Controversies about functioning labels in the autism spectrum: Encyclopedia II - Controversies about functioning labels in the autism spectrum - Background on functioning labels

Controversies about functioning labels in the autism spectrum - Background on functioning labels

The labels we are concerned with here generally seek to divide the autistic spectrum in two, based on how close the subject's behavior is to that of non-autistics. The more autistic group is referred to as "low functioning", having "Kanner syndrome", or (confusingly) simply "autistic". The group closer to non-autistic behaviour is referred to as "high functioning" or having "Asperger syndrome".

Currently, DSM-IV contains two distinct autistic spectrum diagnoses: Asperger syndrome and autistic disorder. The main difference between the definitions is that autistic disorder involves a significant speech delay and Asperger syndrome does not. However, many people diagnosed with Asperger syndrome do have a significant speech delay, and most other sets of criteria allow for this. Moroever, many people believe that language delay is not a sensible or meaningful enough way to differentiate a diagnosis, even if it does divide the autistic spectrum in some way.

The terms high functioning and low functioning may be applied to the spectrum as a whole or specifically to people with a diagnosis of autistic disorder. (Anyone classified as Asperger syndrome is generally considered to be high functioning, although this is not necessarily true in practice.) Conflicting criteria have been proposed to divide the spectrum. One common criterion is for high functioning to be used to describe those who have language skills and low functioning to be used to describe those who do not have language skills. Another common criterion is to describe those who score an IQ above 70-80 as being high functioning, and those who score an IQ below 70-80 as being low functioning. Note that there are autistic individuals without language skills who have a gifted-range IQ and vice versa.

The use of these terms is controversial. Most people who use the terms believe that those who are described as high functioning -- those who can read, write, and speak -- are fundamentally and obviously higher functioning than those who are described as low functioning -- those who can't read or speak and may need constant care. Most people who support the labels believe most or all autistic people can be easily classified into one of the two categories and that the labels are necessary to acknowledge that different autistic people have different abilities. These characterizations, again, are often at odds with the IQ and language skills criteria.

Others believe that autistics vary greatly in their strengths and skills, so that a one-dimensional, high or low functioning level is too imprecise and often misleading. They point out that there are some autistic people who have some characteristics considered high functioning and other characteristics considered low functioning. For example, many autistics have excellent written language skills but no oral language skills at all. Others may have high intelligence and no language skills but still need constant care or who injure themselves. They also point out that not all nonverbal autistics are incapable of self-care, and not all autistics with an IQ below 70 or 80 are incapable of reading, writing, or speech. There are also autistics who have language skills some of the time but no language skills at other times.

Some autistic people find high and low functioning labels problematic when they have combinations of skills which are classified as high and low functioning, because having a characteristic considered high functioning makes it harder for them to get support for their more profound difficulties which are considered "low functioning", and having a characteristic considered low functioning makes it harder for them to get their skills recognized in the first place.

Michelle Dawson and at least some of the people at Autistics.Org are among those who do not believe in a distinction between high and low functioning ^[1].

In addition to the controversy about using intelligence tests to distinguish between high and low functioning, there is controversy about the accuracy of intelligence tests used on autistic people.

Adapted from the Wikipedia article "Background on functioning labels", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki