It’s time we stop pathologizing different neurotypes and get to the root of the problem: we all need individualized care.

Instead of putting the onus of “functionality” on the individual, we need to really evaluate how the systems we have in place (this capitalist, white supremacist, cisheteropatriarchy) put us all at disadvantages depending on the identities we hold. No two autistic people are the same, just as no two neurotypicals are the same.

Let’s start a conversation about what is actually needed: comprehensive universal healthcare and social infrastructure that evaluates the individual’s needs and accommodates appropriately. There is no such thing as a “high” or “low” functioning human. There are only humans who need a more accommodating/understanding/patient environment. Whatever “level” humans operate at, makes them just that—human. Functioning labels serve no one but those who feel the need to “organize” for hierarchy’s sake.

I consider myself disabled due to the combination of my chronic disease and neurodivergence (autism w/ADHD). This means that even though you’ll see me dancing and often “functioning” at the expected level in most social situations, there are days where I can barely get out of bed, let alone get to the store or talk with people in any meaningful way. Social and sensory triggers play a HUGE role in my “functionality,” on top of having a body that fights itself on a daily basis.

Not my words, but relatable AF

Autism is not a condition or disorder.

But it CAN be a disability when needs aren’t met. When the metric for disability is based in how an individual is able to “perform” socially, or independently, suddenly a whole lot of people are either “low functioning” or are able to mask super well which causes its own problems. It’s degrading. We are all worthy of love, dignity, and respect.

When it comes to disabilities that can only be accommodated for so far (from executive functioning issues to having seizures), we have the opportunity to see disability as a non-linear spectrum, as we see autism. Certain disabilities will put a person at a disadvantage compared to others in whatever environment. This is why it’s even more crucial that we have individualized care. And when accommodating for one disability impedes someone else with a different disability, a compromise must be reached.

We are humans of great capacity!

We literally have ALL the power to make our society inclusive and accommodating for *everyone*. We accommodate for everything we can, we do better when we learn better, and we interact with each other with dignity and respect. It all comes down to compassionate communication and individual needs (which is not to say similar needs can’t be serviced collectively, just that systems need to operate on a more personal level than they do now).

So why don’t we make this shift happen? Because the way things are now keep people poor and dependent and allows those in power to stay in power by exploiting others. We can start dismantling these awful structures by changing our language to be more compassionate and inclusive. Will you join me?

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?

Nothing.

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. 

Sources:

healthline.com/health/high-functioning-autism

http://spectrumnews.org/…/large-study-supports…/

http://autismawareness.com.au/…/why-we-should-stop…/

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.