Does ABA Therapy Work for High-Functioning Autism

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What is High-Functioning Autism?

High-functioning autism describes individuals with autism spectrum disorder (ASD) with average or above-average intellectual abilities, good verbal communication skills, and relatively mild or subtle symptoms. Individuals with high-functioning autism can experience a unique combination of symptoms that may vary in severity. Some may even have strengths and talents in certain areas, like art or music.¹

High-functioning autism refers to level 1 of the autism spectrum, in which a person has little to no intellectual disability. Still, they may struggle with social interaction, communication, and emotional expression. Many persons with level-1 ASD can fit in with a neurotypical culture. As a result, it’s typical for people with high-functioning autism not to be diagnosed until later in life. This is especially common for women and girls, who often mask their traits to fit in.

Some common symptoms of high-functioning autism may include:

• Difficulty with social situations, such as challenges making and maintaining friendships, difficulty reading social cues, and issues with reciprocity in conversation
• Difficulty with communication, such as understanding sarcasm and idioms, taking things too literally, and struggling to understand nonverbal communication
• Repetitive behaviors involve specific tasks and movements that cause distress when disrupted
• Sensory sensitivities, such as becoming overwhelmed by loud noises, bright lights, and certain textures or smells
• Individuals with intense passions for certain subjects, such as trains, prehistoric creatures, or mathematics, and a tendency to concentrate on these passions to the exclusion of other hobbies or interests
• Difficulty with transitions or changes in routine; becoming upset or anxious when there is a change in schedule or an unexpected event
• Emotional dysregulation, such as having trouble controlling feelings, getting upset easily, or experiencing intense emotions 

A quick note on language: many autistic people and clinicians now prefer “level 1 autism” or “low support needs,” because functioning labels can understate very real challenges. We use “high-functioning autism” on this page because it’s still the phrase most families search for. Rest assured, we mean it descriptively, never dismissively.

Is level 1 autism the same as high-functioning autism? 

Mostly, yes. When people say high-functioning autism, they’re usually describing level 1 autism spectrum disorder: no intellectual disability, fluent language, and support needs concentrated in social communication, flexibility, and executive functioning [2]. The difference is that level 1 is a formal DSM-5 designation, while high-functioning is an everyday label. If you’re not sure where you or your child falls on the spectrum, a comprehensive autism evaluation can give you clarity. We recommend you take this brief, confidential online assessment and then, as a next step, contact a mental healthcare provider for a full evaluation.  

ABA Therapy & High-Functioning Autism

Applied Behavior Analysis (ABA) therapy treats individuals with autism spectrum disorders or other developmental disorders. ABA therapy focuses on teaching and reinforcing positive behaviors while reducing or eliminating negative or inappropriate behaviors. It’s based on the principles of behaviorism.²

ABA for high-functioning autism typically consists of the following components:³

• Assessment: A qualified ABA therapist will thoroughly evaluate the individual’s behavior, communication, and social skills to identify specific areas of need.
• Goal setting: Based on the assessment, the therapist will work with the individual and their family to set specific behavior and skill development goals.

• Intervention plan: The therapist will develop a personalized intervention plan that includes strategies for teaching and reinforcing positive behaviors and reducing negative behaviors.
• Teaching and practice: The therapist will work one-on-one with the individual to teach new skills and behaviors and provide opportunities for practice and reinforcement.
• Data collection and analysis: The therapist will collect data on the individual’s progress and analyze the data to adjust the intervention plan as needed.
• Generalization: The therapist will work with the individual to help them apply the skills they have learned in different settings and with different people.

There are five strategies for teaching children with autism:

• Discrete trial teaching (DTT)
• Naturalistic teaching
• Pivotal response training
• Token economy
• Contingent observation

These methods involve breaking down lessons, allowing students to set their own pace, improving motivation and self-regulation, and using rewards or removing tokens based on behavior. Children are shown unacceptable behavior in group settings and instructed to observe peers performing successfully.⁴

Autism therapy can be delivered in different settings, such as mental health treatment centers or schools. There is even in-home ABA therapy  for high-functioning autism. It typically involves a one-on-one approach, allowing behavioral therapists to provide personalized attention and support. With consistent practice and reinforcement, individuals can develop new skills and behaviors to help them succeed in their daily lives.

ABA for high-functioning autism helps by targeting specific behaviors or skills that may be causing difficulties in daily life. Treatment is tailored to the particular needs of the individual. It may focus on various skills, such as communication, social interaction, self-help, and academic skills. ABA therapy uses a structured and individualized approach to teaching and reinforcing positive behaviors while reducing negative behaviors.

Athena Care focuses on comprehensive autism testing for children and adults, autism-informed individual and family therapy, psychiatry and medication management for co-occurring conditions, and intensive outpatient care, rather than operating an ABA program. If ABA turns out to be the right fit for your family, we’re happy to point you in the right direction during your first call. Call 877-641-1155 to get connected with one of our care specialists today.

Athena Care offers both in-clinic and at-home ABA therapy.

Insurance may be able to help cover the cost of therapy.

Athena Care is in-network with most major insurance plans. Find out more about your insurance coverage by calling your insurance company or contacting Athena Care at 877-641-1155.

Benefits of ABA Therapy for High-Functioning Autism Treatment

Below are some ways in which ABA programs for high-functioning autism can benefit you or your loved one:

• Improving social skills: ABA for high-functioning autism can help by teaching social skills such as initiating conversations, taking turns, and sharing.
• Enhancing communication skills: ABA may involve speech therapy to teach communication skills, such as using appropriate language and tone and understanding social cues.
• Reducing repetitive behaviors: ABA therapy can teach alternative behaviors to replace repetitive behaviors.
• Managing sensory sensitivities: ABA therapy can teach coping strategies like deep breathing or through the use of sensory tools.
• Building independent living skills: ABA therapy can teach independent living skills in a structured and individualized way.
• Self-care skills: ABA therapy can help improve self-care skills through tools like visual schedules.
• Academic skills: ABA therapy can improve academic skills in those with high-functioning autism by using personalized teaching techniques that break down complex tasks into smaller steps.

Goals of ABA Therapy for High-Functioning Autism

ABA goals for high-functioning autism are individualized and may vary depending on the needs and strengths of each person. They may also change as therapy progresses. ABA therapists will work with high-functioning children and their families to develop individualized intervention plans and track progress through data collection and analysis.

However, some common ABA goals for high-functioning autism include the following:⁵

• Developing social skills: Making eye contact, initiating and maintaining conversations, understanding social cues and norms, and developing friendships are just a few examples.
• Improving communication: ABA therapy for high-functioning autism can help improve communication skills, such as using appropriate language, responding to questions, and expressing emotions and needs.
• Reducing repetitive or self-stimulatory behaviors: ABA techniques can help children with high-functioning autism learn to replace repetitive or self-stimulatory behaviors, such as hand flapping or rocking, with more appropriate, functional, and desired behaviors when those behaviors interfere with learning or daily life. 
• Improving academic skills: ABA works to develop academic skills, such as reading, writing, and math, and helps the individual apply these skills to real-life situations.
• Developing independent living skills: ABA programs for high-functioning autism can teach independent living skills, such as dressing, managing personal hygiene, and preparing meals.
• Reducing challenging behaviors: ABA therapy can help reduce inappropriate behaviors such as tantrums, aggression, and self-injuring behaviors and replace them with more desired behaviors.
• Developing coping strategies: Manage anxiety, sensitivities, and other challenges by developing coping strategies with behavioral therapy.

When is ABA Therapy Right for You?

ABA therapy may be right for you or your loved one with high-functioning autism if you seek a structured, evidence-based intervention to help improve specific skills and behaviors. But ultimately, the decision to pursue ABA therapy should be made in consultation with a qualified healthcare provider who can help assess your specific needs and goals.

ABA for high-functioning autism may be just one of many autism treatment services that can be effective. Considering all available options is important when deciding on a treatment plan. Here are some factors to consider when determining if ABA therapy is suitable for you:

• Goals: If you or your loved one has specific goals related to communication, socialization, behavior management, or academic skills, ABA therapy may be a good fit. ABA therapy can be customized to address specific goals and adjusted over time as progress is made.
• Age: ABA therapy can be effective for individuals of all ages, but research has shown that early intervention is often more effective. Starting ABA therapy at a young age may be beneficial for long-term outcomes.
• Challenging behaviors: If you or your loved one is engaging in behaviors interfering with daily life, such as aggression or self-injury, ABA therapy can help identify the underlying causes and develop strategies to reduce them.
• Family involvement: ABA therapy includes significant family involvement, as parents and caregivers are essential to the therapy team. If you are willing and able to be actively involved in your loved one’s therapy, ABA therapy may be a good fit.
• Availability: ABA therapy typically involves regular sessions with a trained therapist, which can be time-consuming and expensive. ABA therapy may be a good fit if you have the time and resources to commit.

According to some experts, ABA therapy is most effective for children with severe autism, while developmental or play therapy is recommended for others, such as those with high-functioning autism. Developmental and play therapy emphasizes interaction, communication, and emotional growth, while ABA primarily focuses on behavior.⁶

If you’re unsure, a consultation with a reputable behavior analyst can clarify whether ABA fits your child’s strengths and needs before you commit to a program. 

However, parents who refuse behavioral treatment for their child with autism, thinking that their child is already “high-functioning,” might be missing out on effective intervention. Therefore, it is recommended that parents seek help from reputable behavioral analysts that specialize in behavioral treatment for children with autism. They can assess the child and discuss specific objectives and teaching strategies based on the child’s individual strengths and needs. Parents can then make an informed decision on the appropriateness of behavioral treatment.

While ABA for high-functioning autism can be effective for many, it may not be the right fit for everyone. Here are some situations in which ABA therapy may not be recommended:

• Personal choice: ABA therapy involves a significant time and resource commitment. Some individuals or families may prefer other less demanding interventions or treatments.
• Value conflicts: Some individuals or families may have values or beliefs that conflict with the ABA therapy principles, such as concerns about behavior modification or a preference for a more holistic or natural approach.
• Lack of availability: ABA therapy may not be available in all areas, or it may be challenging to find a qualified therapist who has experience working with individuals with high-functioning autism.
• Severe intellectual disability: ABA therapy may not be appropriate for individuals with a severe intellectual disability or who have significant language or communication deficits.
• Medical contraindications: ABA therapy may not be appropriate for individuals with medical conditions, such as severe allergies, preventing them from participating in therapy sessions.
• Trauma history: ABA therapy may not be appropriate for individuals who have experienced trauma, as some components of ABA therapy, such as physical prompting or intensive reinforcement schedules, may be triggering or distressing.

Is ABA therapy only for autism? 

No. Applied behavior analysis is a method, not a diagnosis-specific treatment. Its techniques are also used for ADHD, other developmental disabilities, and general behavior challenges. In practice, though, most US insurance plans only cover ABA when there’s an autism diagnosis. For ADHD without autism, first-line care usually means behavioral parent training, skills-focused therapy, and medication rather than a formal ABA program. 

What about ABA for teens and adults with high-functioning autism? 

ABA was designed primarily for young children, and that’s where nearly all the research sits. Insurers also approve adult ABA far less often. If you’re a teen or adult with level 1 autism, especially if you were diagnosed later in life, supports that often fit better include: 

A comprehensive evaluation, if you’ve never been formally assessed. Testing brings clarity, school and workplace accommodations, and access to autism-informed care. These evaluations are typically for ages 18 months and up  

Autism-informed therapy for the anxiety, depression, and burnout that often accompany a late diagnosis (explore therapy options) 

Psychiatry and medication management for co-occurring conditions like ADHD, anxiety, or depression (learn about medication management) 

Success Rates & Outlook of ABA Treatment for High-Functioning Autism

Early diagnosis and intervention are critical in optimizing outcomes for children with high-functioning autism. Autism does not have a cure or a treatment that works for everyone. However, treating it with early behavioral interventions to reduce symptoms and promote growth and learning can help improve overall functioning.

The prognosis for children with high-functioning autism varies based on several factors, such as the severity of symptoms, age, accessibility of therapies and support, and individual variances in strengths and issues.

Comprehensive, long-term ABA programs typically involve about 25 to 40 hours of treatment per week over one to three years.[8] Focused programs aimed at specific goals run closer to 10 to 25 hours per week [9], and for level 1 autism, fewer, well-targeted hours are usually more appropriate than an intensive full-time schedule. The right amount depends on the individual assessment, the child’s age, and your family’s goals. 

Below are a few statistics regarding the success and outlook for ABA therapy for high-functioning autism:

• Less than half of children referred for ABA treatment stay in services for 24 months, while two-thirds remain for 12 months.⁸
• Some professionals say ABA for high-functioning autism is the “gold standard” for treatment.⁹
• According to one study, the Early Start Denver Model (ESDM), a play-based intervention incorporating many ABA techniques and principles into its approach, improved children’s conduct and IQ. Additionally, it lessened how severe their autism diagnosis was.¹⁰
• Compared to children in control groups, children who receive ABA therapy early in life show more sustained improvements in cognition, academic performance, adaptive behaviors, social behaviors, and language.¹¹
• 45% of therapies that provide long-lasting and visible improvements for people with ASD are ABA therapies, according to the Surgeon General’s study on autism treatment.¹²
• Six months of ABA therapy, beginning at two years old, improved 48 autistic toddlers’ capacity for social interaction and the severity of their symptoms.¹³

An honest note to round out the picture: most ABA research involves young children, so the evidence base for teens, adults, and specifically level 1 autism is thinner. Some autistic adults have also raised serious concerns about older, compliance-driven versions of ABA, and research links long-term masking of autistic traits to higher rates of anxiety, depression, and burnout.[14] Modern, well-run programs look different: play-based, assent-focused, and built around goals the individual and family actually want. Ask any provider how they set goals, how they respond to stimming, and whether they target skills your child wants or appearances other people want. 

Frequently asked questions 

Does ABA therapy work for high-functioning autism? 

It can, especially for children with specific, well-defined goals around communication, daily living skills, or behaviors that interfere with everyday life. Research support is strongest for young children in early intervention programs. For teens and adults with level 1 autism, adapted talk therapies like CBT, ACT, and DBT skills often fit better. The right answer depends on the individual’s age, goals, and preferences. 

Is level 1 autism the same as high-functioning autism? 

Mostly. High-functioning autism is an informal, everyday term, while level 1 autism spectrum disorder is the formal DSM-5 designation for autistic people who require support but have no intellectual disability and fluent language. The 2 terms usually describe the same presentation. 

How many hours of ABA therapy does someone with level 1 autism need? 

Focused ABA programs typically run 10-25 hours per week, while comprehensive early intervention programs run 26-40 hours. People with level 1 autism usually need fewer, targeted hours aimed at specific goals rather than an intensive full-time schedule. Hours should be based on an individual assessment, not a default number. 

Is ABA therapy only for autism? 

No. ABA techniques are also used for ADHD, other developmental disabilities, and behavioral challenges. That said, most insurance plans only cover ABA with an autism diagnosis. For ADHD alone, first-line treatments are behavioral parent training, skills-based therapy, and medication. 

Does insurance cover ABA and autism therapy in Tennessee? 

Most major commercial plans in Tennessee cover evidence-based autism care, including diagnostic testing, and many cover ABA when it’s medically necessary. Coverage details vary by plan, so it’s worth a quick call to your insurer, or reach out to Athena Care at 877-641-1155 and we’ll help you verify your benefits. 

What are the alternatives to ABA for high-functioning autism? 

Common alternatives include developmental and play-based therapies for younger children, CBT and ACT adapted for autistic thinkers, DBT skills for emotional regulation, social skills groups, speech and occupational therapy, parent training, and psychiatry for co-occurring anxiety, ADHD, or depression. 

Does Athena Care offer ABA therapy? 

 Athena Care focuses on comprehensive autism testing for children and adults, autism-informed individual and family therapy, psychiatry and medication management for co-occurring conditions, and intensive outpatient care, rather than operating an ABA program. If ABA turns out to be the right fit for your family, we’re happy to point you in the right direction during your first call. Call 1-855-390-4357 to get connected with one of our care specialists today.