Understanding High-Functioning Autism in Toddlers

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What is High-Functioning Autism?

High-functioning autism is an informal term used to describe people who have autism spectrum disorder with an IQ of at least 80 and are able to speak, read,and write. Many parents, caregivers, teachers, and medical practitioners believe that the terms “low functioning” and “high functioning” should be used to make a distinction between people who have been diagnosed as autistic since there is a range of impairment within the disorder.

Signs, Symptoms, and Behaviors of Autism in Toddlers

Many parents have become fearful for their young children with the high number of new cases of autism being diagnosed each year. Most aren’t sure what to look for when attempting to assess if their child might have autism.

Here are some common signs, symptoms, and behaviors of high-functioning autism in toddlers.

Signs, Symptoms, and Behaviors of Autism in Children

  • lack of interest in other children
  • lack of imitation
  • no pointing to ask for something
  • failure to gaze at an object that another person asks them to look at or follow
  • doesn’t bring objects to show or share with parents
  • lack of response when called
  • doesn’t play with toys appropriately
  • no babbling at the age of 6 months
  • no single or two-word phrases by eighteen months
  • repetitive behaviors like spinning or running back and forth
  • loss of skills they may have learned previously (regression)
  • missing milestones at appropriate ages (rolling over, sitting up, crawling, walking)
  • inability to maintain or make eye contact

For some toddlers with high-functioning autism, the child may actually speak early or have an advanced vocabulary. However, for others, some parents report that their children have spoken later (after eighteen months), but their speech was normal.

Another concern reported by parents was the loss of previously learned skills like speaking, making eye contact, and answering to their names when called. In these cases, researchers aren’t sure if the children regressed due to the onset of autism, or if others around them simply became more aware of the child’s lack of social interaction, communication, and/or unusual behavior.

It is also important to remember that most children with high-functioning autism will speak, read, and write at the same age as their peers. One of the reasons they are misdiagnosed or diagnosed later is because their social interaction, failure to recognize nonverbal communication cues, and repetitive behavior may not seem too far from the norm when they are very young.

In the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatry Association, a person must demonstrate two or more deficits in each of the three main categories of social interaction, communication, and restricted behaviors to qualify for an autism diagnosis. Many doctors are wary of labeling very young children as having autism spectrum disorder. Some delay making a diagnosis unless the child presents severe or extreme signs, symptoms, or behaviors associated with autism.

How is High Functioning Autism Diagnosed in Toddlers?

The number of children being diagnosed with autism has risen dramatically in the last ten years. It is estimated that 1 in 100 children have autism spectrum disorder. The alarming rate of new autism cases worldwide has spurred researchers to create tools to assist parents and pediatricians in recognizing early signs of the disorder in children as young as eighteen months.

Some of these autistic children will be considered as having high-functioning autism. How do doctors detect or diagnose high-functioning autism in toddlers or any form of autism in very young children? The best tool at the moment is the M-CHAT.

The M-CHAT is the Modified Checklist for Autism in Toddlers. The checklist is used primarily in the United States. It was adapted from the original CHAT which was devised by researchers in the United Kingdom.

The M-CHAT is composed of 23 questions. It can be used to evaluate children from 18 up to 24 months. Part A is a parental questionnaire that asks about things like joint attention, pretend play, social interests, motor development, and social play.

Part B is for use by medical practitioners. Doctors are asked to report their observations regarding eye contact, ability to follow a point, pretend play, building a tower of blocks, and other age-appropriate skills.

Currently there is no medical test for autism. Most tools are based on parental concerns and doctor observations for children at least 14 months or older.

Hopefully, medical science will one day create a genetic or blood test to screen for autism as early as possible.


“High-Functioning Autism and Asperger’s Syndrome” Reviewed by David Hirsch, M.D. September 3, 2009, webmd.com, https://www.webmd.com/brain/autism/high-functioning-autism

“Cues May Signal Autism in Toddlers” Jennifer Warner, July 1, 2007, webmd.com, https://www.webmd.com/brain/autism/news/20070705/cues-may-signal-autism-toddlers

“The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders.” Robins, D.L.,Fein, D., Barton, ML, and Green, JA April 31, 2001, US National Library of Medicine National Insitutes of Health, https://www.ncbi.nlm.nih.gov/pubmed/11450812