Why We Must Abolish Functioning Labels in Autism & ADHD Conversations
Bridgette Hamstead
The use of functioning labels—terms like "high-functioning" and "low-functioning"—in discussions about autism and ADHD has long been a source of contention within neurodivergent communities. While these labels may seem like a convenient way to categorize neurodivergent individuals based on perceived abilities, they are fundamentally flawed, reductive, and harmful. Functioning labels erase the complexity of neurodivergent experiences, reinforce ableist narratives, and create barriers to meaningful support and accommodations. To build a more inclusive and affirming understanding of autism and ADHD, we must abolish functioning labels and adopt language that accurately reflects the dynamic and individualized nature of neurodivergence.
The Problem with Functioning Labels
Functioning labels attempt to classify autistic and ADHD individuals based on how well they appear to function in a neurotypical world. Those labeled as "high-functioning" are often assumed to need little to no support, while those labeled as "low-functioning" are frequently denied agency and autonomy. These categories are not only arbitrary but also fail to account for the fluid and situational nature of neurodivergent traits.
Many autistic and ADHD individuals experience fluctuating capacities depending on environmental factors, sensory inputs, energy levels, and social demands. A person who appears "high-functioning" in one context—such as excelling in academics or employment—may struggle immensely with executive function, sensory regulation, or emotional well-being in other areas of life. Likewise, a person labeled as "low-functioning" may have significant communication or daily living challenges but also possess strong intellectual, creative, or problem-solving abilities that go unrecognized due to ableist biases.
Functioning labels also contribute to the dangerous misconception that neurodivergence is a linear spectrum from "mild" to "severe." In reality, autism and ADHD are multidimensional, with individuals exhibiting strengths and challenges in different areas. A person may struggle with sensory overload but excel in analytical thinking. Another may find verbal communication difficult but be highly effective at written expression. The use of functioning labels ignores these complexities, reducing neurodivergent individuals to simplistic, one-dimensional stereotypes.
How Functioning Labels Harm Neurodivergent Individuals
They Undermine the Need for Support When someone is labeled "high-functioning," their struggles are often dismissed. Many neurodivergent individuals who mask their difficulties or who appear to cope well in certain settings are denied accommodations because they do not fit the perceived image of someone who "needs help." This can lead to burnout, anxiety, and long-term mental health issues as individuals struggle to meet neurotypical expectations without adequate support.
They Deny Autonomy and Agency On the other hand, those labeled as "low-functioning" are frequently infantilized and treated as incapable of making their own decisions. This can lead to harmful paternalistic interventions where neurodivergent individuals are denied autonomy over their education, healthcare, and daily lives. People in this category may struggle with aspects of independent living but are still fully capable of having preferences, opinions, and desires that should be respected.
They Reinforce Masking and Internalized Ableism Many autistic and ADHD individuals, especially those labeled "high-functioning," feel pressure to mask their neurodivergence to conform to societal expectations. Masking—suppressing stimming behaviors, forcing eye contact, or overcompensating in social situations—can lead to extreme exhaustion and mental health deterioration. Functioning labels reinforce the idea that one must appear neurotypical to be successful or valid, discouraging self-acceptance and authenticity.
They Ignore Intersectionality Functioning labels fail to consider how other factors, such as race, gender, socioeconomic status, and disability, intersect with neurodivergence. For example, Black and Indigenous neurodivergent individuals are more likely to be labeled as "low-functioning" and subjected to harsher disciplinary actions in schools, while white individuals who display similar traits are more likely to be labeled as "quirky" or "gifted." The racial and gender biases embedded in functioning labels further marginalize already vulnerable populations, reinforcing systemic inequalities.
Shifting to a More Affirming Framework
Abolishing functioning labels does not mean ignoring the very real support needs of neurodivergent individuals. Instead, it means using language that recognizes the fluidity of neurodivergence and respects individual experiences. Instead of reducing people to a binary label, we must focus on:
Describing specific support needs: Rather than saying someone is "high-functioning," we should ask what accommodations and supports they require. For example, "This person thrives with clear written instructions and flexible scheduling but struggles with sensory overload in crowded environments."
Recognizing dynamic abilities: Neurodivergence is not static. Some days a person may manage executive function tasks well; other days, they may need extensive support. Accepting this variability allows for a more compassionate and individualized approach to accessibility.
Centering self-advocacy: The voices of neurodivergent individuals must be at the forefront of conversations about their needs. Instead of imposing labels, we should listen to how people describe their own experiences and respect their preferred language.
Educating professionals and caregivers: Teachers, doctors, therapists, and policymakers need to move away from functioning labels and instead adopt a holistic understanding of neurodivergence. This requires structural changes in education, healthcare, and workplace accommodations to better serve neurodivergent individuals.
Conclusion: Dismantling Harmful Narratives
Functioning labels are outdated, misleading, and damaging to neurodivergent individuals. They create barriers to support, reinforce ableist stereotypes, and reduce complex human experiences to overly simplistic categories. By abolishing these labels and adopting a more nuanced, affirming approach, we can foster a society that recognizes neurodivergence as a diverse and valid part of human existence rather than something to be ranked and categorized.
The future of neurodiversity advocacy must be built on respect, understanding, and individualized support. Every neurodivergent person deserves to be seen for who they truly are—not as "high" or "low" functioning, but as a whole person with unique strengths, challenges, and needs that deserve to be acknowledged and accommodated. The time has come to move beyond functioning labels and embrace a framework that honors the full spectrum of neurodivergent experiences.