I always remember seeing something really important on Twitter about autism and it was something about how High Functioning Autism hides a person’s challenges and calling someone Low Functioning takes away their potential. Lots of autistic people hate functioning labels because they’re harmful and they completely misunderstand what autistic is and how it is experienced. Therefore, in this clinical psychology podcast episode, you’ll learn the reasons why autistic people don’t like functioning labels and how we could make this better for people in the future. If you enjoy clinical psychology and autism, you’ll love today’s episode.
Today’s episode has been sponsored by Developmental Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it.
What’s High Functioning and Low Functioning Autism?
Personally, I know that these autism “types” come from well-meaning people that believe that autism is a deliberating neurodevelopmental disease (it isn’t a disease) and if you have the disease then you are doomed to fail and struggle in life. I know that is how a lot of laypeople see autism but they are completely wrong and to be honest, they create a lot more problems than they could ever hope to solve.
Since autism is a neurodevelopmental condition, and yes people with severe autism who are rendered unable to speak, unable to walk and unable to even remotely live a clinically “normal” life. Autism could be awful for them.
However, for a lot of people, myself included, autism isn’t a problem. It is a great part of us that brings us a lot of joy, happiness and laughter. My autism gives me the ability to focus, learn and have an immense drive for the few areas I really care about, and it gives me the courage to stand up for what’s right because I couldn’t care less about the social norms and offending certain people’s feelings.
There will always be struggles and I do seriously struggle in the social aspects of life. And without speech therapy when I was younger I would be mute.
But to think that because I’m autistic I’m doomed to fail and struggle is silly just. As well as to call me high functioning because I can have a job, because I live a relatively normal life and because I go to university that is beyond insulting. Since there are times in my life when I would have loved, truly loved to have some support about this infuriating complex and cruel social world.
But again, because I was high functioning I was denied support, help and any chance of people making a life easier.
Overall, an autistic person is called High Functioning if they can hold down a job, live a “normal” life and do most things a non-autistic person could do. Whereas a Low Functioning person is when they cannot hold down a job and they conform to the endless serotypes of autism.
Finally, for this section, whatever “type” of autism you have life is still a struggle. You as an autistic person can feel strange, out of place, abnormal in this world so even when a kind person says “You’re high functioning. Well done,”. This is so lost on us because it’s meaningless and it invalidates the reasons why we want help and support in the first place.
What’s The Myth of Being High Functioning?
Another reason why high functioning is such a silly myth is because all it really is masking behaviour. Autistic people that can learn the skill of masking do it earlier on in childhood because it’s a survival mechanism, it helps us blend in with other neurotypical and when we conform to the social norms of this neurotypical world we get rewarded.
This masking tends to be learnt through treatment (never an option available to me), socialisation, parenting and other ways that social skills are taught to us. This all helped autistic people to mask their ideas and these autistic tendencies growing up so they could function, especially when the world tells autistic people that their natural behaviours are flat out averse and wrong. So the reward for that was being called “High Functioning” and when they asked for help they weren’t believed.
That’s what happened to a lot of friends of mine over the years.
Personally, if you ask anyone that knows me, they will say I never struggled, never needed any help and was always great at making friends. To you I would say I was an expert masker, because any autistic person I talk to always knows I’m autistic the moment I open my mouth but any non-autistic person, they’re surprised but they start nodding a few seconds later as they understand why I do a lot of things I do now.
Because I am extremely brutal, I don’t have a filter and if a person is being disgustingly wrong, I will tell them because I don’t care about the social norms of the world. Thankfully, I always make people laugh when I’m being brutal. Thank God.
However, a lot of childhood was masking behaviour. I struggled to make friends, I struggled to function in brand-new scary environments with tons of new people. I hated change with a passion, I hated having to do new things, I hated a lot about my teenage years because people are outrageously cruel to “odd” people or people that are different to them.
And this led to massive, massive problems for me because people would think I was doing something because I was cruel, evil or just weird. When in reality, it was because I’m autistic but no one cared. No one wanted to help me.
Because I was High Functioning.
And no, I’m not bitter about that at all (Grin).
How Functioning Labels Impact Autism Suicide Rates?
Interestingly, South et al. (2021) wrote a great article that investigated the unknown epidemic of suicides amongst autistic adults with them concluding the act of masking is a significant contributor to these high suicide rates.
This is because by calling someone “High Functioning”, a person is invalidating all the struggles, all the difficulties, all the feelings of that autistic person. So they become trapped in a cycle of learning daily living skills, masking their autistic behaviour and maintaining their life. And that gets so old after a while. Especially because masking does force autistic people to endure a lot of negatives because the world has told us that autistic behaviour is aversive and wrong and it should never be shown.
In my opinion, I hate being called High Functioning, as you might have been able to tell, because what I really want is someone to just sit me down and say something. maybe something along the lines of “How are you? I know you’re a good student, great writer, podcaster and business person. But how are coping with life?”
It is something as simple as that, that I would because people never allow me to talk about my struggles because they don’t think I have any. It’s a shame and I force myself to soldier through anything and I have now found outlets for my autistic behaviour. Like the repetition for being the man that makes people laugh because of his brutal opinions.
What’s The Stigma Of Low Functioning Autism?
On the flip side, lots of autistic people have low functioning labels too because they are just as damaging. Due to autistic people with a low functioning label are stigmatised and isolated. As well as their strengths are ignored and they are seen by everyone as incapable of anything.
Something I love about low-functioning people is that there are some mute autistic people in the world but they are amazing writers. They can write their feelings with such depth and clarity that I doubt neurotypicals could do it so that is how therapy sessions can be done. Yet no one cares about their writing skills, they are still “only” “low functioning” people they don’t talk and their facial expressions are flat or aren’t right for the context of the situation. No one cares about the person’s inner workings.
Probably because that’s too hard for people to understand and want to think about.
Why The Diagnostic And Statistical Manual 5th Edition Text Revision Might Be Better For Autistic People?
As you know from other podcast episodes and the immense amount of psychology literature available online, me and basically every single clinical psychologist have immense problems with the DSM and we need a new way to deal with mental health. Yet until those new things come along, the DSM-5 Text Revision offers a slightly better way to offer support for autistic people that isn’t based on functionality.
Since the DSM-5 Text Revision proposes there are three levels of support, but it doesn’t offer reasons as to be autistic people need support. Therefore, it doesn’t limit different types of support for different levels of functioning labels.
· Level 1 is all about people needing some support. For example, the autistic person might need some daily functioning help but they can do a lot on their own.
· Level 2 is about the autistic person needing a lot of support.
· Level 3 is about the autistic person needing a lot, lot more support.
Overall, this approach is better because the support isn’t tied to high or low functioning, it’s all about what the autistic person needs and how much support is needed for them to live comfortably, happily and without unneeded psychological distress.
Why Autism Needs To Be A Wheel and Not A Spectrum?
Personally, I flat out love this idea and I’m really glad that I’ve found this idea.
As a result of a lot of autistic people prefer the idea of an autism wheel instead of an autistic spectrum. Due to the problem with a spectrum is that it’s linear so an autistic person is either a “little bit” or “very autistic”. That flat out does not reflect the real world experiences of autistic people.
Instead autistic people prefer to be seen as people with different needs and wants. I don’t have a problem with that.
Therefore, a wheel of autism helps to acknowledge and understand that some autistic people experience anxiety more than others. Other autistic people might struggle with sensory aversions. Others still might struggle more with communication because they might talk too much or not at all.
In addition, some autistic people might be paralysed by depression. Others might have a mixture of these difficulties or none of the others mentioned.
Overall, being autistic isn’t about a line between having a little autism and having a lot of it. Being autistic is about a spectrum or range of traits that all autistic people have to vary degrees, and the wheel acknowledges that all autistic people struggle and need help. As well as high functioning autism is a myth and low functioning autism is just stigmatising.
Autism and Clinical Psychology Conclusion
I want to finish off this podcast episode by mentioning that for most of history, academic researchers and parents have been the voice of autism. That isn’t always a bad thing but because the researchers and parents like functioning labels that is why they’ve stayed about. Many autistic people don’t like them. They prefer to be seen as humans with struggles and successful like everyone else but they just need a little bit more support depending on their own situation.
If you take anything anyway from this podcast episode, please let it be that functioning labels are awful, they’re damaging and I know if you’ve used them you were trying to be a good person. And me and tons of others appreciate that more than you will ever know. But it is damaging, we need to change that dialogue so functioning labels are a thing of the past and we can start to support everyone that needs help, and we recognise the strengths and how amazing everyone can be. Whether they have autism or not.
Finally, personally, I don’t think autism is a disability because it has given me my drive, focus and everything I value in my life. And it makes me me, I would change it for the world. Granted, I have lost friends, I’ve hated for much hate thrown at me and people have my foul towards me. I’ve experienced awful things because of autism that I doubt anyone can even begin to imagine, but I still wouldn’t change my autism for the world. It is difficult, a struggle and it can be a right pain at times, but I’m happy with who I am. All I ask for is the right to get help when I need it.
Something myself and tons of “High functioning” types have been denied so far.
I really hope you enjoyed today’s clinical psychology podcast episode.
If you want to learn more, please check out:
Developmental Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it.
Have a great day.
Clinical Psychology References:
Clinical Psychology by Carr (2012)
Clinical Psychology Third Edition by Davey et al. (2015)
South et al. (2021). Death by suicide among people with autism: Beyond Zebrafish. Journal of American Medical Association. Jan 4;4(1) e2034018
Wharmby, Pete (Twitter Feed). 2022
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