low functioning vs. high functioning... difference?
Where exactly is the line drawn between low functioning ("classic") and high functioning (AS/ HFA) autism?
If a person is non-verbal but can type understandably on a keyboard, what are they?
If a person doesn't talk at all but is not violent (head banging, aggression, etc), what are they?
If a person can talk but has meltdowns upon leaving the house, and stims violently, what are they?
If a person can talk, write, doesn't stim violently, is skilled, but can't hold down a job to support himself, what are they?
Or is the line drawn at being able to use the bathroom, get oneself dressed, feed oneself, and not stim violently?
That is interesting to think about because you bring up a lot of good points. I have read that high-functioning auties can generally talk and usually do not stim violently. However, since autism is based on a spectrum (as are most disorders), it would then be difficult for even the experts to know where to draw the line in such cases.
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I agree. I think that the distinction is constantly being attempted to determine who qualifies for services and assistance. It is an interesting problem that I am sure would be solved if we let more private companies, charities, whatever, etc. help rather than having some goverment official sit there and dictate who gets what and how much. Because "functioning" is not something neatly describe with check boxes, is it? I mean, the economic aspect is something I am interested in because a lot of people argue that more money and more government programs will lead to better service, but there isn't the demand for efficiency and quality across the board (which is why some schools/states are better than others.) I don't want to turn it into an economic discussion, but I think the biggest problem with "functioning" labels is that they vary from individual to individual and no check box is going to be able to cover that.
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Technically, "classic," Kanner's autism isn't really defined as "low-functioning." It's just set labeled that to set it apart from HFA and Asperger's. But there are many different classifications for Kanner's autism. They range from mild to severe, so there are higher-functioning individuals within the "low-functioning" category, if that makes any sense. Somebody with Kanner's autism won't be diagnosed with "low-functioning autism." They may get a diagnosis, such as "moderate autism." I believe IQ is factored into the equation, as well as severity of symptoms.
-OddDuckNash99-
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Exactly and quite often people completely fail to make the distinction between what are considered low functioning autistic people and those with severe challenging behaviour(they merely take the view that it is a case of high vs low). Of the latter group some may be low functioning and some may be high functioning. There was a young woman with an IQ of 150 and a 13 year old boy with an IQ of 130 - they were both clearly high functioning in terms of intellignece, but their social behaviour in the world of people is unacceptable and neither is what you'd term 'well behaved', though, from their own narrow perspectives they function well.
Briefly the percentages in terms of IQ ranges are approximately as follows(You can find articles on normal distribution on the internet):
IQ 100 down to 86 - 34.1% of population(normal range)
IQ 85 down to 71 - 13.6% of population(low normal)
IQ 70 down to 56 - 2.1% of population - mild intellectual impairment.
IQ 55 down to 40 - 0.1% of population - moderate intellectual impairment.
Under 40 severe intellectual impairment - Percentage? Very small.
Under 25 - profoundly intellectually impaired. Percentage? Even smaller.
Strictly speaking low functioning autistics comprise all those who have intellectual impairments. - about 2.3%+/- of the total population and about 80% of all autistics. However, as has been suggested, some "low" functioning autistics(in terms of their IQs) actually function very well, yet some very intelligent autistics do not succeed.
An autistic woman(considered LFA) once wrote:
"For reference, my objection to the subsets that most people believe exist, isn't that they promote intolerance(although the way they're used often do), but that most of them seem to have been wrongly divided. If I believed for instance that a line could be drawn from low to high functioning for *autism* as a whole - I would have no objection to it, but I haven't seen any evidence that it's true and I've seen much evidence that it isn't."
Further views on HFA/LFA:
http://www.autismvox.com/lfa-and-hfa/
Verbal means being able to speak. Perhaps a better term would be communicative or non-communicative because then that opens up a whole world of possible mediums of communications. Sign language is a form a non-verbal communication, and so is typing or writing. Pictograms can also be a form of non-verbal communication, but the problem there is that there can be so many different meanings of a picture to individuals that exact translation is kind of difficult. Pictograms always remind me of The Golden Compass (Alethiometer) and the layers of meaning it takes to figure out what it is showing.
But yes, in answer to your question, not being able to speak is being non-verbal.
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Prof_Pretorius
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Erm, low functioning is curled in the fetal position and screams incoherently whenever another person comes near.
High functioning is curled in the fetal position and screaming profanity whenever another person comes near.
(Hope this helps clear things up.)
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ShirtPuppet
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I would say that anybody who does not have speech would technically be considered "nonverbal," whether or not they are able to type, sign, use P.E.C.S., or
manage to get others to understand them via body language or even the few who can follow the pattern of one of their "walking tantrums" (actually I hate that term)...but if NO SPEECH, NON-VERBAL...by definition.
High functioning is curled in the fetal position and screaming profanity whenever another person comes near.
(Hope this helps clear things up.)
That's the best distinction I've heard to date! Thanks.
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Just posted this recently about the (mis)definitions of "Kanner" a lot of people use:
I was watching the recent autism episode of The View, and noticed that early on an “expert” repeated the current common usage of the word “Kanner” in relation to autism.
I’m coming to the conclusion that most “experts” on autism have not actually read Leo Kanner’s 1943 paper very thoroughly, and do not know the history that goes along with it. Here are some quotes that show that absolutely none of Kanner’s original patients fit the stereotype she describes on that show:
About Donald T:
About Frederick W:
He bowls, and when he sees the pins go down, he’ll jump up and down in great glee.
About Paul G.:
About Barbara K:
Of Virginia S:
About Dorothy, the sister of Herbert B (not diagnosed as autistic but described as in early life ignoring most people, dancing in circles, making queer noises with her mouth, and reversing pronouns):
About Herbert B himself:
About Alfred L.:
Charles N:
About John F:
He was very serious about this. His father said somethig about the pictures they have at home on the wall. This disturbed John somewhat. he corrected his father: “We have them near the wall” ( “on” apparently meaning to him “above” or “on top”).
When he saw a penny, he said, “Penny. That’s where you play tenpins.”He had been given pennies when he knocked over tenpins while playing with his father at home. He saw a dictionary and said to his father, “That’s where you left the money?”
Once his father had left some money in a dictionary and asked John to tell his mother about it. His father whistled a tune and John and correctly identified it as “Mendelssohn’s violin concerto.”
Elaine C:
As you can see, none of Kanner’s subjects fit the stereotype the “expert” was describing. So why is it that people invoke the name of Leo Kanner to describe people who fit a certain stereotype (an “LFA” stereotype)? It’s interesting. Last fall, I speed-read a number of books on autism, from different time periods, that describe it in different ways. (When I read in that manner, I don’t understand what I read until later.) In one of the books (I wish I could remember which), they are very explicit about their usage of the term Kanner autism. They used it very similarly to the way people today would say “high functioning”. They then described an newer category of “autistic PDD” that was making its way into the concept of diagnosing autism, and that included more “lower functioning” or “severely affected” people than Kanner had talked about.
So invoking the name of Kanner used to mean high-functioning, and now is used to mean low-functioning. (High-functioning and low-functioning by the way are stereotypes, and not things I believe in as realities, because human beings’ abilities are more complex with that.) I wish more people who throw that word around would learn what it means and what it doesn’t mean and who particularly Kanner studied, and who they were and were not. Because all this stuff about “not talking at all, not interacting at all, sitting in a corner rocking and head-banging, unaware of anything, etc” is not what his study of these children actually describes — even with his own biases and such all in there. It’d be nice if people actually read this stuff. By the standards of that particular “expert” on that show, most of Kanner’s patients would probably now be diagnosed with PDD-NOS or possibly even Asperger’s, because none of them fit the stereotype she described.
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Anyway, to reply to Oddducknash, that's not always how the term "Kanner" has been used. As you can see, most of his patients would now be considered "HFA" or "AS" or "PDD-NOS", so it doesn't make sense to use his name to differentiate between autism and those things.
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"In my world it's a place of patterns and feel. In my world it's a haven for what is real. It's my world, nobody can steal it, but people like me, we live in the shadows." -Donna Williams
Anyone else think some of the old definitions need to be thrown out and everything updated? I think a lot of what was written in past about autism and even some of the stuff about Aspergers is turning out not to hold true.
Sometimes on the board we use low and high functioning in reference to only Aspergers. But does the medical and scientific community have any clear definitions of variations on Aspergers or are we just lumped together as one group? Just curious. When I meet other Aspergers people it seems there is extreme variations in functioning or behavior levels.
Prof_Pretorius
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Hear, hear ! ! I second the motion to re-write the defs ! !
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