High Functioning

Several people have answered your first question, but there’s an interesting discussion to be had to answer your later 3. As others have said, functioning is used to convey perceived support needs- hence why a lot of people use high/low support needs and high/low masking. As they focus on ‘ability to do stuff’ these terms lump several important things in with each other that are much more nuanced in reality:

• Communication - this is a big ‘NT’ helping/ASD hindering one (imo) and a lot of people wrongly equate functioning with speaking ability. This means people who can communicate perfectly well without producing the correct sequence of audible words from their mouth are assumed to lack capacity (a common problem faced by deaf/HoH people as well apparently), and people who can speak well may have their struggles overlooked.
• Ability to self-regulate and the ‘visibility’ of this regulation - again someone who struggles to self-regulate/sooth or displays obvious stimming behaviour may be considered ‘lower functioning’ regardless of the individual’s ability to actually, you know, function. This also contributes to the under-diagnosis of women/perceiving women with ASD as needing less support because they are less likely to perform large & visible regulatory behaviours (stims).
• Coping skills- similar to the previous one with internal/external regulation, but both support & functioning terms push the assumption that someone who is HF/LSN is coping well, and fails to account for the severe mental & physical health consequences they may be facing as a result
• Changing ability- this is a big reason I see cited against functioning labels, but also against support needs. My ability to ‘function’/need for support is very different when major external regulatory systems (e.g. school routine) are removed.  
• Capacity - this is a big one (more here: https://www.nhs.uk/conditions/social-care-and-support-guide/making-decisions-for-someone-else/mental-capacity-act/). Using functioning as an equivalent for capacity is problematic and can lead to assumptions of incompetence that are genuinely harmful. 
  
  

I was thinking about this though, as the way I answered your questions has changed.
Originally I was thinking some form of label could be useful for ‘managing expectations’ (e.g. at a Drs appointment) but then I realised - if HSN is always assumed, accommodations for that are unlikely to be harmful for someone with LSN and can be removed. The main concern would be if LSN were assumed and someone with HSN showed up- but then, it would be more appropriate to get details about what sort of accommodations would be suitable. Ultimately it comes down to a resource allocation problem, like everything else in life- assuming support is needed is a safer approach that removes the need for functioning labels, but that requires resources that are already stretched desperately thin.

To compare it to similar situations- my friend and I can both say we have ‘anxiety’, there is no need to specify that one of us has GAD and the other has PTSD- focussing on the symptom enables us to receive better support.

While I appreciate wanting to label things, it can also further drive us apart and miss out on meaningful contributions. For example, someone with ‘high support needs’ Im helping (as part of a group of helpers) could express that the wind is distressing them better than I (‘low support needs’) can (as I’m trying so hard to cope it is difficult to pinpoint what is actually giving you the issue), but then I might be better able to explain why the wind is distressing to the other people involved in the support (e.g., it’s making a whistling noise through that one specific place on the wall and I’ve been pushing myself to try and ignore it)—- so we can then go outside for the rest of our session and everyone is happy (which might not have been an expected solution from just “the wind is hurting”). By separating people into functioning boxes it is easy to disregard the shared experiences of people on the spectrum - I hope that makes sense?

Several people have answered your first question, but there’s an interesting discussion to be had to answer your later 3. As others have said, functioning is used to convey perceived support needs- hence why a lot of people use high/low support needs and high/low masking. As they focus on ‘ability to do stuff’ these terms lump several important things in with each other that are much more nuanced in reality:

• Communication - this is a big ‘NT’ helping/ASD hindering one (imo) and a lot of people wrongly equate functioning with speaking ability. This means people who can communicate perfectly well without producing the correct sequence of audible words from their mouth are assumed to lack capacity (a common problem faced by deaf/HoH people as well apparently), and people who can speak well may have their struggles overlooked.
• Ability to self-regulate and the ‘visibility’ of this regulation - again someone who struggles to self-regulate/sooth or displays obvious stimming behaviour may be considered ‘lower functioning’ regardless of the individual’s ability to actually, you know, function. This also contributes to the under-diagnosis of women/perceiving women with ASD as needing less support because they are less likely to perform large & visible regulatory behaviours (stims).
• Coping skills- similar to the previous one with internal/external regulation, but both support & functioning terms push the assumption that someone who is HF/LSN is coping well, and fails to account for the severe mental & physical health consequences they may be facing as a result
• Changing ability- this is a big reason I see cited against functioning labels, but also against support needs. My ability to ‘function’/need for support is very different when major external regulatory systems (e.g. school routine) are removed.  
• Capacity - this is a big one (more here: https://www.nhs.uk/conditions/social-care-and-support-guide/making-decisions-for-someone-else/mental-capacity-act/). Using functioning as an equivalent for capacity is problematic and can lead to assumptions of incompetence that are genuinely harmful. 
  
  

I was thinking about this though, as the way I answered your questions has changed.
Originally I was thinking some form of label could be useful for ‘managing expectations’ (e.g. at a Drs appointment) but then I realised - if HSN is always assumed, accommodations for that are unlikely to be harmful for someone with LSN and can be removed. The main concern would be if LSN were assumed and someone with HSN showed up- but then, it would be more appropriate to get details about what sort of accommodations would be suitable. Ultimately it comes down to a resource allocation problem, like everything else in life- assuming support is needed is a safer approach that removes the need for functioning labels, but that requires resources that are already stretched desperately thin.

To compare it to similar situations- my friend and I can both say we have ‘anxiety’, there is no need to specify that one of us has GAD and the other has PTSD- focussing on the symptom enables us to receive better support.

While I appreciate wanting to label things, it can also further drive us apart and miss out on meaningful contributions. For example, someone with ‘high support needs’ Im helping (as part of a group of helpers) could express that the wind is distressing them better than I (‘low support needs’) can (as I’m trying so hard to cope it is difficult to pinpoint what is actually giving you the issue), but then I might be better able to explain why the wind is distressing to the other people involved in the support (e.g., it’s making a whistling noise through that one specific place on the wall and I’ve been pushing myself to try and ignore it)—- so we can then go outside for the rest of our session and everyone is happy (which might not have been an expected solution from just “the wind is hurting”). By separating people into functioning boxes it is easy to disregard the shared experiences of people on the spectrum - I hope that makes sense?