What’s the f(x)?
Children or adults diagnosed with autism are often described as either “low” or “high” functioning, or worse, a more judgment-based “he/she is autistic but is really high functioning” or “he/she is low-functioning,” which ends up being a way to communicate and identify innate ability to succeed in this world.
The world of neurodiversity support both understands and advocates for a retirement of the terms “low” and “high functioning” to describe a person’s range of abilities within Autism Spectrum Disorder. Arbitrary and descriptive labels in general do not serve to help or accurately describe functioning, and rather hinder self-concept, self-efficacy, dignity, and can impact life-trajectory. Adjacent support of a more accurate diagnosis and a dismissal of labels led the APA to remove Asperger’s Syndrome from the Diagnostic and Statistical Manual, Fifth Edition (DSM-V) in 2013. Asperger’s Syndrome was often correlated with the phrase “high functioning autism,” and instead adopted the more accurate and general diagnosis, Autism Spectrum Disorder.
One important distinction in support of understanding the nuances to ASD is the concept of sensory overload and how it is connected to the ASD “low” and “high” functioning labels. Understanding sensory overstimulation as a separate experience from ASD, lends support for the retirement of these labels. Overstimulation, simply put, is overloaded and overworked senses, based on the sensory information coming in at any given point in time.
Sensory Processing Disorder (SPD) generally can not stand alone as a medical diagnosis and is separate from Autism Spectrum Disorder (ASD). While there is often overlap, sensory overload or overstimulation can exist within, or outside of, an ASD diagnosis and SPD can exist within, or outside of, ASD. Why is this important? An ASD brain reacting to sensory overstimulation is something that can appear as an indicator of functioning, although not, and has been one of the perceptions leading to the “high” and “low” functioning labels.
An autistic brain already functions in overdrive leading an autistic brain to try and control the information coming in, which can lead to…sensory overload. Think about it in terms of dials on a radio that are almost always turned up to a 9/10. If the dials are already turned up to a 9, there’s no space to incorporate additional volume or sound coming (in this metaphor, just one sensory example) in and it feels like too much. This is far from an indicator of functioning.
What do we say instead?
There is no need to add a label of any kind to the autism diagnosis with a functioning descriptor. We can simply say, autistic or autism. I often say to clients, “you are not a robot,” we are humans with unique individuality and experiences often far beyond what science or we ourselves understand. Autistic humans don’t function or not, they exist in a world not meant for their abilities and are doing a beautiful job.