Besides the alleged differences between Asperger’s, Autism, and PDD-NOS, the other really arbitrary distinction being made in autism is that between “high-functioning” and “low-functioning” autistics. I know that I am not the first to write about this – in 2007, I can hardly be the first to write about any issue in autism anymore, and I’m usually too busy with other things to be the first in writing about anything anyway -, but I wanted to add my view anyway. Because I think that’s the easiest to do, I’m going to write up a list of assumptions about the LFA/HFA divide, and share my commentary.
- Low-functioning means having an IQ below 70. Well, this is one of several pretty official distinctions being made. The problem is that it’s often hard to determine IQ in people with autism: some people may seem high-functioning at first, but their IQ drops as they age cause of increased developmental demands – something that is extremely common in preemies (autistic or not). Others’ IQ jumps by sometimes as many as 50 points as they learn to use a communication modality that others understand. Here in the Netherlands, autistics whose IQ can be assessed as being in the mentally retarded range, are considered autistic as well as mentally retarded, so they essentially have two disabilities that may influence each other and each influence the person’s functioning.
- Low-functioning means non-verbal. This is the other kind of official definition. The only thing it omits to say, is that non-verbal does not necessarily mean unable to communicate. Speech, after all, may not be communication (I sometimes hate it when people assume that everything that comes out of my mouth is intended as it comes across), and communication does not need to mean speech.
- Autistics will always function at the same level regardless of circumstances. I hate this assumption, and have always hated it, whether you relate it to autism or not – I hated it years before I was labeled autistic or even suspected I was on the spectrum. In my own experience, this prejudice comes in the form of “You’re so intelligent, so …” statements. Some people who make these assumptions, can simply be directed to Stephanie Tolan’s article on asynchronous development, but even those who know about this, tend to have difficulty grasping the concept that I do not always function at the same level. I still have a lot of difficulty grasping this concept myself: that, when I’m overwhelmed, I don’t have skills that I have when I’m in a quiet state, most prominently communication abilities. So, when someone sees me here on the computer typing out a review on the HFA/LFA distinction, they may assume I’m very high-functioning, but you wouldn’t guess so when you’d see me when I’m overwhelmed. In this sense, I’m like the amethyst from Dave Spicer’s description. I will have to elaborate on this some more when I have a better understanding of my own situation, cause a variation to this theme seems to be the distinction between theoretical knowledge and practical understanding, and I’m experiencing this big time now.
- Low-functioning means severely autistic. Well, number of symptoms and functioning level in either of the two relatively official respects, are quite different. In fact, some people with severe mental retardation lack the cognitive ability to exhibit some autistic features, such as routines. So are they “low-functioning” cause they are retarded, or are they “high-functioning” cause they are not severely autistic? This is a big reason why I’m glad the Dutch see autism and mental retardation as separate disabilities.
- High-functioning individuals do not exhibit certain behaviors, such as self-injury or aggression. So, when someone does exhibit these behaviors, they must be low-functioning? I’m not proud of this, but this belief makes me pretty low-functioning. Often, however, it’s used the other way round, in that people who meet someone’s stereotype of “high-functioning” (eg. the ability to disagree with Autism Speaks in a way that they can read/listen to), is discredited for certainly not having serious problems. Amanda baggs has written a good article defeating this myth as well as pointing out its capacity to damage autistic people’s lives.
Well, I’m sure there are other assumptions that I’ll have to comment on, but I cannot think of anything to add now. I think it makes no sense to classify someone as “low-functioning” or “high-functioning”. People are autistic and have fewer or more symptoms to a greater or lesser extent, and some of these people have an intellectual disability in addition to being autistic. That doesn’t make them “profoundly autistic”, it just makes them autistic as well as mentally retarded, and both of these disabilities need to be acknowledged in order to help the person live as fully as possible a life while remaining himself.