Autism spectrum disorder (ASD) affects people in different ways. Some individuals may need substantial support in their daily lives, while others are able to live more independently. In the past, the terms “high-functioning autism” and “low-functioning autism” were used to describe these differences. However, these labels can be misleading and problematic. This comprehensive guide will explain the outdated functioning labels, discuss the support levels outlined in the DSM-5 diagnostic manual, and highlight why the autism community wants to move beyond functioning language.
The Flaws With Functioning Labels
For many years, people used the terms “high-functioning autism” and “low-functioning autism” to describe the intensities of autism symptoms and support needs.
What is Low-Functioning Autism?
Individuals labeled as “low-functioning” were considered to be on the more severe end of the spectrum. They often have:
- Minimal or no verbal communication skills
- Significant challenges coping with changes in routine
- Intense sensory issues or restrictive/repetitive behaviors
People with low-functioning autism usually need very high levels of support for daily living skills, communication, and managing the core symptoms of ASD.
What is High-Functioning Autism?
Those referred to as “high-functioning” tend to have milder symptoms and higher abilities in certain areas like intelligence or language skills. However, they still struggle in other ways, like:
- Difficulty with social communication/interaction
- Inflexibility and problems coping with transitions
- Narrowly focused interests or repetitive behaviors
While considered “high-functioning,” these individuals do require some level of support. The functioning labels fail to capture the nuances of each person’s strengths and challenges.
Problems With These Functioning Labels
In recent years, the autism community has advocated moving away from these problematic functioning labels. Here are some of the main concerns:
- They do not accurately summarize a person’s abilities across different settings. An individual may function well at home but struggle greatly at school.
- They minimize the support needs of “high-functioning” people with ASD. These individuals still require accommodations even if they have good language and academic skills.
- They disregard the capabilities of “low-functioning” people. These individuals have talents that may not be obvious at first.
- They promote stigma around autism as a “low-functioning” disorder. In reality, ASD is a spectrum with diverse presentations.
Overall, functioning labels create an oversimplified picture. They fail to capture the variability of autism traits across different environments and individual strengths/weaknesses.
The DSM-5 Autism Severity Levels
When diagnosing ASD, clinicians no longer use these functioning labels. Instead, the DSM-5 outlines 3 severity levels that describe the amount of support needed:^1
Level 1: Requiring Support
This corresponds to what was called “high-functioning autism.” While able to function more independently, individuals at this level still need some support. They generally have strong language skills and can manage academics, but may struggle with social communication, transitions, organization, and planning without assistance.
Level 2: Requiring Substantial Support
At this level, people need more extensive support. They have more pronounced challenges with communication skills, social interactions, behavior, and coping with changes.
Level 3: Requiring Very Substantial Support
This level aligns with “low-functioning autism.” Individuals require very high levels of support across all areas of daily living, communication, and managing autism symptoms. They may be nonverbal or have limited language abilities.
Moving Beyond Functioning Language
Replacing functioning labels with the DSM-5 severity levels provides a more nuanced, individualized picture of each person’s support needs. However, even these updated terms have limitations. Here’s why many advocate moving completely beyond functioning language:
- No label can fully summarize an individual’s complex array of autism traits across all settings.
- Focusing too much on “functioning” promotes stigma and a deficit-focused lens.
- Every autistic individual has strengths and talents worth recognizing, regardless of support needs.
- Functioning language minimizes the voices of autistic people and their insights about their own needs.
Instead of relying on these labels, it is important to understand each autistic person as an individual with a unique profile of strengths, talents, interests, and support requirements. With the right assistance and accommodations, every autistic individual can thrive and contribute meaningfully to society.
Getting the Right Support With ABA Therapy
If your child is on the autism spectrum, applied behavior analysis (ABA) therapy can provide customized support to fit their needs. ABA is an evidence-based approach that develops communication, social, academic, and adaptive skills while minimizing problem behaviors.^2
Here are some key benefits of ABA therapy:
- Focuses on your child’s specific support needs and goals
- Builds skills incrementally using techniques like reinforcement and prompting
- Helps your child generalize skills to new settings and situations
- Regularly tracks progress through data collection and adjustment
- Collaborates closely with families and schools for consistency
In-Home ABA Therapy in Maryland
Jade ABA Therapy provides exceptional ABA services directly in your home throughout Maryland. Our passionate team has years of experience helping autistic children and families thrive.
We conduct a comprehensive assessment to understand your child’s unique profile and create an individualized treatment plan. Our BCBA-supervised therapists use play-based ABA to target social communication, behavior, life skills, and more. We partner closely with you every step of the way.
Get Started Today
Don’t settle for a one-size-fits-all program. With Jade ABA Therapy‘s personalized in-home services, your child can reach their full potential. Contact us today at (410) 616-0901 to get started! Our team is ready to help your family.
References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th ed; 2013.
- Peters-Scheffer N, Didden R, Korzilius H, Matson J. Cost comparison of early intensive behavioral intervention and treatment as usual for children with autism spectrum disorder in the Netherlands. Research in Developmental Disabilities. 2012;33(6):1763-1772. doi:10.1016/j.ridd.2012.04.006