

Living with High-Functioning Autism (HFA) as an adult presents unique challenges and opportunities. Here are some insights that reflect the experiences shared by many adults with HFA:

  1. Feeling Different: Many adults with HFA describe feeling different from their peers, especially in social situations. That can be isolating, but it can also lead to a unique perspective on the world.
  2. Passion for Special Interests: Adults with HFA often have specialized interests they’re deeply passionate about. These interests can lead to fulfilling careers or hobbies.
  3. Struggle with Social Situations: Even with high-functioning autism, understanding social cues and norms can be challenging. Misunderstandings or social mistakes can lead to anxiety in social situations.
  4. Strength in Routine: Routines can be comforting and serve as an anchor in a world that often feels unpredictable. Changes to routine can be distressing.
  5. Sensory Sensitivity: Sensitivity to lights, sounds, smells, or textures can make specific environments or situations challenging.
  6. Living with Co-Occurring Conditions: Many adults with HFA live with co-occurring mental health conditions such as anxiety, depression, or ADHD.
  7. The Value of Diagnosis: A late diagnosis can provide relief and validation, explaining lifelong challenges. It can also open up access to resources and support.
  8. The Power of Support Networks: Support from understanding friends, family, or autism support groups can be beneficial.
  9. Employment Challenges: Navigating the workplace can be difficult due to challenges in communication, understanding social dynamics, or dealing with changes and sensory issues. However, success in the workplace is certainly possible, and many adults with HFA thrive in careers, especially those aligned with their special interests.
  10. The Journey Towards Self-Acceptance: Many adults with HFA describe a journey towards self-acceptance, learning to understand and accept their autism as a part of their identity.

Every person with HFA is unique, and these experiences won’t reflect everyone’s reality. However, these insights can provide a starting point for understanding the lived experiences of adults with HFA. It’s essential to listen to and value the voices of those living with HFA, as they are the true experts in their experiences.


Living with High-Functioning Autism (HFA) as an adult has unique challenges and opportunities. The road may seem complicated, but individuals with HFA can lead fulfilling and successful lives with the proper support and understanding.

Adults with HFA often possess unique perspectives, deep passions, and strengths that can contribute significantly to various aspects of life, including their careers, relationships, and hobbies. Understanding their experiences, struggles, and triumphs is crucial in fostering acceptance and inclusivity in society.

Whether it’s a late diagnosis or a lifelong understanding, identifying as an individual with HFA can provide a lens through which one can better understand themselves and their interactions with the world around them. It opens up pathways to specialized resources and strategies that can assist in managing symptoms and navigating daily life.

Indeed, every person’s experience with HFA is unique, and there is no one-size-fits-all approach. But through shared stories, mutual support, and continued learning, individuals with HFA and the people around them can work together to create an accepting and understanding environment that celebrates neurodiversity.

Finally, living with High-Functioning Autism is filled with learning, growth, challenges, and triumphs. Understanding, accepting, and celebrating these experiences is a step forward in fostering a more inclusive and compassionate society.


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