Do DSM‑5 Autism Criteria Miss High‑Functioning Individuals?
Yes, it’s possible that the DSM‑5 high‑functioning autism criteria may not fully capture individuals with subtle or well-masked traits. While the DSM‑5 provides a comprehensive framework, its diagnostic sensitivity can sometimes fall short when assessing people who have strong cognitive skills or social coping mechanisms. As a result, many high‑functioning individuals may go undiagnosed or misdiagnosed.
Why Some Individuals Slip Through
Even when autistic traits are present, they may not always meet the thresholds laid out by the DSM‑5. Here’s where the system might fall short:
Subtle communication differences
High‑functioning individuals often develop ways to navigate social situations, masking the more obvious markers of autism that are outlined in standard assessments.
Strong verbal and intellectual skills
These behaviours can overshadow neurodiverse traits such as rigidity, sensory sensitivity or emotional overload, especially in clinical settings that rely on overt signs.
Late or missed diagnoses
People with high‑functioning autism may only seek help later in life, often due to burnout, anxiety or a sense of not fitting in leading to undiagnosed autism until adulthood.
Why Sensitivity Matters
The challenges faced by those with DSM‑5 high‑functioning autism are very real, even if it is less visible. This highlights the need to refine current tools to better reflect the spectrum’s complexity and improve diagnostic sensitivity across all presentations.
To explore diagnostic pathways that recognise nuanced traits, visit providers like Autism Detect for personalised assessments.
For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Autism Diagnostic Criteria (DSM-5, ICD-11).
