How to Talk to Someone with “High-Functioning” Autism

I would like to preface this blog post with an explanation of why I chose certain terminology to refer to people within the ASD Community: The professional and research community generally prefer to use person-first language – “child with autism” – due to believing in emphasizing the individual, rather than the disorder.

On the other hand, it has been widely deduced from surveys and research that people diagnosed with autism as well as their families prefer “diagnosis-first” language – for example, “my autistic child”. The idea is that this removes the stigma of autism being some negative affliction to be stuck with and instead choose to embrace their diagnoses as part of their identity and as something to be celebrated. In light of this ongoing debate, I will be using both forms to refer to people with ASD within this blog post.

Acknowledging the Spectrum

Autism Spectrum Disorder (ASD) is a developmental disorder that effects the way in which diagnosed individuals connect and interact with those around them. There are basically three categories in which “symptoms” of autism are categorized: impairment of social relationships, of social communication, and of imaginative thought.

In terms of imaginative thought, an individual may have an intense preoccupation with a specific interest or topic or have inflexible rituals or routines. Repetitive motor mannerisms such as spinning objects or hand flapping are common and often there is a lack of pretend or social imitation play (Family Education, 2017).

As it is a spectrum, and a wide one, there are endless characteristics and varying degrees of strengths and weaknesses that a member of the ASD community may have. This is where the terms “high-functioning” and “low-functioning” autism are often used.

Focus on Individuals Strengths

What is important to understand is that these terms are not generally accepted by people in the autism community. The reason for this is that by labeling a person as being “high-functioning” or “low-functioning”, you leave out the specific characteristics and strengths of the individual that are much more noteworthy and telling of who he or she truly is.

These terms used to describe autistic individuals have never appeared in any diagnostic manual, rather, they are “colloquial conventions used to refer to an individual’s intellectual or verbal ability and/or level of apparent social and everyday capabilities” (Kenny et. al., 2015).

Understand the Impact of Negative Labels

While “low-functioning” makes assumptions about a person’s potential, the “high-functioning” label is felt by most of the community to be misleading as it assumes that cognitively able individuals function well in everyday life, “which is not the case for some such individuals, who struggle to find and retain employment, to live independently and to sustain friendships and intimate relationships” (Kenny et. al., 2015). Additionally, this label may lead to the healthcare system and society further disabling autistic individuals by misleading the public to thinking services are not necessary for their success, which in many cases, is far from true.

That said, a common question people have is centered around how to interact with “high-functioning” autistic individuals (that will be the last time I will use that term within this blog post). The individuals we are referring to are simply language-able people who are capable of social interaction and expressing their own personal needs, wants, and interests.

Appropriate Social Inclusion

Keeping this in mind, there are some concepts to remember that will help you when interacting with an autistic adult or child. For one, do not assume that this person has any limitations in cognitive ability. Some instances of autism may present as difficulty with speech, but the person may fully comprehend the conversation at hand, he or she just may struggle with expressing it verbally.

For this reason, it is also important not to talk about the individual as if he or she is not in the room in order to be respectful of them and to maintain their dignity. Similarly, avoid using terms of endearment or nicknames that come off as belittling, for example “sweetie” or “honey” can be offensive to someone working towards their own independence.

Speak Clearly and Literally

Something else to keep in mind is that often times, “People with HF-ASD commonly exhibit difficulties with recognizing nuances of conversation, turn-taking, understanding humor and non-literal language…” (Kelly et. al., 2018). To prevent confusion and facilitate a successful conversation, it may be necessary to use literal and clear language as opposed to sarcasm and slang, which may hinder their understanding of the conversation.

Ask Questions and Facilitate Successful Dialogue

Autistic individuals who are verbally able and can communicate their thoughts often have very specific interests that they can talk at lengths about. Listening to what the person wants to say can go a long way in showing that you care and support them. If you get confused about what the person is talking about, ask clarifying questions. If the individual makes any inappropriate comments, point it out to them in a respectful way and explain why it is inappropriate.

Feedback like this can help those with autism to learn and have better experiences with social interaction in the future. When unsuccessful social interactions are repeated, they can lead to social anxiety and negative thoughts that may cause an individual to avoid social interactions altogether – further limiting opportunities for practicing social communication skills (Kelly et. al., 2018).

Initiate Conversation and Identify Commonalities

If you change the topic, be prepared for the individual to either bring it back to what he or she prefer to talk about or to no longer be interested in the conversation. As one individual with autism noted “… unless someone starts first and it’s something I’m interested in, then it’s not going to really work out” (Kelly et. al., 2018).

Avoid Distracting Environments

One last thing to remember is that it is common for autistic community members to have difficulty with tuning out distractions when in a less-familiar sensory environment. In another study focused on surveying the communication preferences of people with autism, it was noted that, “Several people found verbal communication overwhelming, sharing that ‘I can’t block out other sounds in the background’” (Howard and Sedgewick, 2021).

For this reason, remembering to be patient and encouraging when speaking to an autistic person can go a long way. Additionally, being aware that the individual may prefer to communicate in written form (text, email, etc.) without discouraging the opportunity to practice that social interaction.

I hope that these tips and suggestions are helpful to anyone who may interact with people on the autism spectrum. The most important thing to remember is to speak to them with the same respect and dignity that you would want from anyone speaking to you.

References:

familyeducation.com. (2017, July 26). Three Areas That Characterize Autism Spectrum Disorders. FamilyEducation. https://www.familyeducation.com/life/signs-symptoms-autism/three-areas-characterize-autism-spectrum-disorders

Howard, P. L., & Sedgewick, F. (2021). ‘Anything but the phone!’: Communication mode preferences in the autism community. Autism, 25(8), 2265–2278. https://doi.org/10.1177/13623613211014995

Kelly, R., O’Malley, M. P., & Antonijevic, S. (2018). ‘Just trying to talk to people . . . It’s the hardest’: Perspectives of adolescents with high-functioning autism spectrum disorder on their social communication skills. Child Language Teaching and Therapy, 34(3), 319–334. https://doi.org/10.1177/0265659018806754

Kenny, L., Hattersley, C., Molins, B., Buckley, C., Povey, C., & Pellicano, E. (2015). Which terms should be used to describe autism? Perspectives from the UK autism community. Autism, 20(4), 442–462. https://doi.org/10.1177/1362361315588200