Despite the progress we’ve made in awareness and understanding of autism, some ideas seem astonishingly resistant to change. One of the most persistent and most damaging is the continued use of functioning labels. In the last week alone, I’ve been described as high‑functioning twice. Each time, it troubled me deeply.
Let’s start with the most obvious point: no one’s functioning is static. Not mine, not yours, not any human being who walks this earth. Functioning is fluid. It shifts with context, capacity, health, environment, stress, sensory load, and age. It fluctuates hour by hour, day to day.
We all know this intuitively. Drink too much alcohol and your mobility, inhibition, and clarity of thought decline. Experience pain or illness and your capacity changes. Bright lights may be tolerable one day and unbearable the next if you’re fighting a migraine. Yet we never describe an allistic (non‑autistic) person as low‑functioning when their capacity dips. Their humanity is simply accepted.
When someone calls me high‑functioning, or if I were to label myself that way, it creates an unspoken pressure. Am I allowed to be low‑functioning? How often? For how long? What happens when I inevitably fall short of the expectation they’ve now set?
And what even counts as high‑functioning? High achievement? Eloquence? Athleticism? Social fluency? I am not all of these things. Some I can mask if I must, but masking is not sustainable. And what about the times I shut down from overwhelm and become non‑speaking. Am I still ‘high‑functioning’ then?
Functioning labels don’t describe autistic people. They describe how comfortable Allistic (non‑autistic) people feel around us.
If high‑functioning is problematic, low‑functioning is downright demeaning. I would never use it to describe anyone – autistic or otherwise. And notably, it’s rarely used for anyone who isn’t disabled.
The label implies burden, incapacity, and limitation. It erases strengths, obscures potential, and narrows opportunities. It reduces a whole human being to a single, inaccurate dimension.
This isn’t just an autistic truth. It’s a human truth.
Functioning changes. Needs change. Context matters.
So if we understand this, why do functioning labels persist?
Functioning labels originated within the medical model, created by clinicians to categorise levels of support need. They were never designed by autistic people, nor intended to define identity. Over time, they crept into everyday language, where they became shorthand for assumptions about intelligence, independence, communication, and worth.
In both clinical and social contexts, they remain deeply flawed. Their real purpose – whether consciously or not – is to sort us into categories based on how easy or difficult we might make other people’s lives.
These labels measure not our humanity, but our perceived usefulness in a socially constructed system.
Worth is inherent. It is not earned through productivity, compliance, or convenience.
Functioning labels obscure this truth.
Camoflauging or masking complicates everything further. Many autistic people, myself included, can appear ‘high‑functioning’ because we’ve learned to hide distress, confusion, sensory overload, or executive functioning challenges. But the cost is immense: burnout, exhaustion, anxiety, and a loss of authenticity.
Functioning labels punish autistic people for coping too well and for not coping well enough. It’s a double bind no one can win.
Support needs fluctuate with environment, predictability, sensory load, stress, and health. A person can be highly capable in one domain and need significant support in another. Static labels cannot capture this complexity.
Instead of functioning labels, we can talk about:
This is more accurate, more respectful, and more human.
Stop using functioning labels.
Be curious about individual needs.
Respect the whole person, not a category.