Why High & Low Functioning Labels Are Harmful
If you’ve ever heard someone say, “They’re high-functioning,” or “Oh, that child is low-functioning,” you’ve probably picked up on a common way people talk about autism.
On the surface, these labels seem like a quick way to describe a person’s abilities.
But in reality? They create more confusion than clarity.
The Problem with Functioning Labels
What People Think They Mean vs. What They Actually Mean
- “High-functioning” usually refers to someone who appears independent but may struggle significantly in ways others don’t see.
- “Low-functioning” is often used for individuals with visible support needs, but it ignores strengths like problem-solving skills, emotional intelligence, or a deep interest in specific topics.
These labels oversimplify a complex neurotype and ignore the reality that autism doesn’t fit neatly into two categories.
Why They’re Misleading
✅ They ignore context. Abilities change depending on environment, sensory input, and stress levels.
✅ They overlook internal struggles. Many “high-functioning” individuals experience burnout, sensory overload, and difficulty advocating for their needs.
✅ They set unfair expectations. A child labeled “high-functioning” might not get the support they need, while a child labeled “low-functioning” may have their autonomy underestimated.
The Harmful Impact of Functioning Labels
1️⃣ They Lead to Misunderstanding & Dismissal
People labeled “high-functioning” often hear:
- “You seem fine. Why do you need accommodations?”
- “You can talk, so you must not struggle with communication.”
Meanwhile, those labeled “low-functioning” may be dismissed entirely:
- “They won’t understand, so there’s no point explaining things to them.”
- “They can’t be independent, so let’s make all decisions for them.”
2️⃣ They Ignore How Abilities Fluctuate
Autism isn’t one fixed level of functioning—it’s dynamic. A person may excel in one area but struggle in another.
Abilities shift based on:
✅ Environment (supportive vs. overwhelming).
✅ Stress levels (meltdowns, burnout).
✅ Sensory load (noise, lighting, expectations).
3️⃣ They Can Delay or Deny Needed Support
Many Autistic individuals labeled “high-functioning” don’t get support for executive functioning, mental health, or self-advocacy. Meanwhile, those labeled “low-functioning” may have fewer opportunities for communication, independence, and autonomy.
A More Affirming Way to Talk About Autism
So, what should we say instead?
1️⃣ Focus on Support Needs
Instead of using functioning labels, describe:
✅ What supports a person needs.
✅ How their strengths and challenges interact.
✅ What accommodations make a difference.
2️⃣ Recognize That Autism is a Spectrum
The autism spectrum isn’t a straight line from “mild to severe.” It’s a spiky profile—someone may be highly skilled in one area and need significant support in another.
For example:
✅ A child may be highly verbal but have difficulty with loud, chaotic classrooms.
✅ Another may struggle with verbal speech but excel at visual problem-solving.
3️⃣ Center the Voices of Autistic Individuals
Many Autistic self-advocates oppose functioning labels because they don’t reflect real experiences. Instead, use language that highlights individual strengths, needs, and autonomy.
Want to Learn More?
If this resonates with you, and you’re ready to learn how to better support Autistic individuals in a neuroaffirming way, check out the NeuroAffirm Therapy Academy. Inside, we dive deep into how to apply these shifts in real-world settings so you can provide the best possible support.
