Autism, or autism spectrum disorder (ASD), is a neurodevelopmental condition affecting how people perceive and interact with the world.
Autism sufferers often have difficulty communicating, social interaction, and behavior. These difficulties can vary widely in severity and type.
Key characteristics of autism are communication challenges that range from verbal communication to difficulty understanding non-verbal cues like facial expressions and tone of voice.
The Difference Between High and Low-Functioning Autism
In this article, we discuss the difference between high-and-low-functioning autism and their support needs. We also explain why labels used to describe the condition pose problems to the autistic community.
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) uses three levels to diagnose the severity of autism:
- Level 1 ASD, previously known as high-functioning autism, is the mildest form.
- Level 2 ASD is the middle level with sufferers requiring substantial support.
- Level 3 ASD, previously known as low-functioning autism, is the most intense with sufferers requiring a high level of support.
People with high-level support autism, also known as Level 3 autism, require a lot of assistance in their daily lives. They face significant challenges in communicating and have extreme difficulty dealing with changes.
These challenges can lead to behaviors that strongly affect how they function. Some individuals may not speak, while others may have very limited or hard-to-understand speech. They usually do not initiate social interactions and may not respond when others try to engage with them.
These challenges make it extremely difficult for people with level 3 autism to complete day-to-day tasks, like caring for themselves or being able to work.
Level 1 autistics, on the other hand, are often able to function more independently but do face challenges with social communication. Although they mostly possess strong language skills (See: Autism speech therapy), this classification of autistics tends to be rigid or inflexible, they have difficulty transitioning between activities.
While people with level 1 autism are often considered high functioning with low support needs, difficulties with social communication, or narrow and repetitive behaviors, can cause significant interference in their day-to-day functioning. Without support, they will face noticeable challenges, including problems with organization and planning that could hamper their ability to become self-sufficient.
Problems Raised with Labeling Autistic Functioning
Autistic functioning labels are often used as shorthand to describe the intensity of autism traits. But these labels can be misleading.
As an example, although people labeled as having low support needs may be verbal and bright, they could have sensory challenges that make it difficult for them to complete their schooling or to hold down a job.
At the other end of the spectrum, a person with high support needs who may not be able to speak could be a successful visual artist.
These examples illustrate how functioning labels can cause confusion and miscommunication because neither describes the ability or functionality across multiple categories. There, functioning labels do not determine:
- Aggression
- Anxiety
- Level of intelligence
- Perseverance
- Sensory challenges
- Special talents
Labels do not offer useful information about where autistics would do best in school because labels do not consider influences such as intelligence, noise tolerance, and social communication into consideration. Some autistic people with high support needs are gainfully employed, while several autistic sufferers with low support needs cannot find or keep a job they enjoy.
Autism versus Neurotypical
Problems inherent in using the terminology high- and low-functioning to describe levels of autism, it is often used to describe the degree to which autistics appear to be like neurotypical (normal) people.
So, autistic people who appear to function ‘normally’ are labeled high-functioning and are considered able to:
- Communicate using spoken language,
- Are more likely to be included, with or without support, in general classroom and extracurricular programs,
- Are more aware of social conventions, such as using utensils correctly and greeting people appropriately,
- Are more likely to appear neurotypical (normal) until a conversation or event reveals their autism.
On the other hand, low functioning autistics are identified as:
- Having no or limited language skills, any relying on picture boards or technology to communicate;
- Clearly displaying their autism by sounding and looking different from their neurotypical peers;
- Are less likely to be included in typical classrooms or activities, and more likely to be categorized in a “substantially separate” academic setting.
None of these distinctions are finite, because autistics behave differently in different situations, with every individual displaying a range of challenges and strengths.
Neurodiversity Describes Reactions Outside of the Norm
Neurodivergent and neurodiversity refers to the premise that thought patterns, learning styles and behaviors differ between humans. A neurodivergent person reacts and thinks differently to what is considered ‘normal,’ or neurotypical.
The neurodiversity umbrella includes autism, dyslexia, attention deficit hyperactivity disorder (ADHD), and Tourette’s syndrome.
Sensory Overload in Autism
Although somewhat rare, aggression at varying intensity levels does occur in autistic people. Depending on the circumstances, even low support need autistics can suffer meltdowns. This again illustrates how the use of labels is misleading as they cannot indicate the likelihood of aggression.
See: Using sensory color cubes: Sensory strategies for autism
How Autistics Differ from the Norm
Autistics display different social interactions which they often find challenging. Examples are difficulty in making eye contact, understanding another’s point of view, and interpreting social cues such as facial expressions and tone of voice.
They also engage in repetitive behavior and prefer set routines.
What is Asperger Syndrome?
Many autistic people are oversensitive to sound, textures, smells, and lights. Asperger’s is an outmoded term for level 1 autism (high functioning) and is named after Hans Asperger who identified the malady in the 1940s.
While Asperger sufferers can display difficulties with social interaction, clumsiness, and repetitive behaviors, they are generally highly intelligent and develop obsessive interests that they research to a high level of expertise.
The name Asperger’s is considered offensive and is not used in some circles. According to research, Dr. Asperger was tied to the Nazi party, cooperated with the child euthanasia program, and publicly supported ‘race hygiene’ policies.
Summary
The terminology high and low functioning autism is misleading and outdated, as are the use of functioning labels. In its place are three levels of autism based on the level of support required.
Level 1 autistics are generally high functioning, requiring the least support, while level 1 autistics are lower functioning, requiring a higher level of support. Labels can lead to people discounting the abilities of level 3 autistics and overlooking the support needs of level 1 autistics.
Regardless of levels, support needs can vary or can be inconsistent from one day to another. As an example, a child who needs minimal support in the home environment may need a great deal more support in an unstructured social situation.
