High/Low Functioning: to label or not to label

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Yes 39%  39%  [ 9 ]
No 61%  61%  [ 14 ]
Total votes : 23

graceksjp
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27 Apr 2020, 1:11 pm

Do you believe we should use the terms high/low functioning when describing autism and ourselves?


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27 Apr 2020, 1:23 pm

I would love if the use of “low-high support needs” eventually supplanted the currently-popular functioning labels as the primary way of referring to how much support an individual autistic needs, but I feel it would be too difficult to get all the NT therapists/clinicians/Autism Speaks employees out there who are used to using functioning labels to change on a whim.


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27 Apr 2020, 2:14 pm

Zakatar wrote:
I would love if the use of “low-high support needs” eventually supplanted the currently-popular functioning labels as the primary way of referring to how much support an individual autistic needs, but I feel it would be too difficult to get all the NT therapists/clinicians/Autism Speaks employees out there who are used to using functioning labels to change on a whim.


I'm in my late 50's. I was diagnosed 11 years ago. I didn't tell everyone about my diagnosis, but now cringe that I told some people at all. Okay, so I'm "super-organised" and can find patterns, detail, and resolve certain problems. But, with the benefit of hindsight, I'd still rather do it without the "high-functioning" label and possible expectation: I'm still me - Ok at most things. Getting by, on the whole. Too much of an expectation I'll solve all problems, and generally now wish I'd said nothing about diagnosis at all. Diagnosis sometimes helps me understand myself, but not sure it helps others who easily use it as a convenient label to excuse their occasional poor conduct towards others. It really has made me reflect on my relationships and cleanse those that were unhealthy.



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27 Apr 2020, 2:18 pm

graceksjp wrote:
Do you believe we should use the terms high/low functioning when describing autism and ourselves?
For accurate descriptions, yes.  For general purposes, maybe not so much.



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27 Apr 2020, 2:51 pm

I don't understand the debate or know how it arose.



Joe90
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27 Apr 2020, 3:10 pm

I don't think autism should be split into just high or low-functioning, but I do think there are people on the spectrum who are more high-functioning than others. So functioning labels do exist but should not be relied on as a concrete diagnostic tool.


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27 Apr 2020, 3:31 pm

I do think there should be some sort of differentiation, because there's a huge difference between people on either end of the autism spectrum, and also people closer to the middle. Perhaps "high," "moderate" (which is what I call myself - I was diagnosed before functioning labels were given out, so I'm really just guessing, I guess), and "low" would be sufficient, or perhaps we need more gradients. I do agree that it would also make more sense if the "levels" were determined based on how much support a person needs.


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graceksjp
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27 Apr 2020, 4:38 pm

domineekee wrote:
I don't understand the debate or know how it arose.


someone said i was being ableist and degrading when i referred to myself as high functioning because the labels can be seen as harmful
its putting a box around a person and sets unrealistic expectations upon those labelled high functioning which might keep them from getting the proper help they need in their areas of struggle
low functioning might have such low standards that they are not pushed to achieve their greatest potential
its apparently a term for NTs to try and slap a label on us and then assume that high functioning = nt

however, I've never seen it that way because there is a distinction between people who can function in society largely by themselves and those who.....well cant. who cant communicate or live alone. who will never have a job.
I have nothing against them and don't mean to be rude or mean or belittling or discriminatory, but i can recognize that those in that area need more help overall than say, I do.

regardless, autism is a unique and complex spectrum where you can be high in certain areas and low in others, so the best way to go about 'treating' it is to cater to each specific persons needs. everyone is different.
being seen as normal and high functioning might not necessarily mean you don't struggle in everyday life


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27 Apr 2020, 4:43 pm

Coincidence - I just watched a video about this last night! She has some interesting and valid points.

https://www.youtube.com/watch?v=fD5jAwPlSDY



Sahn
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27 Apr 2020, 5:07 pm

graceksjp wrote:
domineekee wrote:
I don't understand the debate or know how it arose.


someone said i was being ableist and degrading when i referred to myself as high functioning because the labels can be seen as harmful
its putting a box around a person and sets unrealistic expectations upon those labelled high functioning which might keep them from getting the proper help they need in their areas of struggle
low functioning might have such low standards that they are not pushed to achieve their greatest potential
its apparently a term for NTs to try and slap a label on us and then assume that high functioning = nt

however, I've never seen it that way because there is a distinction between people who can function in society largely by themselves and those who.....well cant. who cant communicate or live alone. who will never have a job.
I have nothing against them and don't mean to be rude or mean or belittling or discriminatory, but i can recognize that those in that area need more help overall than say, I do.

regardless, autism is a unique and complex spectrum where you can be high in certain areas and low in others, so the best way to go about 'treating' it is to cater to each specific persons needs. everyone is different.
being seen as normal and high functioning might not necessarily mean you don't struggle in everyday life

After being a carer for a high needs autistic guy, I'm less concerned about those who only want their condition validated and more concerned that his needs are met. If a distinction helps to serve that purpose I'm all in favour of making one. Having said that, maybe the "functioning" term could be changed.



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28 Apr 2020, 1:29 am

I think it's fine for a self-description. I don't care that much what people say about themselves as long as it isn't misleading or nonsense.

I think doctors should be more descriptive. "Low-functioning" is probably typically autism+ID or some other secondary condition. I think doctors are already making combo diagnoses like that now, so that's good. It's the parents/caregivers who aren't making the distinction between autism by itself and autism+something else that's a problem I think.

The diagnoses should at least point out the most disabling symptoms. Maybe the doctors could rate the individual parts of the diagnostic triad (sensory, social/communicative, repetitive/restricted behavior). Like "sensory: low, social/communicative low, repetitive/restricted: moderate." Then people will know they are dealing with a very sensitive, very atypically social person who is not constantly stimming, and they can plan interventions around that.



carlos55
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28 Apr 2020, 3:26 am

Functioning labels are there to understand a person`s needs in a hugely wide spectrum.

If I said bob has problems with his spine, has he got back ache, or is he paraplegic in a wheelchair?

If I said Jane has problems with her eyes, does she wears spectacles to drive or is she blind as a bat with a guide dog and white stick?

There has already been a removal of a label “Asperger’s” and that has caused all kinds of problems that most are aware of that I won’t go into fully here.

Removing Asperger’s has probably scared off many potential employers, as when someone says they have autism on an application form the employer doesnt have a rough idea where they are on the spectrum and what their needs and capabilities are.

The same is true on medical notes for first time referrals.


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28 Apr 2020, 4:16 am

This is what I wrote on another forum re a question of how functioning vs disabled we were .

Quote:
For me the problem is white (good functioning) vs black(bad functioning) whereas functioning ,depending on the task , can go from black to shades of grey to white . Most of us,functioning wise, will be a mix of black ,grey and white in terms of how well we function . We all have our relative strengths and weaknesses .

The same issue occurs with ASD.



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28 Apr 2020, 4:48 am

What I'd like removed,if it hasn't been already, is any estimation of functioning and needs based on intelligence . In a predominantly verbal exchange with someone I come over as far smarter than most . However in a non-verbal/practical use of intelligence way I'm way lower than the mean . The truth is I do better with support , and would actually be a prime candidate for a group home or sheltered housing without it .

Short verbal exchanges with people , such as MH professionals, give a false picture of well I function . The term 'adaptive functioning' springs to mind . A term that seems to be used far more in the USA than the UK . My adaptive functioning level is significantly below what might be expected based on a short verbal exchange with me .



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28 Apr 2020, 4:50 am

Varies. It shouldn't be simply something as black and white as 'high/low'.

The discrepancies between it's description and the actual thing of both labels are glaring.
One could just add another dimension of spectrum; separate yet relevant to the spectrum wheel of traits that came from an individual (mainly 1st person).
If one insists the variables of high/mid/low, think one that usually simplifies as;
Severity(1st person) based on personal profiles
Support(2nd person) based on needs and accommodations
Performance(3rd person) based on achievements and outcomes



My own conclusion is that science had yet to find more other ways to measure what makes any individual function and as it is relevant, one that would reflect real time-real life.


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MrsPeel
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28 Apr 2020, 7:42 am

I said "no" to functioning labels.

I did once refer to myself as "high functioning", shortly after being diagnosed, but after some reading on autism I regretted that. There are problems around who decides what functioning label to give and why - because an aspie might be fine self-identifying as high functioning, but to have high we must have low, and the "low functioning" label is hardly helpful to anyone.

The current DSM diagnostic labels are much better in my view, because they describe the level of support one needs. It's like the difference between saying "he can't tie his shoelaces" and "he needs velcro shoes" - taking the emphasis from the deficits of the person to the amount of assistence they require. (Activists would say this is moving from the medical model of disability to the social model).

I'm no activist, but I've decided to adopt levels of support needs instead of functioning levels, I think it's more helpful.