Why do so many people hate functioning labels?
In a nutshell, this.
On the one end, to be diagnosed at all means that you have enough of an impairment that it negatively affects your life. But people hear "high-functioning" and assume that the person is just a normal person who is a little shy and awkward. But we all know there is more to it than that.
On the other end, a person who is nonverbal might be labelled low-functioning, which people assume means the equivalent of mentally challenged, despite the fact that the person might be extremely intelligent and competent in particular areas.
Functional levels are related to the ability of a person to navigate the world with or without assistance and as such have limited utility for measuring the actual scale of neurological deviations from the norm.
I would never have been considered low functioning. But my ability to survive "unassisted" requires a great deal of effort and constant diligence.
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DSMV is proposing to use a unidirectional ASD ordinal scale of severe, moderate or mild autism.
HFA and AS would likely fall under mild.
That is partially true. AS has varying degrees and it would be scaled appropriately just like a diagnosis of Autism itself would be scaled.
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The easy one is:
1) Why do so many think that a person who can't talk, is unable to do everyday tasks such as dressing and brushing teeth without assistance, has very severe sensory issues is similar to a person with mild Asperger's?
And I think the answer to that is, "Who said that?" I don't recall anyone saying such a thing.
Someone on here said something like that, last October. They said that people with AS have milder symptoms than people with "LFA", but other than that, they are similar.
This is something I said and I stick by it, just a different shade.
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Functioning-levels don't necessarily compare to the severity of symptoms. That's the problem I have with them.
Functioning-levels also don't give a hint at whether a person has co-morbid disorders that influence their ability to function, takes meds that improve and/or worsen their ability to function, how that person manages their symptoms or whether they received the same opportunities as another person to improve their functioning or whether they were put through circumstances that worsened their functioning. Personality traits play a role in it too.
But despite that all, functioning-levels are usually thought to be the same as the severity of a person's autism.
I don't think that any two people on the spectrum are even just almost about the same. Similar, yes, I think that's as far as it goes.
I know a kid who has many autistic symptoms (out of the long list of symptoms) quite alike to mine at the same age, but mine were more severe at that age. But the kid has another co-morbid, a totally different personal background and a different personality. These really have a massive impact on functioning.
I was more incapable solely by the ASD of many things at the same age, but I bet even then I'd have been assessed as more HF. We live quite differently. Back then I never had to do the things the kid has to do now despite struggling at them to varying degrees - so it didn't matter much that I couldn't do most of them.
And not to forget time! Being, say, 6 years old and autistic in 1994 and being 6 years old and autistic in 2011 can make quite the difference. Expectations people have of you and options you have as an autistic person of what paths to try to take in life change greatly with time.
Functioning-levels are hardly comparable for all those reasons. But one can't dismiss that's about all others have to assess autism and to try to make it comparable. It's largely impossible to determine the level of severity of autistic symptoms.
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I hate functioning labels because they lead people to believe that these and other traits and abilities come bundled when actually they don't.
I have very little experience with other people with autism in real life.
The reason why I like functioning labels is because I get treated as a low-functioning person all the time. People use "small words" that a person would more likely use on a person use with a small child, for example, a teacher at my school was explaining what a lockdown was. She said that it is when there is mean people in the hall, I would have have preferred that she said "There are criminals in the hall".
People also get surprised when I can do really simple tasks.
I am mostly treated as a low-functioning person, even though I'm not. The people ignore the functioning labels and treated everyone with autism the same way. That's my experience anyway.
Janissy, I know they exist, but I have never personally, known a non-verbal person who had an average or above average IQ, they exist, I just haven't run into any.
So if I understand correctly you are assuming the people who speak to you slowly (like you are not normal intelligence) are doing so because of your label?
DSMV is proposing to use a unidirectional ASD ordinal scale of severe, moderate or mild autism.
HFA and AS would likely fall under mild.
That is partially true. AS has varying degrees and it would be scaled appropriately just like a diagnosis of Autism itself would be scaled.
AS is a mild manifestation of autism. Seems to be plenty of posters on this forum who seem to operate on the presumption that AS is a separate diagnosis to autism. ASD is a spectrum and AS exists on the same continuum as more severe forms of autism which down the scale may functionally impair the individuals in one or more ways.
I would guess no. People who treat me that way have no idea that I have a label at all--they just assume that I'm slow and that that somehow gives them the right to treat me in a totally patronizing way. Other people assume I'm a genius and then get baffled or annoyed when I can't do something.
And that's it in a nutshell, really. Functioning labels are a way of saying "This person has these traits," without allowing for variety and the reality that people are diverse and autistic people even more so. Either you get overestimated or underestimated, because whatever functioning label you get, there'll always be parts of it that you just don't fit into.
If you wanted to talk about how independent somebody was, why not just say "lives independently"? If you wanted to talk about how well they could communicate, why not just say "Can speak at will" or "Uses PECS as back-ups for when speech fails"? If you want a simple evaluation, then GAF will do just fine--it acknowledges that people's ability to cope changes as their circumstances change, as time goes on and they learn things or get more or less stressed out.
Functioning labels serve no purpose that cannot be better served by more precise description of a person's trait. The only thing they have ever done is mess things up for everybody. We need to drop them.
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The text I highlighted is one of the worst phrases to be attached to Asperger's Syndrome. Like functioning labels, it seems to imply that someone labeled with it is capable of many things they might not actually be capable of. If it causes impairments, it is - per the research I've read - just about as impairing as autism would be for someone labeled as HFA.
That is to say, if Asperger's Syndrome does not cause impairment, then one does not have Asperger's Syndrome. That doesn't mean that one doesn't have a lot in common with autistic people who are impaired - or aren't necessarily Aspies - but it's a distinction that I think should at least be respected.
I guess another thing is that which one you get as a diagnosis may not actually depend as much on your presentation of symptoms, but on the person who diagnoses you and the philosophy under which they choose to apply each particular diagnosis.
The text I highlighted is one of the worst phrases to be attached to Asperger's Syndrome. Like functioning labels, it seems to imply that someone labeled with it is capable of many things they might not actually be capable of. If it causes impairments, it is - per the research I've read - just about as impairing as autism would be for someone labeled as HFA.
That is to say, if Asperger's Syndrome does not cause impairment, then one does not have Asperger's Syndrome. That doesn't mean that one doesn't have a lot in common with autistic people who are impaired, but it's a distinction that I think a lot of people try to erase or remove, and try to paint an AS diagnosis as perhaps more benign or less limiting than it often can be.
I guess another thing is that which one you get as a diagnosis may not actually depend as much on your presentation of symptoms, but on the person who diagnoses you and the philosophy under which they choose to apply each particular diagnosis.
I agree with everything you've posted Verdandi.
However the context of my post referred specifically to the proposed DSMV ordinal scale. I was trying to indicate that as far as the spectrum model AS = autism as the poster seemed to be under the impression that AS is a separate diagnosis. No I'm not a fan of labelling, especially if the so called scale for symptoms and category is not exactly a linear relationship.
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However the context of my post referred specifically to the proposed DSMV ordinal scale. I was trying to indicate that as far as the spectrum model AS = autism as the poster seemed to be under the impression that AS is a separate diagnosis. No I'm not a fan of labelling, especially if the so called scale for symptoms and category is not exactly a linear relationship.
I knew that, but I wasn't clear about it when I posted.
However the context of my post referred specifically to the proposed DSMV ordinal scale. I was trying to indicate that as far as the spectrum model AS = autism as the poster seemed to be under the impression that AS is a separate diagnosis. No I'm not a fan of labelling, especially if the so called scale for symptoms and category is not exactly a linear relationship.
I knew that, but I wasn't clear about it when I posted.
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Good question!
I don't think all autistic people hate functioning labels. I personally dislike them because I find them to be restrictive. For example, a "low functioning" person might be denied opportunities just because they are "low functioning" and a "high functioning" person might be denied accommodations because they are "high functioning" and "should be able to function like a NT." Also someone's functioning can change day to day based on their energy and environment. Every autistic person is different.
Instead, I think it would be better for professionals to summarize an autistic person's personal strengths and weaknesses, instead of calling them "high functioning" or "low functioning." For example, it is better to say "Suzie is autistic. She struggles to understand nonverbal social cues and make friends. She has a special interest in birds and cannot tolerate the texture of certain foods" than simply "Suzie has high functioning autism." This acknowledges the fact that every autistic person is different and cannot be summarized by a functioning label.
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