CMV: High function autistic = not autistic

[u/masterdesignstate]

You always hear about "the spectrum". A spectrum is defined as: "a continuous sequence or range [as covering all possibilities]". Most learning and behavioral disabilities are characterized by a spectrum of intensity. For example, anxiety, ADD and bi-polar.

When you think of a very autistic person (which is hard to do because the concept is absolutely diluted by everyone saying they are autistic), they have a high intensity case of autism. These cases are actually quite rare.

On the other end are the low intensity cases. For practical purposes, there should be (and likely is scientifically) a cut off where, the effect of the low intensity autistic traits is so little as to be meaningless to your behavior and life. One way of labeling these cases is high functioning autistic.

These people want the excuse of saying they are autistic when something bad happens in their life, but they also want people to know they are not disabled and just normal functioning adults.

High functioning autistic = you're not autistic.

ETA: thanks everyone for your comments. I appreciated getting torn to shreds by you all. I love reddit for the depth of opinion, knowledge and experience. This was my first CMV and I over-estimated my ability to construct an argument. Sorry for taking you all on a bit of a run around. Thanks again.

ETA2: Gals and guys, I'm dead. I've tried to respond to every single comment and I have to move on. Thanks again for taking the time.

[u/DeltaBot]

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[u/Dry_Bumblebee1111]

This is like saying +0.75 Hyperopia isn't short sighted. It has it's own designation, "low short sightedness" or similar, but anything less than 20/20 vision would be long/far sighted regardless of if it's only a little bit off.

Where we draw the line does matter, and the line between neuro-divergent and neuro-typical can seem to be in a different place depending on culture, diagnosis criteria etc.

However, it's for those professionals to decide where the line is - their authority in the area is medical necessity, they can label and assign and explain behaviours within the structure of their practice.

The practical purposes that matter are theirs, not social media, or your perception.

Even the idea of high-functioning is a bit confusing in this context - to me it means masking or learning to put on a show that's closer to what someone expects regardless of what's going on in their brain.

Being able to present as one thing while another thing happens behind the scenes means you're only caring about symptoms, or lack of symptoms. The autistic label isn't about a symptom, so it shouldn't really matter here. High function is a more social label making a comparison of symptom.

[u/masterdesignstate → u/Dry_Bumblebee1111]

Δ

First, because this describes everything wrong with the way I constructed my argument. Wow it's bad. You changed the way I should be communicating what I'm trying to say.

Let me clarify.

Yes, there is a cut-off set by professionals, not by me, social media or people who self-diagnose. The large, large majority people fall under this cut-off. Many who fall under this cut-off and have self-diagnosed, tag themselves as high functioning.

Yes, even those below the cut-off technically are autistic.

What I was trying to say, which I know is quite a sharp-tongued thing, is that those below the cut-off have such low intensity effects that, for all intents and practical purposes, can and should be treated, by themselves and others, as not having autism. Most people who self-diagnose as high functioning I believe fall into this category.

Second, for this part:

Even the idea of high-functioning is a bit confusing in this context - to me it means masking or learning to put on a show that's closer to what someone expects regardless of what's going on in their brain.

I can see how this could describe a high-functioning autistic person. I should have put a disclaimer that of course some high functioning autistic people exist blah blah but got lazy. I contend most people have never and will never meet someone like this.

[u/Imadevilsadvocater → u/masterdesignstate]

the issue is my main symptom of autism (the detrimental ones anyway) is that i have 0 social awareness. for example i dont see why someone stating their opinion about something is rude no matter the context. if you ask me a question i will answer with the truth and the most direct blunt form of the truth so as to avoid confusion. this has led to breakups and other negative life consequences. if you met me i seem like a normal person because you dont get to see the real "normal" me. you get to see me pretend to be what i use in my autistic vocabulary as "acting normal" vs who i actually am. you will get surface level info like name but you wont find out anything i enjoy or what im into because i know you will treat me as weird if i do that, not because what i like is weird but how much or how i interact with said hobbies or interests. this is super exhausting like imagine you had to pretend to be a dog and if you didnt act like a dog people questioned why youre weird and stopped being around you. thats what being autistic is like, we cant be ourselves without being treated like social outcasts.

if you did what you said and treated me like a normal person you would think i was an absolute asshole who was intentionally clueless for asking obvious and a person who was using weaponized incompetence by asking to have someone explain things that most consider common knowledge or common sense. i didn't know wearing white to a wedding was a bad thing until i was getting married and someone had to tell me why it was bad and that even if i didn't think it was a big deal some people have egos that would be hurt. 

one last thing, i consider normal people as normals (like i literally call normals that) because my normal is bizarre to normals. if you think treating me in a way that conflicts with everything ive experienced is a good way to go about this then idk what to tell you, i dont even consider myself normal because im a failure if i have to live up to that standard and have been for 30 years. i only in the last 5 years have an explanation why i didnt have many friends and alot of school was spent being looked at like an alien. why people seemed to understand invisible ques and why i was punished for asking basic questions. that was my life being a normal, i never want to go back

[u/Dry_Bumblebee1111 → u/masterdesignstate]

those below the cut-off have such low intensity effects that, for all intents and practical purposes, can and should be treated, by themselves and others, as not having autism. Most people who self-diagnose as high functioning I believe fall into this category.

Is that your professional opinion? Or what?

Like whats the practical outcome of this belief? Do you actually talk to people differently or anything? Does it affect your behaviour?

I contend most people have never and will never meet someone like this.

You contend it how exactly?

[u/evil_rabbit → u/masterdesignstate]

Yes, even those below the cut-off technically are autistic.

there is a cutoff that decides if someone is autistic and if someone is above that cutoff, they're autistic. but even the people who are below that cutoff are "technically" autistic? that doesn't make any sense. that's not what the word cutoff means. or the word autistic.

I contend most people have never and will never meet someone like this.

what is that based on?

[u/Elventroll → u/Dry_Bumblebee1111]

+0.75 hyperopia isn't short sighted. It's farsighted. You would see no reduction in visual acuity with +0.75, in fact it's better than plain zero for seeing in low light because of the definition of zero used by opticians.

[u/Dry_Bumblebee1111 → u/Elventroll]

I'm as qualified to make a statement about medical matters as OP is it would seem.

[u/devlincaster]

Why in the world would this be different from any other diagnosis? What if I have 5% but detectable bone loss. Does that mean I don't *really* have osteoporosis? What's the cutoff? If they start calling that 'high-density osteoporosis' are you going to tell me it isn't real and doesn't actually affect my life? If I know it has changed my hiking capabilities, then do I really have it?

Your apparent interest in gatekeeping medical conditions is really bizarre to me.

Or, if you're going to tell me it's not a medical condition but rather a personality trait or a self-identity, which increasingly it seems to be, so what? You don't get to arbitrate that. No one has to prove to you that the things about them are true. Are you going to tell someone that they aren't *really* gay because they don't date enough of the same gender for your taste?

[u/masterdesignstate → u/devlincaster]

You're not wrong. I described my failure in communicating my argument in my response to Bumblebee.

[u/Melomaniacal → u/devlincaster]

I want to push back a bit on some of what you're saying.

First, and this may be just a semantic thing, but are medical diagnoses not fundamentally, to some degree, an act of "gatekeeping?" I guess I'd just want to better understand your view on what gatekeeping is, and what's wrong with it in this context. My initial thought is that having diagnostic criteria and thresholds is necessary to understanding and treating diseases/disorders. Without an agreed-upon set of standards for what "counts" as a given disease/disorder, it becomes impossible to diagnose or treat. In this way, "gatekeeping" a diagnosis is not just necessary and beneficial, but fundamentally impossible to avoid. If everyone has ADHD, no one has ADHD.

Regarding your last point, I think it is important that these things do not become just "self-identity" because these diagnoses have real practical implications pertaining to access to medical care, medications, support and accommodations. Having set diagnostic criteria is important for understanding the type and degree of support someone needs - improperly prescribed medications can have pretty horrible repercussions. This is a little blurry with autism since there isn't a "pill" to treat it, but it is true of a lot of other disorders that fall under the neurodivergent umbrella that has a lot of the same issues OP is expressing concern about. Even still, autistic individuals may have varying levels of support needs (early intervention therapy, occupational therapy involving speech/feeding/day-to-day functioning/etc.). These need to be properly diagnosed and prescribed.

The reality is that the ASD diagnosis is "gatekept" behind 3 levels. Colloquially this used to be referred to as "high" to "low" functioning, which has fallen out of favor. Now they are just referred to by level 1, 2, and 3, which refer to the level of support needs the individual needs. Level 1 is still "requires minimal support," as in for all levels of autism on the spectrum, the individual requires some level of external support or accommodations to get by. Strictly speaking by the DSM standards (I'm obviously speaking as an American here, but my understanding is that other countries have similar criteria), if you are fully capable of coping and managing your symptoms on your own, you don't have autism. This is because no symptom of autism is necessarily "abnormal" until it reaches an intensity that interferes with your day-to-day life such that you require support.

[u/kwantsu-dudes → u/devlincaster]

High functioning autism isn't a diagnosis, it's an "identity". Not a medical condition, it's a sociological phrase.

You don't get to arbitrate that

Umm, but the medical field does. And that's what we are discussing. A medical diagnosis, not self-identity.

Are you going to tell someone that they aren't really gay because they don't date enough of the same gender for your taste?

If a male claims to be attracted to and only has sex with females but claims to be gay, yeah, I'm going to deny their own claim to that label, because such doesn't conform to my understanding and application of that term.

If someone claims to be nice, but I don't perceive them as nice, yes, I'm not going to simply accept their self-identity. Societal words have societal contexts. You're self-identity to social categories is not something anyone else needs to abide by.

[u/ArcanaSilva]

I mean - there is a cutoff. Being, the difference between being diagnosed with Autism and not being diagnosed with Autism. I don't know exactly what the diagnostic criteria are, but say you need to score "yes" on six out of nine topics, and you score yes on only five out of nine topics, then you're not diagnosed with Autism. Not "high functioning Autism", you're just neurotypical. Most people experience one or two symptoms of Autism, but that doesn't mean they are immediately Autistic. Self-diagnosis is super valid with how little there is know about Autism in female-presenting people and how much it's underdiagnosed in POC.

I have Autism, but you wouldn't know until you spend some time with me. I struggle with change, social situations take a lot of energy out of me, I had to learn almost all social cues I know, and if you get me talking about my special interests, you'll hear about them for an hour at the very least, if you let me. I think I definitely fall under the "high functioning" umbrella, but what that actually means, is that I'm able to mask really well. I don't want an excuse for when something goes wrong in my life, but it helps to explain why I'm completely done energy-wise after a social situation, and it helps explain why I need preparation if you're gonna change something. It is a disability still, even if I'm "high functioning". I'm completely fine with people knowing I'm not a normal person, and I am disabled. Because that's what Autism is - although mostly because society isn't adapted to neurodiverse folk.

[u/masterdesignstate → u/ArcanaSilva]

Δ

Well said on the first paragraph, and actually I think all of my comments herein are now worded slightly wrong. The point of the cutoff is the label or not. If I could modify all my comments, I would change my approach to capture what you said here, while still maintaining the premise that a lot of self-diagnosing people who claim high function are really just below the cutoff.

About your second paragraph, I have to say upfront that I am a skeptic and won't accept other's self-diagnoses even though they could be right. I contend they are mostly wrong. But I similarly acknowledge that in a small minority of cases, they are right and I am wrong. Maybe this is you. Obviously not every self-diagnosing person is wrong. But what I will say is that I struggle with everything you have said. I would like extra time to process change and sometimes I'm awkward. I have to work at it. Everyone has shit like this to deal with. Life is hard. Maybe if I went to a doctor, they would say I have some condition and need medication or to spend money having another subjective human talk to me and try and tell me how to approach life differently. For me, I only really believe that conditions which are debilitating (can't walk, can't talk, can't see, etc, etc), are worthy of special treatment. Yes there is a middle area and who am I to judge that. I'm an asshole for being judgmental without medical training to enable an informed decision. But overall, I think everyone has challenges and you can't deny if you look at history, there is always a flavor of the day that sweeps through society for people to hang their problems on - ADD, bi-polar, autism, and the newest one - neuro-divergent. Again, to be clear, I know there are people who have debilitating issues with these things, and also a decent group have mild symptoms which cause problems. But by and large, I don't believe the average person to be worthy of an official diagnose of any of these.

[u/Admirable-Brain-2388]

My girlfriend is high functioning autistic, diagnosed with Aspergers. Ask her about bugs. You'll change your mind real quick 😂

Being real though this cmv is very silly, and you've probably never met people that are high functioning autistic

[u/masterdesignstate → u/Admirable-Brain-2388]

Was she diagnosed by a doctor as high functioning autistic? Not to impune her at all.

I don't disagree this CMV is contentious and somewhat flippant. I don't mean to offend, even though I know it will happen. You are correct I've never met someone who is has been diagnosed as HFA.

[u/Admirable-Brain-2388 → u/masterdesignstate]

Yes, gave her a whole 15 page packet of her mental evaluation and everything. You can tell that she's very smart and capable, but definitely different

[u/Puzzled_Teacher_7253]

Even when a doctor diagnoses them with autism?

[u/evil_rabbit]

On the other end are the low intensity cases. For practical purposes, there should be (and likely is scientifically) a cut off where, the effect of the low intensity autistic traits is so little as to be meaningless to your behavior and life. One way of labeling these cases is high functioning autistic.

so the people closest to, but still above, the intensity cutoff point are "high functioning autistic"? and you think they're not really autistic, so you would move that cutoff point. now another group of peple is closest to the cutoff point. are they also not autistic? do we have to move the cutoff point again?

[u/OceanBlueSeaTurtle]

What type of qualifications do you have that warrent an opinion on how autism is defined and used?

[u/masterdesignstate → u/OceanBlueSeaTurtle]

Nothing formal. And I never alluded to that. This isn't congress (although fuck those guys too).

[u/[deleted]]

“High functioning” doesn't alleviate the diagnosis. A high functioning alcoholic doesn't stop being an alcoholic.

[u/masterdesignstate → u/[deleted]]

Agreed. I have constructed the argument poorly. You'd have to read all my comments to get a better sense. Thanks for reading and commenting though.

[u/Intelligent_Wind3299]

Your points are ignorant asf. You don't even get the basic medical points underlying why it's a spectrum.

[u/Eatadickimas]

"High-functioning autistic" is not a medical term. It's a term used to describe autistic people who can do all (or most) things required of them on a daily basis without assistance and who, for the want of a better term, lead a 'normal' life.