Discussion on High & Low Functioning Labels

SARRC's Vice President & Research Director Christopher Smith explains whether high and low functioning labels are useful, and offers other solutions instead.

By Christopher J. Smith, Ph.D., SARRC vice president & research director

Background: In 2019, autism researchers from the Telethon Kids Institute and the University of Western Australia called for the term “high-functioning autism” to be
abandoned because of the misleading and potentially harmful expectations it creates around the abilities of children on the autism spectrum.

What is “functioning,” anyway? 

The word “functioning” can refer to language, intelligence, social competence or daily living skills. However, ability in one area does not imply equal ability in all areas. People with autism who have an average, or even high IQ , may still have impaired social competence or daily living skills. A problem occurs when people hear that a person with autism is considered “high functioning,” they assume that person needs less support. Perhaps even worse, when someone with autism is less fluent with language, people may assume they are far less capable than they really are, which limits opportunities like friendships, classroom placement or employment. 

What’s the problem with labeling people using “high” or “low” functioning? 

Even if we had a clear, universal definition of “functioning,” it still may not be appropriate to classify someone as high or low functioning. There is a range of functioning for all different kinds of people. Some students get better grades than others. Some employees perform better. We can even say the same for teenagers and adults – some are model citizens while others are more challenging. This range of functioning is clear, yet we never refer to students, employees, teens or adults as high or low functioning. It would be wrong to classify people in this way. 

What should we consider instead?

First and foremost, people with autism are people. When describing any individual it’s better to describe their attributes, like “my son has autism and he is highly verbal” or “my daughter has autism and she is learning to live independently.” Those phrases clearly describe the individual rather than using terms that lump them into poorly defined groups. So, it’s better to avoid terms like “low-functioning” or “high-functioning” altogether. Not only could using these terms be insulting, but they do not convey useful information about the person. Recognizing the individual with autism is generally better.