What is “high” and “low” functioning?
According to the levels in the DSM-5, high functioning people use spoken language to communicate, are more likely to manage the expectations of an academic setting, and more likely to be aware of social conventions. Basically, they are able to pass as “normal” or “typical” in most areas of life.
Low functioning people are described to look and sound different from their typical peers with their disability being more visually and orally obvious, and are less likely to engage in typical classes or activities.
Why is this a problem?
The “high functioning” or “low functioning” dichotomy came from eugenics (a movement aimed at selectively breeding desirable traits and out-breeding neurodiverse individuals [among other marginalized identities]). It is based off a person’s ability to produce capitalistic value or not which is inherently wrong.
The distinctions between low and high functioning individuals is artificial and not absolute. This is because autistic people behave differently in different situations and every individual has a range of strengths and challenges.
For example, a “high functioning” person who appears “normal” (or even exceptional) in a classroom may find it impossible to function at a party or concert. Meanwhile, a “low functioning” person who can’t use spoken language to communicate may be more than capable to lead an online conversation.
Why is this a problem?
Autistic people labelled as “high functioning” often receive less care and support from communities, peers, and medical professionals because they are deemed capable of functioning “normally” in society without assistance. This becomes an issue once they are no longer capable of functioning “normally” due to sensory overload or any other triggers. This idea also promotes the harmful and excessive use of “masking” where autistic individuals prevent themselves from stimming or a meltdown to maintain the expectations of a “high functioning” person.
On the other hand, autistic people labelled as “low functioning” are deemed of less value than their “high functioning” and neurotypical peers. They are often excluded and isolated from social circles, are underpaid, and denied workplace rights and healthcare rights.
What should we say instead of “high” and “low” functioning?
Focusing on people’s functioning gets us nowhere. Autistic people’s needs and experiences are too varied to fit into any dichotomy, no matter what you call it. The conversation should be focused on the amount of access to care rather than the amount they “function.” Obviously some people need more care and different forms of care than others but labelling autistic people on “high” and “low” functioning is the opposite of supportive.
Simply approach each autistic individual with an open mind and kind heart without forcing us into restrictive and demeaning boxes.
also a huge thank you to all my fellow peers from the autistic community for sharing your thoughts and opinions on this issue with me [heart emoji] -@safehaven.activists
Thanks to @safehaven.activists for the awesome info slides. Read my commentary here in High vs. Low Functioning Labels for Autism, Part 2.