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The term “high-functioning autism” has been declared incomplete and insensitive by the divergent community for years.
The term “high-functioning autism” was coined in the 80s to describe people who have autism but not an intellectual disability. The concept was first used by a highly specialized group within the medical community; it was specific to neurodivergent people. However, it is not a diagnosis, and as it sneaked into the language of everyday use, it began to be mentioned as a kind of medical opinion. The risk is that this generates misinformation regarding the neurodivergent community, which has been protesting its use for years, not only because it is an offensive term but also inaccurate.
Researchers at the Telethon Kids Institute and the University of Western Australia conducted a study about autism. Of 2,225 children, those who would be “highly functional autistic” (and not classified with intellectual disability) had functional skills below the expected average for their IQ. In contrast, those with “low functionality” had skills more in line with what would be expected using the same coefficient. “We demonstrated that those who didn’t have an intellectual disability – what people would have classically called ‘high functioning autism’ – in fact have marked challenges with their everyday skills compared to what we would typically expect from their IQ,” commented Dr. Gail Alvares, leader of the team that conducted the study.
Many children and young people with autism who have an age-appropriate IQ have trouble carrying out everyday activities. Such as getting to their schools, using public transportation, communicating at the same level as their peers, and other essential actions, Alvares explained. In this context, using the category of “high functionality” casually to refer to people with autism creates a false image that those in this category do not have problems, do not need help, and make their difficulties invisible.
The more severe problem is that policymakers have casually used this classification to decide who should receive services, support, or funding, rather than conducting an in-depth assessment case-by-case, as Andrew Whitehouse, a professor, and researcher at Telethon Kids, explained to Spectrum News. However, perhaps the most onerous burden for people designated as “high-function” is the mental and emotional tax of socializing and navigating the world as if they were not neurodivergent people.
A profound and personal cost
“If I was standing next to you waiting for an elevator, I would make small talk and smile, and you wouldn’t know I’m autistic.” This piece about the experience from the writer and neurodivergent spokesperson, Christine M. Condo for The Washington Post, offers a heartfelt and revealing perspective on day-to-day autistic life that we do not conceive. Each interaction that a “highly functional” autistic person makes in their space or with the people around them results from exhaustive observations of neurotypical people’s behavior. They must repeat and rehearse their most optimal behavior to socialize and suppress their natural selves to avoid inconvenience or generate adverse reactions in other people.
The emotional investment in this process is enormous due to the extreme state of awareness, alertness, and stimuli in their environments that they must manage to function in a predominantly neurotypical world. Condo compares the experience to being forced to walk dangerously close to a wall of thorns that constantly threatens to pierce you. The feeling she describes is one she experiences all the time, as do many people we call “high-functioning autistic.”
By referring to them in this way, we are drawing an arbitrary line separating people from different spectra of neurodivergence to the detriment of people with other degrees of intellectual disability that we classify as “low functionality.” We are also making invisible the cognitive and cerebral differences that autistic people with sufficient intellectual abilities have as they try to integrate into the neurotypical world. In their attempt, we do not see or recognize the struggle of people whose brains work differently. We assume that imitating neurotypical behaviors to ensure social survival is the same as learning, adapting, and executing them without more effort than we apply. The term “high functionality” has helped normalize this blind spot. It is time to remove it from our vocabulary.
Translation by Daniel Wetta
Disclaimer: This is an Op-ed article. The viewpoints expressed in this article are the author’s own and do not necessarily reflect the opinions, viewpoints, and official policies of Tecnológico de Monterrey.
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This article from Observatory of the Institute for the Future of Education may be shared under the terms of the license CC BY-NC-SA 4.0 
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