Types of 'High-Functioning'

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DISCLAIMER: Please don't interpret the categorizing as anything other than how I personally view high-functioning autism strictly in the context provided.
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From what I've observed (regressive autism etc. are irrelevant), there seems to be two ways that an individual comes to be classified as 'high-functioning':

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Type 1: Begins life as a low-functioning autistic individual.

Behaviour is typical of low-functioning throughout much of childhood, and IQ test scores are likely <70. As the individual ages, they 'bloom' (a word used by others, hence the quotations) into a high-functioning individual. This seems to be a relatively rare occurrence, as it is usually a case where autism is markedly severe, though without presence (perhaps a little) of mental retardation.

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Type 2: Begins life as a high-functioning autistic individual.

Most individuals that are born high-functioning are labelled with Asperger's, simply because that's what the diagnosis entails. It is still unknown as to whether or not Asperger's is actually autism, though it is currently believed to be. Individuals can have more severe cases of Asperger's, however that is uncommon, and as I will briefly elaborate on below, those individuals tend to differ from those that are not born high-functioning, throughout their lives.

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IMPORTANT - The reason I make this distinction is not to categorize, but to highlight something I believe to be an important difference in neurological being. Those that 'become' high-functioning later in life tend to maintain traits commonly associated with lower functioning, such as complete social disinclination, a viewing of humans as objects etc. Those that are born high-functioning tend to feel loneliness, and wish for human contact.

I haven't really made myself clear in this post, so I apologize for any confusion. Whether you interpret this as a possible distinction between Asperger's and Autism (or low and high functioning, as I set it up) or simply an act of convenience (in that I ignore exceptions), that's entirely up to you.


TL;DR - If you glance at the post and read only this, all I ask is that you don't comment how I have oversimplified something complex, rather take the idea that I've provided - different paths to high-function = different traits.

What about when you are born high functioning, but it's only in ONE area. For example, a special interest.

I really don't like the phrase "high functioning" sometimes. I need clarification on what is high functioning, because we are all different. What about some of us who seem to be 50/50? Or other percentages?

So you label high and low function according to IQ rather
than according to social success (using NT terms)????????

Whether involved with AS or not it's usual for all
to retain traits from our past.

I have always had a high IQ but have always hungered
for the friendship of others.

Research studies frequently use IQ for autism functioning.

I don't think IQ is a useful way to measure functioning. Some people are obviously autistic, but very smart. And some people are mildly autistic, but are mentally disabled. Kind of like Sam from "I Am Sam".

What about those of us that are mid functioning as children: having issues learning in school, constant shutdowns etc.. but that then become more higher functioning in teens... but as adults are somewhere back between mid and high (still have some issues in school but mostly don't "get" people... and eventually tire of trying to fit in and no long crave presence of others.)?

The issue I have is when people think of functioning and ASD, they think of being socially and developmentally normal. IQ can influence how much a person may be able to reasonably learn certain skills, but it isn't the sole factor. I don't understand how IQ alone would be an indicator of functioning level when ASD is a developmental disorder, not an intellectual one. From what we know now, functioning can be so drastically different with several different areas that it's now called a spectrum. We can't even reasonably put people in the 3 categories anymore because it doesn't make sense diagnostically based on the evidence.

My understanding is that technically, as used by researchers and clinicians, functioning = cognitive functioning = general intelligence = IQ.

IQ < 70 = low functioning.
IQ > 70 = high functioning.

That is all that is meant when test results are discussed.

People are confused because they think a more vernacular use of functioning is implied, something like "how well can you function in daily life" but this is not implied at all by "high functioning" or "low functioning."

There are many people who are technically "high functioning" who can barely function in day-to-day life.

I think the clinicians don't clarify this for the people being diagnosed or their families because it takes the edge of the diagnosis. "Your child is autistic, but very high functioning" sounds to the parents like, "Your chid has this scary label now, but don't worry, they'll be able to get on in life."

In fact the data do not support an optimistic understanding of the phrase "high functioning."

the guy in i am sam wasnt autistic, he was just intelectualy disabled.

as for low functioning and high functioning,medicaly/officialy speaking they are determined by IQ,a lot of aspies think they are low functioning because their autism traits clash with a part of their daily living-severity of traits clashing with daily living or a part of it isnt the same thing as overall functioning.
actualy being low functioning is a different spectrum all together,it makes our autism present very differently and we have very complex needs,very high support needs and severe challenging behavior.
sorry for posting this,as am aware am always pointing out the iq difference whenever this topic comes up and dont want people to think am purposely being annoying.

KingdomofRats, you are not being annoying at all. It's good to point this out because people do get confused over this definition. It is true that, clinically, functioning is based strictly on IQ level. and nothing else. The idea of basing functionality on the ability to do certain things in day to day life is clinically incorrect but we do it in our informal speech. Perhaps we should come up with a better word to use in our daily speech to differentiate day to day ability to function rather than the clinical IQ definition.

I know that I am sam is technically not autistic. I just happen to know autistic people who are similar to him.

thanks skibum.

it sounds more normal/natural for a HFA to say they have difficulties with part of their functioning, or 'some functioning difficulties'-in the UK we have learning disability [intelectual disability] and learning difficulties [specific difficulties with learning] to show a difference between people who have global functioning problems and people who have part/specific problems like dyslexia, dyspraxia etc.

In the USA, it's not like that anymore. It's all a spectrum and there is more emphasis put on functioning levels and what you need help with rather than if you are high or low functioning. This is because someone can be quite intelligent yet be low functioning with something like routines and social functioning. It would get even more specific from there, saying what specific social difficulties you have. The recent research has blurred the lines between high and low functioning.

The ADOS testing has a total of (I believe) 32 ratings for various activities. The cut off for ASD is 7, I believe, and the cut off for Autism (I assume classic or lower functioning?) is 10. Each point represents the level of severity. I appear very "normal" to many people, yet I scored an 11. My routines/special interest category is on the very severe scale. I'm also "higher functioning", yet I DO have meltdowns and always did as a child. I also have sensory difficulties. A lot of people still tell me I can't have those because I'm only high functioning. I scored an 8 in the social interactions, and the cut off for that is 6 for autism. I scored a 3 in communication, and the cut off is 3 for autism. So, I technically would have been diagnosed with more severe autism. Yet, for all practical purposes, most people would label me as higher functioning.

Depending on what needs you are talking about, I need very little or a LOT of help. This is why I just don't get the HF vs LF thing. To quote the psychology wiki because I'm lazy, level of functioning is "the ability level of a person is their observed level of performance in particular tasks. These may include academic, cognitive, health, perceptual or occupational assessments of ability."
Therefor, IQ and academic performance is only one area of level of functioning. When we are talking about Autism, a lot of the level of functioning groups are going to be coming from activities of daily living and social interactions. The level of functioning in those types of categories also matter. Since autism is not an intellectual disability, using IQ to determine level of functioning makes no sense if it's the ONLY factor being used.

This is exactly what regular people who are not in the medical field mean, though, and that's the issue. Also, why would Autism functioning levels be classified solely based on IQ levels when autism is a developmental disorder, not an intellectual disability? When you have a developmental disorder, you also have to use developmental milestones to diagnose it. Thus, the level of functioning in that area matters. This can also be referred to as assessing activities of daily living. You also need to assess the social functioning of the person.

Edit: This sums up what I was trying to say, with a few studies. I will look for even more. http://sfari.org/news-and-opinion/news/ ... -in-autism

It has been my understanding that the past few years have shown IQ is not the best indicator for functioning levels. I wish I could find my studies. If I find them, I will post. For now, that link states what I was trying to say far more eloquently. There is also the issue I have with IQ tests not being a very good intelligent measurement for ANYONE, let alone autistic people. Why would people think an NT intelligent test would properly test intelligence in a developmentally disabled person? There have been several examples of autistic people being tested with them and they all had an IQ of <70, yet it turned out the tests were dead wrong. This often happens with non-verbal people, I think.

Last edited by bleh12345 on 28 Jul 2014, 2:20 pm, edited 1 time in total.

Over in the USA, learning disability refers to problems like dyslexia, dyspraxia, etc. However, an intellectual disability refers to mental capacity. In other words, this is the one where your IQ would be low and you have reduced mental capacity. Also, a developmental disability would be autism or something that stunts your development.

The diagnosis of autism includes evaluating behavior and development, NOT IQ. IQ is not part of the criteria at all. Therefor, when people say "high or low functioning", they mean high or low functioning in regards to the criteria, which still does not include IQ. This means: Is X high functioning in social situations? Are they high functioning when reading body language? Are they high functioning with sensory perception? Are they high functioning with interests and routines?

The problem is slapping high or low functioning on someone makes no sense. Since there are several criteria, it's better if everyone focuses on the functioning levels of the individual tasks or groups of behaviors, since people on the spectrum often have varying levels of function in many areas.

I don't think Sam, from "I am Sam" was autistic at all. He had a mild-moderate intellectual disability. He was very social. His "autistic" behaviors, I believe, came from being overwhelmed in the courtroom. Sean Penn played that sort of person well.

I was "low-functioning" in a lot of ways until I was 5. I don't believe I had a "low IQ," though. It was thought I was intellectually disabled. I morphed into an Aspergian after I acquired speech. I am definitely the type that likes to initiate social contact, but is awkward at it. I have "hierarchy blindness" as well. I was a 'little professor" at a young age, and had a somewhat pedantic manner when I was reeling off facts and figures. Otherwise, I was just a "regular kid" in a lot of ways. I used to have a penchant for talking to strangers, though I didn't like hanging out in groups of more than two.

Last edited by kraftiekortie on 28 Jul 2014, 2:22 pm, edited 1 time in total.