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LipstickKiller
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28 Jul 2009, 12:32 pm

It seems there are a couple of different ways of determining whether someone is highfunctioning or not. I thought it was IQ, but when people speak of HFA and LFA it seems to have more to do with how much assistance one needs and how well one can live independently. So which is the generally accepted version?



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28 Jul 2009, 12:48 pm

It depends.

Once upon a time... (something like that) high-functioning was the unofficial description of a DSM-IV-TR diagnosis of autistic disorder without an Axis-III diagnosis of mental retardation. (It is Axis-III I believe?)

With this definition of high-functioning, it does not matter how severe the autistic disorder is. A person can have zero ability to read others for example or not talk, but if they have normal IQ, they are HF.

It also doesn't matter whether someone is able to live independently either, but only if they do not fulfil the criteria of a cognitive disability on top of their autism.


More often these days, high-functioning is (mis)understood as severity.

If somebody got mild symptoms (little problems to read body language, few routines, talks well) many professional call them 'high-functioning' even if they function not so well for how mild they actually are. Meaning, if they are still horribly clueless about friends and getting along though they are actually only a little bad at social stuff.


I think I also heard that some people (for whatever reason?) think that somebody who talks = HF and somebody who doesn't = LF.

Of course, that's not making a lot of sense, though the inability to talk or to talk at all times can give you many problems but it not necessarily.


High-functioning can also nowadays describe the ability to function as opposed to how severe symptoms are. Most people don't seem to know this.

Somebody might not be able to talk, but work and communicate with others as an adult and have friends and do really well. (The ability to talk isn't exactly something all success depends on.)

Somebody can have zero ability to get the social stuff, yet 'fake' (=find ways to work around their severe autism) it well enough to seem to do well socially and better than somebody with mild AS.


There might be more definitions?


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Malsane
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28 Jul 2009, 1:02 pm

I always figured that the functioning was the point. Can this person function in society? Can they contribute to society? I didn't think it was really a marker of how they feel, but more if they're 'useful' to the society a large. I don't really know, that's just always been my impression.



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28 Jul 2009, 2:41 pm

I don't know what the official definition of functioning level is-- but I've had this sneaking suspicion for the longest time about what it has come to mean.I suspect is that in most people's minds functioning level has little to do the persons ability to attain independence but has more to do how visibly autistic/unusual they are (or aren't).

If that makes any sense...

:?



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28 Jul 2009, 9:45 pm

I always thought if some could work and live independently that they were high functioning. That's why I say I have moderate AS because I do things more slowly (like cleaning) and I can't work, therefore can't live independently. But there are some days where I function worse than usual, in which I require someone to assist me.


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28 Jul 2009, 10:11 pm

It means an IQ over 70/75 (there's a direct correlation between IQ and severity with autism).

It's not "high-functioning" in the slightest. About 60% of people with HFA live in institutions/group homes for example. It's just in comparison to those with LFA, and compared to that, it's "high-functioning".



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28 Jul 2009, 10:17 pm

And once again I've given a word an improper meaning. Meh.


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28 Jul 2009, 10:54 pm

This is clearly something I was confused about, thanks in part to the inconsistent terminology used by the neurologists, psychiatrist, psychologists, and therapists I've seen in my life. I've been told I am "high functioning" based on my IQ and ability to live on my own. But I've been told I function at about the pre-teen to teenage level (I'm in my 40s).

I've never figured out this obvious contradiction. I know I have extremely limited social skills, and cannot expect to have anything resembling a normal social life (NT style, that is). I score 42-44 on the AQ, and if it weren't for a happy congruence of coincidences I don't know that I'd be freelancing successfully enough to live on my own. With no family or friends to take me in, I'm not sure what will happen if this situation changes.

I think I'll stop referring to myself as "high functioning". Thanks for the insights here in this thread.



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28 Jul 2009, 11:32 pm

People do use high-functioning as an informal term when comparing you to someone else with the same label, but this isn't an accurate measure, nor is it the original meaning of the term.

The whole LFA/HFA thingy was created by researchers a long time ago. For example, all of Kanner's original individuals were "high-functioning" (contrary to popular belief), but they started finding that people who they thought were severely mentally ret*d [without structural brain damage], actually had autism. Then they did a whole heap of studies based on symptom severity and outcome, and came to the conclusion that IQ was a good predictor for severity.

This was before the popularity of AS, which was seen as "subclinical" autism back in the day.



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29 Jul 2009, 1:51 pm

Than you for the answers, this is all very interesting, mainly because I'm generally interested in the power of words. The way I think my psychologist would divide it is: low IQ= low functioning, normal IQ, but language delay = HFA, normal IQ, no language delay=Asperger's. But he said that basically as an adult you can't tell HFA and Asperger's apart, so I guess that particular distinction isn't terribly important.

Maybe there'll be a new line-up in the future: autism with IQ in lthe low/normal/high range with functioning level of low/moderate/normal. How do you like that set-up?



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29 Jul 2009, 3:04 pm

Malsane wrote:
I always figured that the functioning was the point. Can this person function in society? Can they contribute to society? I didn't think it was really a marker of how they feel, but more if they're 'useful' to the society a large. I don't really know, that's just always been my impression.


In which case I would be terribly low-functioning.

Anyway, LFA and HFA are no formal DSM diagnoses. There's just autistic disorder, Asperger's disorder and PDD-NOS, and with autistic disorder and PDD-NOS there may or may not be an additioanl diangosis of mental retardation. And to complicate matters furhter, with Asperger's there may actually be an additional diagnosis of borderline intellectual functioning (IQ 70-85), and in some countries (eg. the Netherlands) these people are classified as mildly mentally ret*d for educational/support purposes.

One's functioning level in terms of how psychiatrists determine it, is totally different, and is determined by one's GAF score (global assessment of functioning) on axis V of DSM. This functioning level is defined by such criteria as whether someone can keep friends, hold a job, have appropriate personal hygiene, etc.).

All differnet theories about LF and HF autism get mixed up (the whether someone can talk or not is also one, but I can't justify that by DSM stuff), and it creates a blend of all sorts of ideas in which anyone can be just whatever they want. I am:
- HF if it's defined by IQ
- HF if it's defined by language skills
- LF if it's defined by living independently or need for support (I need "24-hour care")
- Inbetween if it's defined by certain behaviors (eg. self-injury/aggression, have some issues with this but not badly)



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29 Jul 2009, 3:20 pm

There are different ways of working it out. If you have an IQ over 70/75 you're high functioning.
And there's the global assesment of functioning which determines functioning level by how well you cope in life, and it is alot more reliable because it gives you an actual number where as "HF" and "LF" are much too vague.


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29 Jul 2009, 3:28 pm

Danielismyname wrote:
It means an IQ over 70/75 (there's a direct correlation between IQ and severity with autism).

It's not "high-functioning" in the slightest. About 60% of people with HFA live in institutions/group homes for example. It's just in comparison to those with LFA, and compared to that, it's "high-functioning".
yes im living grouphome and i have asperger i guess someone should hit up a poll, but im guessing that most of us are not in just because of autism itself..for me im in care because of my meltdowns and cant get off until someone decides good apartment for me or i finish school


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29 Jul 2009, 6:40 pm

I always thought "High Functioning" meant really smart, like IQ over 120.


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29 Jul 2009, 10:45 pm

gramirez wrote:
I always thought "High Functioning" meant really smart, like IQ over 120.


in the NT world, it sort of does. for AS, it just means you can keep up at the bottom end of what is considered "average", so to speak. 75IQ or higher. i personally don't care for the term. not because of some politically correct stance, i just don't get the point.

you either get by in the world or you don't. Depending on how far to the left or right you are, coaching and guidance can improve things. i would like to see some more clear definitions of the classification, should the medical world continue to use it.


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29 Jul 2009, 11:49 pm

Quote:
highfunctioning means what?
Absolutely nothing.


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