An initial clinical interview with a parent of a child with an ASD commonly follows this script:
Me: “Can you tell me about your child?”
Parent: “Yes. Well, he’s high-functioning. He…..”
Question to Reader: Have you heard this before? Said this before? If so, complete the sentence with what you have said or heard.
Compendium Parent of Responses: “…is potty-trained, is verbal, is highly verbal, has friends, completes hygiene routines, sleeps alone in bed, is mainstreamed, greets others, is smart, is bright, is intelligent, makes eye contact, can articulate feelings, recognizes anxiety, has a paraeducator in the regular classroom, does tae kwon do, plays soccer.”
End Script. Commence confusion.
Clearly, I have heard versions of this script more times than I can count. As such, the word “high-functioning” has lost meaning, if it ever had any for me.
Many years ago, the term “high-functioning” referred to the individuals with autism whose IQ was in the average range. Or, to say it another way, they had autism but were not mentally retarded because their IQ was above 70. During this time, the prognosis for individuals with ASD and with a relatively adequate IQ was presumed to be more positive because other skills (such as those listed above) were intact. Currently, the term is ubiquitous, vague, and over-used by professionals (medical and educational) and parents.
Let’s step back and really think about what we are saying. At its most positive, we are proud of and lauding the skills (either organic or learned) that a child on the spectrum has attained. But, apparently, we are surprised that they have these skills. At its worst, we are exacerbating and prolonging the stigma associated with the word autism by trying to distance ourselves from it. We always say autism is a spectrum, but there appears to be part of the spectrum that we don’t want to associate with.
Ironically, those individuals on the spectrum who are supposedly “high-functioning” (those with AS, those with high IQs) want so desperately for others to understand that they struggle in ways as severe as those who are “low-functioning.”
I am not saying that individuals on the spectrum do not function at different levels. They do. In fact, they function at different levels within themselves. They function at different levels on different days. They function at different levels in different places. There is a spectrum within the spectrum. But, that spectrum is intended to generate unity and identity, not to exclude or include