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What’s the Difference Between High Functioning and Low Functioning Autism?

AGXStarseed

Well-Known Member
(Not written by me)


This post is inspired by many interactions I have had both online and in “the real world” with other parents of Autistic children. I have noticed a significant emphasis on functioning labels in the autism parenting world. When I have made the argument that functioning labels are arbitrary and make no sense, I am accused of not knowing what it is like to parent a child with “real autism” because I would not say these things if my child were not “high functioning”. I am very, very sad for the children of such parents. No child should ever feel like they are not completely and unconditionally loved. I am also heartbroken for those parents, because they are turning their backs on a loving and beautiful relationship with their own children. No amount of “support” and “sympathy” is worth that.



First, let’s address those functioning labels.

What is “high functioning”? What is “low functioning”?

Often, the distinction seems to be made on the amount of verbal speech your child uses that is considered “functional speech”.

So, a child who can talk and have a conversation with you is “high functioning”?

What about a child who uses scripting instead?

What about a child who sometimes loses speech and uses typing to communicate?

What about a child who sometimes has a hard time with typing, so they have to use picture cards to communicate instead?

What about a child who finds that the picture cards are sometimes too overwhelming and communicates the only way they know how, with frustration and sometimes, SIB’s? Oh, you didn’t know that behavior is communication? Because it is.

All of these describe my child. There are days when everything fits together, and she is fully supported and her sensory needs are being met, and she can have a lively spoken conversation, even with strangers.

More often though, her speech is scripted.

At home, she mostly types to communicate because there is no pressure on her to “conform” and stop acting Autistic already.

On the days where she has reached her limit with the very difficult task of trying to talk, she uses the picture cards. Usually though, if she is too exhausted to talk, that is when her frustration comes out and she communicates the only way she knows how to. Some people call them “bad behaviors”. I know better.

Is that a “high functioning” or “low functioning” child?

You tell me.

What about the things that she needs help with?

At 11, she still needs me to stay next to her so that she can get to sleep. She also needs a lot of help staying asleep, but that’s okay. That’s what she needs and I am her mother. This is what I am supposed to do.

Though she is an avid learner, my child needs help staying focused and “on track” with visual schedules and checklists. Without them, she will often become confused and anxious because she is unsure of the next step in her school work. We support her because she is worth it, and lamenting about how much support she needs won’t change the fact that she needs it. It will just make her feel bad about who she is and the things that she needs help with. Because we value her, we know that helping her with these things will teach her that needing support is not shameful.

When you go in our bathroom there are picture cards tucked inside the medicine cabinet to help her with toileting and hygiene. She will often forget a step if there is not a visual cue to remind her.

My “high functioning’ child is not yet potty trained and still has to use diapers. We support her and teach her, but we never shame her publicly or otherwise for being Disabled and on a different developmental path than other children her age.

Wait, does that make her ‘low-functioning”? I get confused because she is also reading ‘The Hobbit”, which might make her “high-functioning”.

It’s almost like I was right when I said that functioning labels are arbitrary, ableist and totally made up.

Perhaps it is sensory or dietary issues that decide our functioning label?

We are fairly careful with our diets because many foods trigger seizures or migraines in my child. Even though these issues are separate from autism, many people don’t realize or understand that, so I thought I’d include this in deciding her functioning level. In addition to these health concerns, sensory issues with taste and texture limit her diet even further.

My child also has several sensory issues with auditory processing that makes going to crowded box stores or restaurants very difficult for her. So, we accommodate her instead of telling complete strangers on the internet that autism is to blame for our hard time parenting or the adjustments it takes to support her. (for the record, we eat meals late or early if we want to go out to avoid the crowds and we don’t apologize or become embarrassed by her being openly Autistic in public. She has a right to participate in the community as much as anyone else while being her own authentic self at the same time).

She also requires a lot of proprioceptive and vestibular input and a lot of breaks throughout the day to stay regulated and happy. We spend a lot of time on the trampoline, or spinning or swinging. We spend a lot of time stimming. Because knowing when you need to take care of yourself is an important step to learning self advocacy, we always encourage her to speak up when she needs a break or sensory play time. Some days she spends the majority of her time taking breaks instead of doing school work. So, is she “low functioning” because her sensory needs are so intense or is she “high functioning” for recognizing what she needs to regulate her mind and body?

Confusing stuff, these functioning labels!

Since I am not sure she would fit neatly into any of these “categories” of autism anyway, and because I find them disrespectful to her as a human being, I refuse to use functioning labels. My child is Autistic, and I love and accept her no matter how much support she needs. No matter much spoken language she uses. No matter what, because her life is worth living. Honestly, I am disgusted by those who would force me to put her in a category and determine how worthy she is based on what she can or can not do.

How dare anyone attempt to place a value on my child’s life?



So, now Let’s talk about your assumptions

When you assume that my child is “high functioning” (whatever that means) because I tell you that it’s not okay to determine how much acceptance an Autistic person deserves based on a functioning level, you are making assumptions based on your own bigotry. You are assuming that I could only love and accept my child because I don’t know what it is like to deal with “real autism”. Do you realize that says a lot more about you than it does about Autistic people, or me, or my child?

It is saying that you think that loving a person you consider “high functioning” is easier than loving a person that might need more support.

It is saying that it’s okay to accept someone who is able to “pass” or conform, but not someone whose disability makes that impossible.

It is saying that some Autistic people are worth more than others.

It is saying that you think it’s okay to write off the very real support needs of people you deem “high functioning” because if they can pass sometimes, they must be able to get over themselves and pass all the time.

It is saying that you don’t know the first thing about autism.

It is also saying that you have some deeply held and rather troubling ableist beliefs that you should probably come to terms with and get help for. You owe that to your children.

On a personal level, I find those assumptions to be incredibly insulting because you are putting a value on the life of my child based on your own ignorance. Don’t you dare do that to my kid. My child needs a lot of support. I still love and accept her completely and totally no matter what developmental track she is on. I am disgusted and offended by those that think my love for her is conditional and based on her not being a “real” Autistic. Nothing could be further from the truth. I accept all of her, her gifts, her challenges, her whole complete self. She can’t be separated from her neurology and I wouldn’t want her to be.

You are harming and dehumanizing my child and all Autistic people when you perpetuate your ableist beliefs.

Stop telling people that some Autistics are worth accepting while others are not. Stop making assumptions about my child and other Autistic people based on your own ignorance and prejudice. Most importantly, stop talking about autism as if you understand it at all. Because when you use functioning labels, it is clear that you don’t.


About the Author
Romana Tate is the pseudonym of a busy mom. She does not write under her real name to protect her child’s privacy, but felt like she wanted to say something about people’s assumptions about functioning labels. She enjoys spending time with her family and educating parents and families about parenting their Autistic children with compassion, acceptance and unconditional love.



SOURCE: What’s the Difference Between High Functioning and Low Functioning Autism?
 
I am not a mother, but I applaud you for being a great mother!

Labels, labels and more flipping labels, is the lot of the supposed "professionals"!

I spoke to this amazing American lady on the telephone not so long ago, for I had decided that I really ought to get a professional diagnosis, as I feel it would make life easier for me, but sadly, it seems to not be happening, because I cannot find an English speaking therapist ie in France. Anyway, I phoned SOS that is based in Paris for the English speaking, living in France. She amazingly knows a lot about aspergers and in her words: aspergers is not STATIC; some days are better than other days and visa verse.

I generally prefer text form or messaging online, to verbal communication. But I do have my good days, when yes, I can look in someone's eyes and have an ok conversation with them and strangers too. In fact, those who know me, tend to say: having a good day, today, Suzanne, you seem more confident?

I too deal better with a structured environment. Even to the point of needing to know my husband's moves; not because of distrust, but because I feel more secure knowing where he is. Thankfully, he does not take this the wrong way and like I have a chain around him or that it is because I am doing bad things and do not wish to be caught out! Perhaps partly because if it were me going out, he would want me to let him know, for we are a together couple, despite our differences.

I actually believe now that if I did go to see a therapist, it wouldn't take too much time to say I have aspergers, because unless I am feeling extraordinary good at that time, it will show plainly what I have to contend with.

It reminds me of the time, when against my sense of right and wrong, I sent off for compensation for child abuse. I was turned down the first time, because there was no PROOF of the abuse! I got angry with that and was encouraged to apply again and added some more detail and was rewarded £2,000. They said they were only awarding me a small amount because there was no sexual intercourse and a list of what you would get, for what ever was done to you!!!!!! So because I couldn't get pregnant, for he was cunning ie father, I was condemned!

This American lady said that the best ones to diagnose are aspies themselves, because they become the very experts that experts are not! But we would be prejudiced against because we are "mentally ill"!
 
I am not a mother, but I applaud you for being a great mother!

Labels, labels and more flipping labels, is the lot of the supposed "professionals"!

I spoke to this amazing American lady on the telephone not so long ago, for I had decided that I really ought to get a professional diagnosis, as I feel it would make life easier for me, but sadly, it seems to not be happening, because I cannot find an English speaking therapist ie in France. Anyway, I phoned SOS that is based in Paris for the English speaking, living in France. She amazingly knows a lot about aspergers and in her words: aspergers is not STATIC; some days are better than other days and visa verse.

I generally prefer text form or messaging online, to verbal communication. But I do have my good days, when yes, I can look in someone's eyes and have an ok conversation with them and strangers too. In fact, those who know me, tend to say: having a good day, today, Suzanne, you seem more confident?

I too deal better with a structured environment. Even to the point of needing to know my husband's moves; not because of distrust, but because I feel more secure knowing where he is. Thankfully, he does not take this the wrong way and like I have a chain around him or that it is because I am doing bad things and do not wish to be caught out! Perhaps partly because if it were me going out, he would want me to let him know, for we are a together couple, despite our differences.

I actually believe now that if I did go to see a therapist, it wouldn't take too much time to say I have aspergers, because unless I am feeling extraordinary good at that time, it will show plainly what I have to contend with.

It reminds me of the time, when against my sense of right and wrong, I sent off for compensation for child abuse. I was turned down the first time, because there was no PROOF of the abuse! I got angry with that and was encouraged to apply again and added some more detail and was rewarded £2,000. They said they were only awarding me a small amount because there was no sexual intercourse and a list of what you would get, for what ever was done to you!!!!!! So because I couldn't get pregnant, for he was cunning ie father, I was condemned!

This American lady said that the best ones to diagnose are aspies themselves, because they become the very experts that experts are not! But we would be prejudiced against because we are "mentally ill"!

I'm 67 and labeled high functioning, an Asper. There was no diagnoses as any autism 60 years ago. Family sent me to the shrink at 6. The result was that I was fundamentally ok but that my parents had issues and that I should be put in a foster home. My Ma fought to keep me with her, to my regret still, and lived far too long shunned, incarcerated at home, not allowed to eat with the family and basically tormented by them under the guise of discipline.
School was no better.
The first time I felt like a human was in the service, but believe me Aspers in the military is worthy of a post or two, also.
Here is my slant. With most of my life behind me, I don't care much what happened long ago and far away. I excelled beyond even my own expectations and am content.
The low functioning seem to have difficulties socializing and improving their lives without some help, training and support.
The high functioning also are socially inept but are bright enough to overcome many obstacles by developing systems that get around or over the social stigma. Newton, Epicureans as a group, Einstein, Bill Gates and perhaps Edison and Tesla are all possible Aspergers contenders.
I would say, and I do not know what I am talking about, that the low functioning have difficulties changing their lives without support.
The high functioning have difficulties changing the world without support. Thanks for your time. EP
 
I would say, and I do not know what I am talking about, that the low functioning have difficulties changing their lives without support.
The high functioning have difficulties changing the world without support. Thanks for your time. EP


Your summary above is fantastic, EP. Sounds to me like you know exactly what you're talking about. I don't think I've heard it said any better.

Understand that I don't pity you, but I'm sorry for all you've endured. You've certainly come out of it a very thoughtful person.
 
Your summary above is fantastic, EP. Sounds to me like you know exactly what you're talking about. I don't think I've heard it said any better.

Understand that I don't pity you, but I'm sorry for all you've endured. You've certainly come out of it a very thoughtful person.

Slithy, thank you, I am flattered an humbled.
In those rough times even as a young kid, I knew who I was and my BS detector was always going off. Isolation gave me time to read and think, a lot.
Existential philosophy gave me the outlook to at least understand myself and promoted being true to myself.
Marcus Aurelius gave me the will to try to be excellent if I could.
Markus Twainus gave me irony and satire.
Sci fi writers gave me the idea that tomorrow might be a better day.
Aspergers, a recent diagnosis gave me the focus and mind to develops survival tools.
A google search of probable Asper's in history as well as now, gave me dignity and even pride.
This forum gave me a platform to rant on, friendship, support and more intellectual stimulation than I've had in years.
My wonderful wife gives me love and acts as a buffer between me and others.
My choices have been keen and productive and my life is very comfortable.
So being an Epicurean Pariah as well as an existentialist prompts me to consider that every thing that brought me to this perfect moment, was vital to my growth and choices, and was/ is perfect and fine. Not forgotten or forgiven but accepted and overcome, now even embraced.
 
a quote from J. Robinson
Robison: "The biggest virtue of pointing out the continuum is that when we do, we recognize that people can occupy different positions on the continuum at different points in their lives. One of the things that troubles people about the use of labels like “low-functioning” and “high-functioning” is that people will call a five-year-old kid who can’t talk “low-functioning,” yet a kid who has language skills, like me, but doesn’t have any friends, is described as “high-functioning.” First of all, of those two children, the so-called high-functioning kid is the one who is at material risk for suicide by the time he’s 16. Most people would not call a dead kid highly functional."
 
Your summary above is fantastic, EP. Sounds to me like you know exactly what you're talking about. I don't think I've heard it said any better.

Understand that I don't pity you, but I'm sorry for all you've endured. You've certainly come out of it a very thoughtful person.

Slithytoves, thanks for your kind words. I think that was my 3rd day at AC, I was surprised that kestrel discovered it, I thought every post just got buried deep by the new posts, like sediment, and plunged under the continental shelf never to have the context of thought brought to the surface of the frontal lobe once again. Thanks
 
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Often, the distinction seems to be made on the amount of verbal speech your child uses that is considered “functional speech”.

This is a big problem, I think. People who don't speak are often treated like furniture. Society's attitudes toward non-speaking persons and towards intellectually disabled people (who are usually equated with one another anyway) are terribly abusive.
 
I am wondering mow, is Aspergers the same as high functioning autism? I never really understood the difference.
 
I am wondering mow, is Aspergers the same as high functioning autism? I never really understood the difference.

Edit: I am reorganizing this so the information is more accessible (instead of a block of text)

According to the DSM-V it is the same.
Under DSM-IV criteria for Aspergers, you needed fewer overall autistic traits to qualify, although you were disqualified if:

1. you had enough traits to qualify for Autistic Disorder
2. you had a speech delay
3. you had intellectual disability

However, some clinicians ignored the first two, and I have met at least one person who was diagnosed Aspergers despite failing the last requirement. In addition, despite "autistics" being frequently stereotyped as non-speaking, many do gain speech on the same order as Aspies or even NT's, merely later, and intellectual disability is not as frequent as stereotypes claim either.

So you've got some people who can only be distinguished from Aspies up to a certain age, and you've got "aspies" who meet the criteria for Austistic Disorder but weren't diagnosed with it for one reason or another. At the same time, you had people who didn't fit either category perfectly but who were still obviously on the autism spectrum somewheres, and maintaining the idea that these populations were totally separate from each other just got sillier and sillier.
 
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It is my understanding, using the criteria from DSM-4, that the difference between Asperger's Syndrome and classic Autism is that with classic Autism there is a certain amount of cognitive and linguistic impairment. With AS, that impairment is not there. The difference between AS and High Functioning Autism is that with HFA that impairment is there, but is slight. Using the criteria from DSM-5, they are all the same. The only difference is the level, or where you are on the spectrum. I would like to say that this is only my understanding which certainly doesn't make it right. This a very complex issue.
 
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It is my understanding, using the criteria from DSM-4, that the difference between Asperger's Syndrome and classic Autism is that with classic Autism there is a certain amount of cognitive and linguistic impairment. With AS, that impairment is not there. The difference between AS and High Functioning Autism is that with HFA that impairment is there, but is slight. Using the criteria from DSM-5, they are all the same. The only difference is the level, or were you are on the spectrum. I would like to say that this is only my understanding which certainly doesn't make it right. This a very complex issue.
@cig114, yes I agree. To put it another way it is the difference between common English and the legalese English of a contract, all NT equivocation and nuance, elevated to an art form.
 
High functioning and low functioning are all relative. I don't like to see people use those labels when there is already a label, Autism. I speak Asperger English, and for me, it is hard when people take what I say wrong. Some people say I am high functioning while others say moderate functioning, but I don't think like that. Those terms should be banned. No one has more autism than another autistic. We all have the same amount of autism in U.S. It is how it affects us that tells people those terms.
 

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