The misnomer of 'high functioning autism'

‘High functioning autism’ is a term often used for individuals with autism spectrum disorder without an intellectual disability. Over time, this term has become synonymous with expectations of greater functional skills and better long-term outcomes, despite contradictory clinical observations. This study investigated the relationship between adaptive behaviour, cognitive estimates (intelligence quotient) and age at diagnosis in autism spectrum disorder. Participants (n = 2225, 1-18 years of age) were notified at diagnosis to a prospective register and grouped by presence (n = 1041) or absence (n = 1184) of intellectual disability. Functional abilities were reported using the Vineland Adaptive Behaviour Scales. Regression models suggested that intelligence quotient was a weak predictor of Vineland Adaptive Behaviour Scales after controlling for sex. Whereas the intellectual disability group’s adaptive behaviour estimates were close to reported intelligence quotients, Vineland Adaptive Behaviour Scales scores fell significantly below intelligence quotients for children without intellectual disability. The gap between intelligence quotient and Vineland Adaptive Behaviour Scales scores remained large with increasing age at diagnosis for all children. These data indicate that estimates from intelligence quotient alone are an imprecise proxy for functional abilities when diagnosing autism spectrum disorder, particularly for those without intellectual disability. We argue that ‘high functioning autism’ is an inaccurate clinical descriptor when based solely on intelligence quotient demarcations and this term should be abandoned in research and clinical practice.
For the full article please visit: journals.sagepub.com/doi/full...

[@bjdefilippo447]

💯. As an Aspie, I can attest to the fact that having an IQ higher than your weight doesn't mean functioning well enough in social settings to keep employment without support. Especially for females who mask well, we often educate ourselves out of looking like we need it, but once outside of educational settings where's it's easier to get help, our deficits are often magnified. What's the good in getting good employment if we can't maintain it?

[@fionnawheatley9095]

I actually don’t like the term of “high functioning “. Most people think high functioning means that my autistic children should be able to cope in society. They can’t.

[@werr2832]

you kids do not have level 1 autism. They need to have some of the following:
a little bit social problems (Required)
a little bit repetitive behaviour
no self injurious behaviour. (Required)
A little sensory processing disorder.
should be iq 100+
Needs to function is society 95% of the time at least. (Required)
I am a doctor. I know this well since I work with people with HFA and they barely have ANYTHING AT ALL!!!

[@fionnawheatley9095]

@@werr2832 Dr Werr,
In Western Australia, where there is a gold standard of diagnosis, levels are assigned to assist funding through our national disability fund. All of my children meet the social, linguistic and behavioural criteria to achieve a diagnosis. All of my children are considered to be “high functioning” as they have language and iqs ranging from 128- 142. However, they cannot, without assistance function in society. My eldest, with the highest iq, cannot use public transport or manage to coordinate himself to ride a bicycle. My middle one can’t enter a supermarket without a meltdown because the frequency of the noise of the refrigerator is too loud. He is desperately lonely because he can’t keep up with the artifice of teenage friendships. They are classed as high functioning, but as part of society, they struggle. I’m glad your patients don’t have the same challenges as my children. You are fortunate to only have a clientele, who can “pass”. Not our reality. High functioning for us is not an accurate description.

[@DevonExplorer]

That was interesting but for the life of me I can't understand why separate information was quickly flashed on the left side of the screen at the same time as the lady was speaking. It's exactly the kind of thing that can give us Aspies headaches and disorientation. It definitely drove me mad and I missed a lot of what was said because of the distraction, lol. So much for understanding our needs! ;)

[@fionnawheatley9095]

Sorry foxy Devon lady, it is probably aimed at people like me... neurotypicals with neuro divergent children...

[@DevonExplorer]

@@fionnawheatley9095 Yes, I see what you mean, Fionna. I didn't really notice that. Mind, there are parents who are on the autism spectrum themselves too, such as me, lol! I'm just amazed how people can listen and read something different at the same time. I can't even make a cup of tea if someone's talking to me, lol. :)

[@fionnawheatley9095]

@@DevonExplorer it’s ok, nobody can...everyone is faking it! But the telethon institute, which funds these RUclipss, is doing an amazing job getting the information out there. I’m sorry it was tricky to follow. I hope they listen to you as it is a valid comment!

[@DevonExplorer]

@@fionnawheatley9095 Thanks, Fionna. :)