How do you define high functioning?

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I'm interested in everyone's perspective on this, I've been diagnosed Asperger's and so of course am in the 'high functioning' group of people, and I guess in many respects I am, I hold down a job, study and look after my animals. But looking around my house if a stranger walked in right now they would think I was completely incapable of looking after myself, same goes for my bank accounts they are a shambles, and personal relationships well I just won't go there...

Of course it's not the same as being physically incapable of doing things but at what point do you say you can't look after yourself? How many aspects of life have to be severely impacted before you are classed as needing help?

Basically if you can dress yourself, feed yourself, take care of yourself and have some level of communication with people.

I got the dressing part down. I'm not so good with the feeding part. I can get food into the mouth and swallow. Sometimes I get it all over me and sometimes I choke on it. I think I eat a bit too fast. I'm pretty damn healthy though. I exercise too. I've got limited restorability though so if that changes I'm unsure if my routine will stay.

Taking care of myself....hmm. I've had some health issues as a result of not taking proper care of myself. I can't do my own grocery shopping, or work (awkward in job interviews), or take care of myself in the long term. Knowing when to wash clothes, self and when to clean my house can be exhausting. My bedroom is caked in dust as we speak. I need to set up a time and take medication just to do that.
I can't drive so I rely on others to get me to certain places.
I also still live with me mam.

Relating to people...oh God no. I give yes and no answers then stand there awkwardly while looking at my shoes. My meds make me talk more but it's just a bunch of random stuff. I still can't have conversations. I find them a bit boring anyway.

My sensory issues can affect my ability to function. Anything from sounds being too loud, textures being too coarse and lines coming out of nowhere or objects coming to life. It makes it hard to do anything when that happens.

Most people will see me as high functioning but really I'm just drugged up so I'm able to do things. I mean sometimes off meds I'm fine and sometimes I can't even walk a short distance.

Or maybe it depends on if you can get on disability. Do you think you can or do you think you don't need it? If you don't need it then that should be a clear indicator of what your functioning level is.

Btw most people here hate functioning labels but I don't mind them.

I wouldn't get on disability and dont need it because I have a job and even when I didn't I was able to get one. It's more just help at home, if I was on a better wage I could pay someone to clean and organize for me but that's not possible at the moment.

I just find it interesting because in some aspects of life I get along fine even though the Aspergers can make things a bit more difficult (communicating at work etc) but usually I can 'fake it till I make it' but my home life is often a shambles. I suppose I've always been taught to 'keep up appearances' and so the effort that goes into that results in me collapsing in a heap when I get home and not being capable of much else by then.

There is the objective criteria for what it means to be functionally impaired, then one's subjective sense of impairment. Sometimes these can be wildly divergent. It is possible to think oneself is doing rather well, when the reality is much more grim, and vice versa.

There have been times in my life when I was unemployed, completely penniless, without a scrap of food in my house, with my utilities shut off, and facing eviction. I've also had periods where I could go to a bookstore every week.

Depending on when you saw me, you may come to a different conclusion as to how high functioning I was. Myself, I could view my current state compared to my previous states, and get a much different view. "I may be making minimum wage, but look! I have electricity and heat. I'm doing much better than I was before!"

Right now, I think that I am not doing very well. But I have been in worse positions, and better positions. I think that objectively I would be classed "high functioning" according to many diagnostic criteria, but it feels like such a struggle that the term seems meaningless.

One tiny bit of misfortune can bring it all down. A better term would be "robustness."

How robust is the structure of your life? How much damage can it take before it falls apart? This seems to be a better way of looking at things.

A robust life would be able to absorb things like car accidents, health problems, unemployment, and such, without snowballing toward homelessness. It implies that one has some measure of financial security and supportive relationships. A buffer zone.

Some people may appear to be high functioning, but without robustness. They may be a few bad days away from living on the street. Others may appear low functioning, but capable of withstanding the same impact without degradation to their standard of living.

ETA:

In programming, a similar concept is Bus factor: how many people on your team need to die in a bus accident before the project will inevitably fall apart? The higher the number, the better the project has been distributed. If all it takes is one programmer dying for everything to fall apart, you have been allocating way too much responsibility to them, and your methodology will be as a result extremely brittle.

Last edited by ZeroGravitas on 11 Apr 2011, 3:16 am, edited 1 time in total.

I define it as, "You don't match the doctor's stereotype of autism." Or, "You seem more capable than the doctor expects of autistic people."

It has little to do with your actual ability and everything to do with how others perceive you. Being called "high-functioning" can still be a valuable piece of information about how other people see you; but it should not be taken as any sort of definition of what you can expect from your particular type of autism.

ZG I tend to agree that it depends very much where you are at in your life and your support network, I recently had a big health problem and without the support of good friends everything would have fallen apart very quickly.

Yeah I think when you feel like everything is getting on top of you the term high functioning is cold comfort.

Stress can rapidly deteriorate your skills.

But still if someone who needed to be cared for could longer receive that care you think they will pull themselves up from their bootstraps, apply and get a 9-5 job and marry a rich businessman? I think not. I just saying that when things fall apart for them their lack of experience will make it harder for them to succeed. My psyche thinks that if my mother could no longer support me that I will be fine on my own, but I fail to see how. She still cooks my meals. I was even worrying about when to cook myself dinner and watching my favourite TV show but then I saw she was making my food for me. There's no way in hell I'd miss the show just to make myself dinner. I would wait to make dinner until after the show except I have a strict eating routine and I'm kinda hypoglycemic.
If my mum could no longer care for me another family member would step up. I really don't want that to happen. I hate not being independent but I'm not capable of taking care of myself because I haven't the finances nor do I have any experience with adult responsibilities.

In some areas I'm high functioning like with knowledge compared to most of my family. I'm also strict on my dieting and exercise. That's really so my symptoms don't become worse but I take better care than most of my family. But still these people work and can take of themselves without needing to exercise or keep a healthy diet.
I do know what it's like not being able to take care of your home. My mum is barely at home and so the house becomes messy and it's up to me to clean it. I medicate to clean my room but could only manage a few rooms on it. Doing it while not medicated will make it happen 5 times slower and I'll not be as thorough. I was going to clean on the weekend but couldn't manage it. I tried exercising and that was hard enough. I can't exercise on medication too so I exercise over two days to keep the blood flowing.

Oh I know what you mean with cooking I really can't cook, I go to a friend's place for dinner nearly every day as it's the only way I get a square meal, when I was living further away I would survive on microwave meals and packets of chips which was really bad for my health.
I used to forget to eat a lot when I was watching tv or reading a book, now I do the opposite and nibble on junk a lot.

i see the HFAs [on both planets] as ones who i can't tell are anything but NT unless their very subtle autistic traits are shown to me- think bill gates. i see the HFAs here on WP as those who proudly post how they have "bootstrapped" their way to girlfriends and abundant $ucce$$ while simultaneously expressing disdain of other struggling WP members who lack the same wherwithal. just my 2-cents' worth, not adjusted for inflation

I am not sure exactly but I think I come off as higher functioning then I am...I've kind of had to. But I also have to take into consideration that it could be some of my other mental problems that also play a role. I mean I've had aspergers for my entire life obviously and i have had depression and anxiety ever since I can remember. I also have PTSD but that was not until after I was 16.

Sometimes people mis-perceive things about me though...like someone ignorant of my normal state might think I should not drink because it would interfere. But personally I don't see why I should not drink just because I struggle with certain things, I would struggle with things regardless.

All of that.

From what I've seen, what functioning level you get called has to do with:

1. A very small number of abilities (the rest get ignored)
2. Those abilities tend to be the ones considered most 'important' or 'normal' to the person looking at you.
3. Those abilities may just be assumed by the person, or if your abilities fluctuate a lot, they may assume that whatever abilities you have (or lack) are permanent, and that any actual fluctuation is either pretending to have difficulties you don't have, or falsely appearing to have abilities you don't have.

This all gets stirred around in the observer's head, complete with a boatload of assumptions about what disability is, how the world works, etc., most of which the person is unaware of. (And they're usually particularly unaware of how society shapes their opinions of these things, to the point where they'll flat-out refuse to believe it if confronted on the matter.)

I wouldn't really mind if functioning level were somehow used as "what a person can do, at this particular point in time, in this particular skill". As long as it was accurate (which would actually be hard even then, because most skills don't have simply a "one to ten system" where you can rate how good at it the person is... there's also qualitative differences as well, and that makes it harder than most people think it is). But as an overall measure of a person's abilities it rapidly becomes damaging.

I consider my self to be high funtioning. my docotors do not. But they do not know how I rely am.

It is a complicated and subjective issue. A person observed as highly functioning, highly successful, and with no diagnosis, could be entertaining thoughts of suicide on a daily basis.

A person in a coma that gains the ability to communicate may respond that they are in a happy state.

The issue becomes extremely important when someone needs financial assistance for disability. At that point the most objective measure becomes someone elses observation.

At this point the diagnostic criteria specifically used for Autism, Aspergers, and PDD NOS does not specify what constitutes high functioning other than average and above intelligence for Aspergers. There is no clear definition for HFA other than average and above intelligence.

The only objective measure I know of, other than intelligence testing, is the Global Assessment of Functioning criteria that can be used to assess the function of anyone, with or without a formal diagnosis.

If the GAF was used to rate the successful person in the first paragraph they are seriously impaired in functionality because they have suicidal ideation, regardless if they are observed as functioning well in life. However, if they hid their ideation, it would not be considered.

The proposed DSM V critieria for the general autism disorder addresses severity levels by addressing support aids required to live with impairments of major life activities specifically related to Autism. It is not a perfect measure, but at least it focuses on activities specifically related to Autism.

Vineland II tests functioning in multiple areas. Autistic people tend to score fairly low on this - in the same range as people who have intellectual disabilities.

Do you have any more details on Vineland II tests? Are they a normal part of the diagnosis procedure that some psychiatrists and psychologists use?

Also the ABAS (Adaptive Behavior Assessment System), is a similar thing. They basically ask someone who knows you (in my case, it was a staff person) a bunch of questions about what you can and can't do, basically how often you can do any particular thing. It divides it up into several categories (such as self-direction, communication, functional academics, etc.) The whole thing is based on what you can do in the practical world rather than what you understand, so if used right it can be much more useful than the sorts of tests that assume that understanding something is being able to do it. (For instance, functional academics isn't about what academic level you've achieved. It's about your ability to apply those in real-life situations.) It also has some serious problems (I'm told it has a very low ceiling), but it's not a bad test in some circumstances. It gives scores in each specific area, and then an overall score that resembles the IQ system in what the numbers look like (100 for average, etc.).

(In my case, I kept hitting the floor in various areas and then even my better parts brought my overall score to just several points above the floor. And that was many years ago when I could do more, so I don't want to know what my score would look like now.)