What behaviors/abilities/symptoms make a person “high functioning” or not, in your view?

[the_tortoise]

See thread title.

I am unable to answer my own question....I don’t actually have a concept of “high functioning“.

It is usually described in vague, abstract ways that mean literally nothing to me.

When “high functioning” is (so very rarely) talked about in more concrete and specific ways, I am struck by the disparate ideas people have about who is “high functioning “ or “mild” and who is not, and how people group (sometimes totally unrelated) abilities together (assuming similar ability levels across skill domains and contexts).

I am always curious (and often confused) about what people have in mind when they talk about “high functioning” or “on the mild end of the spectrum”.

My reason for asking is both curiosity for its own sake/seeking to understand others points’ of view, and seeking to guess how others would categorize me and why. (But I do not want this thread to be a discussion about my functioning level....I want to know more, in concrete/specific terms what “high functioning” is and is not in the minds of others.)

 

[Aspychata]

I had a doctor/spouse tell me he was high functioning bipolar. To him it meant he held a job, and could deal with most daily issues. But stats on bipolar divorces suggest don't get married to one. So marriage doesn't always fall into that category.

So does it mean hold a job, deal daily with normal issues? Really believe we can apply this to all individuals on the planet. High functioning person is one who isn't involved in criminal enterprises, supports themselves financially, and is socially responsible.

 

[Progster]

I'm not so keen on the term 'functioning,' it makes us sound like we are some kind of machine. Indeed it is vague, but when people use this term, I take it to mean a person who is well adapted and who has good, effective coping strategies, who has learned or improved on their social skills and can mask fairly well in most circumstances, who has at least an average IQ, who is relatively independent (can live on their own, support themselves financially).

 

[Peter Jansen]

In my opinion, being able to do whatever an NT person does with proficiency is the definition of "high-functioning."

 

[the_tortoise]

I take it to mean a person who is well adapted and who has good, effective coping strategies, who has learned or improved on their social skills and can mask fairly well in most circumstances, who has at least an average IQ, who is relatively independent (can live on their own, support themselves financially).

deal daily with normal issues

What does it look like in specific , concrete examples:

To “deal with normal daily issues?” What are examples of “normal daily issues”?

To be “well adapted“ (to what?) versus not?

To “[have] good, effective coping strategies” ( for what?) versus not?

To have “learned and improved on their social skills and can mask fairly well in most circumstances ” versus not?

To “live on their own” versus not (does it still count if you need help to clean or shop or budget or pay your bills, for example? Does it matter what kind of help or how many things the person needs help with? Does it change the functioning category the person is placed in if the person has capacity to choose and/or direct and/or search out the help they receive versus needing others to have more control and/or provide more direction/input?)

 

[Nervous Rex]

When I was diagnosed, the counselor said that ASD levels 1, 2, and 3 denote how much support a person needs. Here's an interesting ASD screening guideline.

I believe that "high functioning" isn't an official diagnosis, but a nickname for ASD level 1, since ASD-1 people might be able to live with minimal support.

 

[Pats]

I also take it to mean the ability to live with minimal support or assistance. Not having to be instructed when to shower and activities of daily living. Being able to go to a job every day and work without help. Just being able to live a somewhat normal life.
What I don't like about the use of high functioning is that, some of us may be able to force ourselves to do these things, but it's very difficult and masking IS involved and burdensome. Others assume it's easy for us and assume we are capable of handling anything.

I've got a perfect example. No one thinks having a baby is easy, do they? (Well, hope not). But due to my inability to ask for help, even if I needed it, I not only didn't get any help, but overheard my husband (at the time) on the phone saying to a friend, "No, she's like a horse. She doesn't let anything get to her." The friend's wife had also just had a baby and was in bed being taken care of. Just because I wasn't in bed, didn't mean I didn't need some help.

 

[the_tortoise]

When I was diagnosed, the counselor said that ASD levels 1, 2, and 3 denote how much support a person needs. Here's an interesting ASD screening guideline.

I believe that "high functioning" isn't an official diagnosis, but a nickname for ASD level 1, since ASD-1 people might be able to live with minimal support.

That guide has useful examples of ASD symptoms.

I have read the severity label table before (included at the end), though, and it is exactly the kind of thing I refer to when I talk about descriptions that are so vague and abstract they mean literally nothing to me.

 

[the_tortoise]

Not having to be instructed when to shower and activities of daily living. Being able to go to a job every day and work without help.

What if a person can go to a job and work without help but not shower without prompting/instructions?

Or can shower without prompting/instructions but cannot go to a job and work every day without help?

Does one thing in the “not high functioning” category make a person not high functioning or does it require multiple things? Does it matter which things are in the high functioning versus not categories - like are different skills/symptoms weighted differently?

 

[Judge]

In the final analysis, does such a question really matter?

Simple point- It's not a formal medical term pertinent to the diagnostic process.

Beyond that it might as well be a pop culture term implying anything from one to be able to take care of themselves in the most nominal of manners to being sufficiently financially independent to live on their own.

That it ultimately means different things to different people, from within and without the autistic community itself.

 

[the_tortoise]

In the final analysis, does such a question really matter?

It matters in the context of trying to communicate with others about my autism or their autism or autism in general - it matters for communication and understanding for as long as people use terms that conceptualize functioning or support or symptom severity levels in terms of broad heirarchical categories to communicate things of significance to others. (And at this point in time, on this site and seemingly almost everywhere else, lots and lots of people use functioning /severity/support level terms to communicate things that I infer are significant or of importance, otherwise why refer to functioning/support/severity level at all?)

I would prefer to just not bother with such categories but I don’t get to decide how people talk about and conceptualize things.

 

[Judge]

It matters in the context of trying to communicate with others about my autism or their autism or autism in general - it matters for communication and understanding for as long as people use terms that conceptualize functioning or support or symptom severity levels in terms of broad hierarchical categories to communicate things of significance to others.

Think of it this way. Here within this community, when you choose to interact with other fellow members, do you really first and foremost consider whether or not the person you are communicating with is deemed "high-functioning" or not?

I don't, and I suspect most people here don't either. That we tend to focus on understanding what others are saying. And that if we do, we sustain a dialog, for better or worse. That such distinctions don't really seem to matter.

Of course this dynamic can change in an instant out in the real world, where the first person you encounter is likely to be Neurotypical. Yet at that point if your ability to mask your traits and behaviors is sufficient, then in those circumstances such distinctions won't matter with them either.

 

[the_tortoise]

Here within this community, when you choose to interact with other fellow members, do you really first and foremost consider whether or not the person you are communicating with is deemed "high-functioning" or not?

No but I see a lot of discussion where “high functioning” and “mild” get thrown around. If it doesn’t matter why is it ever mentioned in the first place?

And I have seen people who identify themselves as high functioning, including on here occasionally, actively trying to disassociate themselves from those who they identify as not high functioning (for whatever reason(s)). Which again to me shows clearly that to some people it does matter (and not just to NT people).

 

[Pats]

What if a person can go to a job and work without help but not shower without prompting/instructions?

Or can shower without prompting/instructions but cannot go to a job and work every day without help?

Does one thing in the “not high functioning” category make a person not high functioning or does it require multiple things? Does it matter which things are in the high functioning versus not categories - like are different skills/symptoms weighted differently?

I kinda think it's a societal thing. And your question back to me is exactly why 'high functioning' should not be a thing. If you can go to work, it's assumed you can shower. People live on assumptions and presumptions.

 

[Judge]

No but I see a lot of discussion where “high functioning” and “mild” get thrown around. If it doesn’t matter why is it ever mentioned in the first place?

It's indicative of our own insecurity. Whether one is compelled to claim to being as such, or whether one is so absorbed in trying to determine whether they meet such an alleged standard or not.

It's much like the dynamic that can elude even the best scientific minds. Where they are so self-absorbed in attempting to prove something, that they fail to consider whether or not they should even try.

In the end, "high-functioning" amounts to just another insignificant benchmark, like your IQ test score. Yet people continue to discuss it, whether they buy into it or not. Often to a point where it never dawns on them that in the "big picture" it simply doesn't matter.

Your neighbor just bought an absurdly expensive car to park in their driveway. Does that really mean you must reevaluate your personal net worth? You see what I am getting at?

 

[Pats]

No but I see a lot of discussion where “high functioning” and “mild” get thrown around. If it doesn’t matter why is it ever mentioned in the first place?

And I have seen people who identify themselves as high functioning, including on here occasionally, actively trying to disassociate themselves from those who they identify as not high functioning (for whatever reason(s)). Which again to me shows clearly that to some people it does matter (and not just to NT people).

I think it's mentioned by those who do not yet have the understanding of what the 'spectrum' actually is.

 

[Progster]

What does it look like in specific , concrete examples:

To “deal with normal daily issues?” What are examples of “normal daily issues”?

To be “well adapted“ (to what?) versus not?

To “[have] good, effective coping strategies” ( for what?) versus not?

To have “learned and improved on their social skills and can mask fairly well in most circumstances ” versus not?

To “live on their own” versus not (does it still count if you need help to clean or shop or budget or pay your bills, for example? Does it matter what kind of help or how many things the person needs help with? Does it change the functioning category the person is placed in if the person has capacity to choose and/or direct and/or search out the help they receive versus needing others to have more control and/or provide more direction/input?)

I'm just saying what I take it to mean when someone else uses the term. I guess you'd have to ask them what they mean when they use the term to understand what exactly it is that they mean.

 

[Aspychata]

Speaking of high functioning- my ex does take showers but since l left him- he is back to growing his nails obsessively long, and his hair is also too long. He presents with a unkempt appearance. Is he still high functioning- he does take showers. So high functioning is extremely vague and means different things in different context at different times. Does it include medication? Then what is low functioning? Needing 1 + more social services or care providers?

 

[Aspychata]

If we break down low-functioning first, then anything outside of that would be high- functioning?

 

[Judge]

Humans in general seem to crave simple and often linear explanations. Even where none are to be found. Then consider the possible number of autistic traits and behaviors, along with their amplitude (or intensity) plus or minus for each of them.

It's impossible to establish any really meaningful benchmark under such circumstances, short of perhaps establishing whether or not one can exist on their own without any help from others. But even that amounts to yet another nebulous benchmark. That most everyone at some point of their lives requires help of some kind. Should that disqualify us from ranking someone towards the top as opposed to the bottom of some hierarchy?

The answer? Don't bother trying to create such a hierarchy in the first place. Don't "go there" because doing so serves no purpose.