Functioning labels in autism
By Arshia Verma
Most people who have heard, read, or seen anything about autism have come across the terms “high functioning” and “low functioning” at some point, whether it was through social media, movies, books, or a conversation. In the 1980s, researchers started using the “high functioning” label to refer to autistic people who didn’t have an intellectual disability. Society has come to use this term to imply that autistic individuals without intellectual disabilities can function without any support among neurotypical peers. Unfortunately, this label really only looks at cognitive ability and fails to take into account the other areas of life that these individuals may struggle in.
Functioning labels are primarily used to identify an individual’s communication methods and intellectual ability. If a person with autism is labeled “high functioning,” they usually haven’t had a speech or language delay, communicate verbally, and have normal to high intellect. Unfortunately, the label of “high-functioning” can undermine the daily difficulties individuals face and make it harder for them to receive the support they need at school, work, or in social settings. People often tend to believe that people with autism don’t need accommodations if they communicate verbally and present mostly as neurotypical. People seen as “high functioning” may not be given credence even when they do speak about their autistic traits such as sensory overload or social struggles. Our society’s desire to ignore the true needs of autistic individuals who “pass” as neurotypical and fit them into a mold ultimately denies them access to the services they need.
The problem can compound because a lack of support early on might pose more significant challenges later in life, as hiding the traits of autism can take a toll. Masking signs of autism and presenting a front of being neurotypical can lead to very detrimental consequences such as anxiety, depression, autistic burnout, and increased risk of OCD, PTSD, and suicide.
Individuals labeled ‘low functioning’ usually do not use spoken language and instead use a different form of communication like sign language, picture exchange system (PECS), augmentative and alternative communication (AAC), or have some kind of intellectual disability. Some of the common conditions that are grouped into the “low functioning” category include intellectual disability, sensory differences, apraxia, non-speaking, and epilepsy. The “low functioning” label can be misleading in that it often leads to a reduction in opportunities at school and work solely because of the communication method an individual feels most comfortable with. Unfortunately, people who are labeled low functioning tend to be undermined and stigmatized due to them not using the conventional method of verbal communication. Their societal worth is measured based on how well they can mimic or resemble non-disabled, neurotypical peers.
Neither label can truly be used to come to a conclusion about an individual’s general ability to work well due to the wide variety of strengths and challenges people with autism have. Furthermore, people’s functioning capabilities can change dramatically even within 24 hours, so labels are ineffective. Autism is a spectrum, and as such, it should not be approached in a black-and-white manner. Instead of trying to apply a broad functioning label, asking an autistic person about their strengths and needs can be more helpful in pinpointing exactly how we can support them. Another consideration is that as a society, we need to move away from the belief that people with autism need to be ‘fixed’ or taught to act neurotypical. Rather, we should focus on understanding the best way to accept and communicate with them.