Friday, May 4, 2012

High and low functioning of Autism

We start this process when we seek a diagnosis to begin with. For parents with young children (1-3 years of age) who are seeking a diagnosis, I often recommend that they don't wait for the diagnosis. Forget about the label, begin supporting whatever developmental delays the child is showing. However, the diagnosis of "autism" doesn't say much about the degree of disability. There is too much variability in strengths and skills. When a diagnosis is not descriptive enough, people look for more specific ways to categorize the severity of disability. Not that high and low functioning are that descriptive.

In the medical field, diagnoses are categorized by symptoms and how much they impact the person's daily "functioning." It is the impact the disability has on the person's "functioning" that drives a lot of the services. For the most part, "high functioning" usually refers to good expressive speech, fair to good receptive understanding, and fair ability to function independently in their daily settings. "Lower functioning" is usually reserved to very limited verbal skills, often nonverbal, extreme difficulty understanding daily instructions, and needs a lot of assistance in doing their daily routine.

The confusion among parents and professionals is between "level of functioning", and "severity of disability." I know of children who are labeled "high functioning" who have severe autistic disabilities (very rigid/inflexible thinking, very resistant to change and uncertainty, and meltdown over simple snags in their day.) However, they are considered "high functioning" because they are very verbal, get good grades in school, and can do personal care independently. I have also met children who are considered "low functioning" because they are nonverbal, have difficulty with performing personal care, and difficulty with academics, but who's autism traits are less severe; more flexible in their thinking handle daily transitions easier, can reference others better, and have fewer meltdowns. So, level of functioning doesn't also correlate with the severity of the autism. Just because a child is labeled “high functioning”, doesn’t mean he doesn’t have severe autism. Sumber:  

Autisme.My

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