What the Term "High Functioning Autism" Gets Wrong
Twice-exceptional kids are often called "high functioning" - but that can be hurtful.
Many people believe that gifted autistic kids* are “high functioning” because they are so bright and because their autistic characteristics are often less visible to an outside observer. But the autistic community has criticized the use of functioning labels because these labels are harmful and inaccurate.
So what’s wrong with the term “high functioning”?
Why is it inaccurate, and why is it criticized by autistic folks themselves? There's a lot to say about this topic, so I won't cover all the critiques in this email. Instead, I've focused on some of the key issues through a gifted/2e lens.
(1) Many 2e kids don’t receive the support they need because they are labeled as “high functioning”
Twice-exceptional autistic kids, by definition, have extremely strong verbal abilities, reasoning abilities, spatial reasoning abilities, or academic skills. That's why they are identified as gifted.
But cognitive abilities are not the same as daily functioning. The same 2e kids who amaze others with their vocabulary, wit, intricate building projects, and quick reasoning can struggle mightily with daily tasks and academic demands. When parents and educators equate these kids' intelligence with being "high functioning," they often neglect the accommodations, supports, and appropriate expectations these kids need to thrive.
It's important to note that cognitive functioning is not the same as academic functioning either. Many 2e kids understand concepts at a high level but don't have the capacity or interest to complete daily assignments, manage lengthy projects, or handle other academic production demands that most schools require.
For example, a 2e kid may understand complex math but not be able to show their work in writing because writing by hand is too effortful, tiring, and difficult to read. Similarly, a 2e teen may have a sophisticated idea for a science fair project but find the executive functioning demands overwhelming. Many 2e autistic kids are also ADHDers, dyslexic, or have dysgraphia, which make it even more difficult to keep pace with traditional school demands unless they're given appropriate accommodations.
If 2e autistic kids are labeled as "high functioning," it's often assumed that they can function well at school and home without the appropriate accommodations or supports.
(2) Other 2e kids don’t receive the challenge they need because they are labeled as “low functioning”
Many autistic kids labeled as “low functioning” have unrecognized strengths that are not as obvious to an outside observer. For example, some kids are so dysregulated and overwhelmed by sensory sensitivities, demand sensitivity, or other experiences that adults don’t notice the child’s giftedness - they’re too focused on supporting or managing the child’s emotions and behavior.
Other kids may be labeled as “low functioning” if they develop vocal language later than average, have unreliable access to vocal speech, or use assistive communication devices. But kids with any of these communication patterns and preferences can be verbally gifted or gifted in other domains as well.
(3) Functioning labels are essentially meaningless because autism is a dynamic disability
All of us “function” better on some days and worse on others. Our capacity fluctuates depending on many factors - how much sleep we got, the food we’ve eaten, how many tasks we’re managing, other stressors, and whether we’ve been getting along with or in conflict with the people around us.
Autistic kids are often more sensitive to their environment and to internal bodily experiences, so their capacity fluctuates even moreso than others’.
If you have a 2e autistic kid, you’ve probably noticed that their abilities and capacity aren’t consistent day to day. Your child might manage a task easily one day but refuse the task or feel overwhelmed by it the next.
A 2e autistic kid might spend an hour crafting a detailed Lego structure using creativity and flexible problem-solving, then have an emotional meltdown because you serve them a different lunch than they were expecting.
That’s why the concept of any child being “high functioning” or “low functioning” is essentially meaningless - “functioning” always depends on the situation, and a child's capacity is always in flux.
(4) Functioning labels imply that a person’s worth is based on their functioning
Functioning labels aren’t just inaccurate, though - they’re harmful. It’s harmful to suggest that someone is somehow better or more valuable because they “function” better in society.
I’ll admit that this was not always my view. Our ableist, capitalist culture heavily promotes the belief that any person’s worth is tied to their achievement, productivity, and “functioning.” Growing up, my family culture also placed a lot of value on academic excellence, independence, and "appropriate" behavior.
A focus on a child being “high functioning” implies that a 2e autistic child is only okay because they are also gifted - or only okay because they “function” well overall and don’t need too much support.
Many people use the term “high functioning” or describe a 2e person as “mildly” autistic because they feel like they need to separate the 2e person from other autistic people who have higher support needs, who need assistance with daily tasks, or who have more visible differences in their behavior.
But it’s okay to need support. It’s okay to need accommodations. It’s okay to ask for help, to need co-regulation, to dislike personal care tasks or feel overwhelmed by school. It's okay to use assistive communication devices. It's okay to not speak. It's okay to flap your hands, jump in circles, cuddle stuffed animals your whole life, or stim and regulate in other ways.
Every person and every child is valuable and worthy, regardless of how much or little they accomplish and regardless of how much or little support they need.
What you can say instead
In the autistic community, many people prefer the terms "low support needs" or "high support needs." These terms aren't perfect, though - as I mentioned above, support needs naturally fluctuate day to day.
Whether you're talking with teachers, friends, family, or your child themselves, it's often effective and clear to talk about your child's specific characteristics, preferences, and needs. For example:
My teen is very sensitive to noise, especially in a busy environment. They use earbuds to block some of the noise that bothers them. It really helps if they can eat lunch in a quiet space and have a break from the busy classroom one or two times during the day.
My child is autistic and has a high IQ. They have really strong visual spatial abilities and make amazing constructions out of Legos. They thrive with a routine and when they know what to expect. Unexpected change is really stressful for them. If you have to make an unexpected change to the schedule, can you try to give them a heads up in private, or offer them something appealing or distracting to help them regulate?
My child is a really strong reader and loves to get lost in fantasy worlds. They need access to challenging language arts curriculum so they can stay engaged with reading at their level. They love to discuss ideas from books. When they get excited about an idea they tend to share a lot and might need a reminder to share the discussion time with others.
* A note about terminology - I use the term “autistic kids or teens” instead of a “kid with autism” or “a teen on the spectrum.” During my graduate training, I was encouraged to use “person first” language such as “a kid who has autism,” theoretically as a way to show respect. Many autistic folks prefer “identity first” language, though, because autism is an integral part of their identity and not something they “have” or are “on.”
In this way, autism is similar to giftedness - we say “a gifted person” not “a person with giftedness” because we see giftedness as integral to that person’s way of understanding the world. Identity-first phrasing also suggests that there’s no shame in being gifted and it’s not something you need to separate from your child or yourself. Similarly, identity-first language such as “an autistic person” indicates that being autistic is an integral part of how someone sees the world. There’s no shame in being autistic and it’s not something you need to separate from your child or yourself.
If you want more ideas like this directly to your inbox, sign up for Gifted Lab Notes, my weekly email with tips and information for supporting your intense or sensitive gifted or twice-exceptional (2e) kid.
If you want to learn more about neurodiversity-affirmative language and approaches to use with your 2e autistic kid, check out my parent coaching program for parents with intense gifted/2e kids! I help you develop an affirming and strengths-based view of your child's autistic characteristics, then guide you through the key principles to support their well-being and reduce intensity and conflict at home.