What “Functioning Labels” Get Wrong About Autism
- Emily Linder
- Oct 16
- 6 min read
For decades, the public understanding of autism has been filtered through a lens of “functioning labels.” These terms, like “high-functioning” and “low-functioning”, are often used in educational, clinical, and social settings to describe the perceived abilities or challenges of autistic individuals.
But what if these labels are more harmful than helpful?
In this post, we’ll explore where functioning labels come from, why they miss the mark, and how to shift toward a more nuanced and respectful way of understanding autism. Whether you’re autistic yourself, a parent, a provider, or someone trying to be a better ally, this topic is essential to creating more inclusive and supportive environments.
What Are Functioning Labels?
“High-functioning” and “low-functioning” are not clinical diagnoses. They’re informal shorthand often used by professionals, media, and families to describe how well an autistic person appears to manage daily life tasks like speaking, socializing, holding a job, or living independently.
“High-functioning” usually refers to someone who speaks fluently, has average or above-average intelligence, and can perform daily living tasks with minimal support.
“Low-functioning” typically refers to someone who is non-speaking, has co-occurring intellectual or developmental disabilities, and may require substantial support for daily needs.
On the surface, this seems like a convenient way to communicate needs. But in reality, these labels can erase complexity, reinforce harmful stereotypes, and limit access to care.
Where Did These Labels Come From?
The concept of functioning labels has roots in outdated understandings of autism. Earlier diagnostic manuals (such as the DSM-IV) divided autism into subcategories like “Asperger’s Syndrome” and “Autistic Disorder,” creating a false hierarchy based on language skills or IQ. While these categories were removed in the DSM-5 in 2013 in favor of a unified Autism Spectrum Disorder diagnosis, the legacy of categorizing people by perceived functioning has lingered.
Functioning labels may also reflect society’s bias toward productivity, verbal communication, and independence; standards that don’t always align with neurodivergent strengths and ways of being.
What’s the Harm in Using Functioning Labels?
1. They Oversimplify a Complex Experience
Autism is not linear. It’s not as simple as high or low, capable or incapable. The spectrum is multidimensional; people may excel in some areas and struggle in others. Someone who appears “high-functioning” because they can speak fluently may still experience intense sensory overwhelm, social anxiety, or executive dysfunction that severely impacts their quality of life.
Conversely, someone labeled “low-functioning” may have rich inner lives, strong preferences, and valuable insights, even if they do not communicate in conventional ways.
2. They Lead to Misunderstanding and Misdiagnosis
“High-functioning” individuals often have their needs minimized or overlooked. They may be denied accommodations or support because they “seem fine” on the surface. Many late-diagnosed or undiagnosed autistic adults, particularly women and people of color, slipped through the cracks due to masking or being perceived as “too smart” to be autistic.
On the other hand, “low-functioning” individuals are often underestimated. They may be treated as incapable of growth or independence, even when they are fully capable of learning and self-advocacy with appropriate support.
3. They Ignore Fluctuation Over Time and Context
Autistic people’s abilities can vary dramatically depending on stress levels, environment, sensory load, and social context. Someone might be articulate and composed in a quiet, supportive setting but become non-verbal or shut down during a meltdown.
Functioning is not static. Labels don’t capture the ebb and flow of capacity, which means they can be dangerously misleading.
4. They Reinforce Stigma and Dehumanization
Terms like “low-functioning” can dehumanize. They reduce a person’s identity to perceived deficits, suggesting that their lives are less valuable or less worthy of autonomy. Even “high-functioning” can be weaponized as in, “You’re too high-functioning to need help” or “You don’t look autistic.”
These labels are not just inaccurate; they also contribute to the systemic marginalization of autistic people, especially those who are multiply disabled, non-speaking, or from marginalized racial or gender groups.
What Can We Say Instead?
To move away from functioning labels, we need a language of respect, specificity, and support needs.
1. Use Identity-First Language (When Preferred)
Many autistic self-advocates prefer identity-first language (“autistic person” rather than “person with autism”) because autism is an integral part of who they are, not something to be separated or cured. Always follow the lead of the individual in how they wish to be described.
2. Describe Specific Support Needs
Instead of vague terms like “high-functioning,” be clear about what a person needs or experiences.
For example:
“Needs support with executive functioning”
“Uses AAC (augmentative and alternative communication)”
“Experiences sensory sensitivities”
“Thrives with routine and predictability”
This language centers support instead of judgment, helping others understand how to create accommodating environments.
3. Acknowledge Strengths and Challenges Without Hierarchy
Every autistic person has a unique profile of strengths and struggles. Some may have exceptional pattern recognition, deep empathy, or intense focus on passions. Others may struggle with transitions, self-regulation, or unstructured environments. None of these make someone more or less autistic.
Avoid language that implies superiority or inferiority. Instead, speak to the full humanity of each person.
What Autistic People Say About Functioning Labels
Many autistic adults have spoken out against functioning labels, pointing out how these terms failed to represent their lived experience. Here are some of the recurring themes in autistic self-advocacy:
“High-functioning means people expect too much from me.”
“Low-functioning means people expect nothing from me.”
“I function, until I don’t.”
“People only see what’s visible. They don’t see the cost.”
“I can be both competent and struggling.”
These reflections highlight the emotional and practical toll of being mischaracterized based on a snapshot of performance.
The Role of Masking and Misinterpretation
Functioning labels often fail to account for masking, a survival strategy where autistic people suppress their natural behaviors to fit in. Masking can involve mimicking facial expressions, rehearsing small talk, or suppressing stimming behaviors.
People who mask well are often labeled “high-functioning,” even though the effort of masking can be exhausting and lead to burnout, anxiety, and identity confusion. It’s not that they don’t need support, it’s that their needs are invisible.
Conversely, people who don’t or can’t mask may be seen as “low-functioning,” when in fact they are being more authentic in expressing their neurotype.
Understanding masking is essential to understanding why functioning labels miss the mark.
Moving Toward Respectful, Affirming Language
Here are a few guiding principles to move toward more inclusive language:
Presume competence: Don’t assume what someone can or cannot do based on appearance or communication style.
Honor autonomy: Support self-determination for all autistic people, regardless of how they communicate.
Center lived experience: Listen to autistic voices and incorporate their perspectives into policy, care, and community spaces.
Ditch the binary: Think in terms of spectrums and intersections, not rigid categories.
What Allies Can Do
Whether you're a parent, teacher, therapist, coworker, or friend, you can help shift the culture:
Stop using functioning labels in conversations or documentation.
When someone says they’re autistic, believe them whether they are diagnosed or self-identified.
Advocate for supports that meet people where they are, rather than forcing them to fit neurotypical norms.
Amplify autistic voices, especially those of non-speaking individuals, people of color, and gender-diverse community members.
Respecting autistic people means rejecting labels that erase their complexity.
Autism Is Not a Performance
Autism is not about how well someone fits into neurotypical systems. It’s not about how independent, verbal, or visibly distressed someone appears to be. Functioning labels try to simplify a reality that is anything but simple and in doing so, they cause real harm.
Instead of sorting people into hierarchies, let’s meet them with curiosity, compassion, and individualized support. Let’s build a world where autistic people are understood not by what they can’t do, but by who they are and what they need to thrive.
If you're looking to deepen your understanding or advocate more effectively, start by challenging your own assumptions. Language matters and how we describe others shapes how we treat them. So let’s leave functioning labels behind and move toward something better: dignity, nuance, and respect.
Disclaimer: This content is NOT meant to be a replacement for therapy. This is also not treatment advice or crisis services. The purpose of this content is to provide education and some fun. If you are interested in receiving therapy look up a therapist near you! If you are in Cleveland, Ohio visit www.calibrationscc.com to schedule with one of our counselors today! We offer free video consultation calls so you can make sure we will be a good fit for you.
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