High Functioning

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DSM-5 ASD Severity Scale 0-3
Here is the latest official APA diagnostic criteria:

Moderate
Requiring SUBSTANTIAL support
(i.e., Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions and reduced or abnormal response to social overtures from others.)

I think the reason "high" and "low" functioning labels are so confusing (and not all that useful, but maybe they're just not useful to me) is this:

(1) They were created based on faulty/overly-simplistic assumptions/ideas/theories about the relationship between IQ scores and functioning.

The categories "high-functioning" and "low-functioning" are split by IQ because it used to be thought (and still is, by many people) that IQ scores and real-life functioning (including abilities not even measured on IQ tests) have a direct one-to-one sort of relationship.

IQ and functioning levels are definitely related to whatever degree, but the degree is often assumed to be greater than it actually is.....The relationship between IQ and functioning level is not a direct one-to-one relationship, it's complicated and messy and can look different from one person to another; This is partly because IQ scores are an average of all of the abilities measured by the IQ test (which may not all be at the same level or even close to each other); Partly because real-life functioning relies on so many different cognitive processes/skills and only some of those processes/skills can be assessed using IQ tests.


(2) When the "high-functioning" and "low-functioning" labels are not used to reference IQ alone/at all and instead refer to behaviors/symptoms/difficulties (which technically they were never meant to do -- they were meant to reference both IQ and functioning because it was assumed there was a more direct relationship between IQ score and functioning in autistic people than exists in reality), nobody can agree on the definitions. Everyone (including both professionals and laypeople) has their own ideas about what kinds of behaviors/symptoms/difficulties in different areas should be called "high functioning" versus "low functioning".


(3) The abilities of a single autistic person can be hugely disparate. One person may be very highly skilled in some things and have very serious and obvious disability in others....their IQ subscores and/or real-life abilities may be a mix of both "high" and "low" functioning. To call that person either "low" or "high" functioning out of any specific context becomes inaccurate, and also becomes problematic when it comes to providing real understanding of their specific strengths and weaknesses, areas of ability and disability.

Even when a person has only a few areas of severe disability that stand out from otherwise mild disability, it can be problematic to call them "high functioning" if it's assumed that "high functioning" means not having any areas of severe disability -- and vice versa.

91 - 100 No symptoms. Superior functioning in a wide range of activities, life's problems never seem to get out of hand, is sought out by others because of his or her many positive qualities.

81 - 90 Absent or minimal symptoms (e.g., mild anxiety before an exam), good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied with life, no more than everyday problems or concerns.

71 - 80 If symptoms are present, they are transient and expectable reactions to psychosocial stressors (e.g., difficulty concentrating after family argument); no more than slight impairment in social, occupational, or school functioning (e.g., temporarily falling behind in schoolwork).

61 - 70 Some mild symptoms (e.g., depressed mood and mild insomnia) or some difficulty in social, occupational, or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, has some meaningful interpersonal relationships.

51 - 60 Moderate symptoms (e.g., flat affect and circumlocutory speech, occasional panic attacks) or moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-workers).

41 - 50 Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) or any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job, cannot work).

31 - 40 Some impairment in reality testing or communication (e.g., speech is at times illogical, obscure, or irrelevant) or major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed adult avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school).

21 - 30 Behavior is considerably influenced by delusions or hallucinations or serious impairment, in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) or inability to function in almost all areas (e.g., stays in bed all day, no job, home, or friends)

11 - 20 Some danger of hurting self or others (e.g., suicide attempts without clear expectation of death; frequently violent; manic excitement) or occasionally fails to maintain minimal personal hygiene (e.g., smears feces) or gross impairment in communication (e.g., largely incoherent or mute).

1 - 10 Persistent danger of severely hurting self or others (e.g., recurrent violence) or persistent inability to maintain minimal personal hygiene or serious suicidal act with clear expectation of death.

0 Inadequate information

I think to ahve HFA, you need to have speech delays though. That's what I had when I was younger. I didn't start really talking much until about four or five. I also have a more mild form of autism, and the only thing that's severe for me are my meltdowns and dealing with my emotions or moods. It's not in a bipolar kind of sense or anything though.

They should make a global assessment scale for people with autism, like the GAF (Global assessment of Functioning)

[...]

GAF takes into account ability to hold down a job, ability to maintain friendships, ability to maintain personal hygiene etc.

Adaptive Behavior scales are sometimes used, but I don't know how similar/different they are to the GAF in terms of how they're used.

Not one low functioning person several. And what about demonizing people with Asperger's as elitist or having a superiority complex because they cannot tolerate the unpredictable behavior of lower functioning Autistics? This has been the only place where I've been criticized for referring to someone who attempted to physically assault me as a monster. Why is it okay for someone who goes and punches people at random to be in public anyways? Or is that another behavior meaning communication people should just understand?

Also, adaptive behavior scales aren't autism specific.

These were the areas that got assessed for disability:

-maintenance of place one is living in and household chores
-evaluating and avoiding danger
-communication and social contact
-transportation
-being able to eat independantly
-being able to wash and dress independantly
-ability to work

They assessed it by how far the autism interferes.

I do not have the documentation, as it is on my old PC which got a virus because of windows XP and does not even start anymore, but I found some things I did write here and from memory and it's due to sensory processing issues, problems with theory of mind (people are unpredictable for me resulting in a high vulnerability to get abused or bullied eg. in a working environment), processing differences, executive functioning problems, communication problems, distress at change and the rest I don't remember.

I know, I know many people here are sick of me ranting about this.

Was that an adaptive behavior scale? That sounds very thorough and makes a lot of sense.

I think, that these areas get assessed with any disability when someone applies.
They relied on the information from the psychologist and the psychiartrist and a personal interview.

They made a mistakes in the diagnostic criteria of Aspergers. So instead of fixing the mistakes they just killed it. Aspergers was confusing but ASD is even more so. Aspergers was a label that was hugely helpful for people. People felt positive about it. This was a new phenomenon for a medical diagnosis and that bothered the hell out of certain people. Especially those that are in a profession that makes money about feeling bad about themselves. A portion of Aspies after years of being bullied for who they are overdid it and became the "Aspie elitists" . That made Aspies the perfect enemy for parents of LFA who struggled 24 hours a day 7 days a week. A perfect scapegoat also for school districts and stressed out taxpayers. And so it began, Aspergers was overdiagnosed, Aspies were elitist, looking for money or excuses. While lack of scientifically relevant differences was trotted out to say why Aspergers should be taken away, if people want to opine that aspies were elitist or overdiagnosed no scientific proof is required.

I loathe to admit it but the slander against aspies worked. It mostly associated with the Sheldon's of the world these days. Aspergers is medically a big part of me and always will be but with my unemployment some speech issues and motor coordination problems and average intelligence I don't fit the 2014 colloquial term.