For decades, neurodivergent individuals—especially autistic people, ADHDers, and those with related conditions—have been categorized by "functioning labels." These labels, such as high-functioning or low-functioning, are often used by professionals, educators, and even family members to quickly describe how someone appears to navigate the world. But what if those labels aren’t helpful at all? What if, in fact, they are not a realistic description of the neurodivergent experience, reinforcing stigma, and may lead to a lack of support and understanding.

As we learn more about neurodivergence we move away from categorising individuals into particular boxes and labels. There is still a lot of work to be done here, but we are starting to move away from these ‘functioning labels and assumptions’

Neurodivergent individuals are NOT broken and do not need to be fixed. They may need some support and accommodations, as the world is not designed for these brains that work differently to the ‘norm’.

What Are “Functioning Labels”?

Functioning labels are shorthand descriptors that suggest someone’s capacity to “function” in society. A person labeled as high-functioning might be seen as independent, articulate, or capable of working a job. Meanwhile, a low-functioning individual might be seen as needing more support or not being able to communicate effectively.

On the surface, this may seem like a practical way to categorize support needs. But these labels are based on external perception—not on lived, internal experience. They are subjective, often misleading, and tied to how "acceptable" or "productive" someone appears to be within a neurotypical framework and perspective

The Weight of Being "High-Functioning"

The label high-functioning might sound like a compliment, but it often carries a heavy burden. It suggests that a person is "doing fine" and therefore doesn't need—or shouldn't ask for—support. More dangerously, it creates a pressure to constantly appear capable, even when someone is struggling underneath.

This label contributes to:

Masking: The deliberate or unconscious suppression of neurodivergent traits to appear “normal.”
Self-silencing: Avoiding asking for help to maintain the illusion of capability.
Internalized shame: Feeling like a failure for not living up to the expectations created by the label., and therefore leading to burnout and trying harder.

People labelled high-functioning may feel they must suppress their

own needs and accommodations to fit into societal boxes—like staying in a situation, even when they’re overwhelmed, forcing eye contact, mimicking social norms they don’t understand or feel uncomfortable with, or pushing through sensory overload at work or school, leading to a significant crash in energy and capacity when they can finally rest.

This masking might help someone "blend in," but it comes at a significant cost. Over time, masking can lead to:

Chronic stress and anxiety
Identity confusion
Emotional exhaustion
Autistic or neurodivergent burnout
Depression and other mental health conditions
PTSD-like symptoms from long-term self-repression

Undoing this damage and self view can be a long, painful process. It often takes years of unlearning, self-reflection, and therapy to begin recognizing who you are beneath the mask. And it takes immense courage to start living more authentically in a world that has told you to hide.

Spiky Profiles: The Reality Behind the Label

Human beings are not linear. Neurodivergent people, in particular, often have what’s called a spiky profile—a cognitive pattern where strengths and challenges vary widely across different domains. Someone may have exceptional verbal intelligence but struggle with sensory regulation. Another person might be brilliant at problem-solving yet have difficulty with executive functioning, like organizing daily tasks or initiating action.

A spiky profile can look like:

Advanced reading comprehension
Difficulty with motor coordination (possibly due to dyspraxia)
Intense sensory sensitivities (e.g., to sound, texture, light)
Strong memory or niche interests
Trouble with emotional regulation or transitions

This variability defies the tidy boxes that functioning labels try to create. One person may present as highly independent in certain areas and need substantial support in others. These inconsistencies are not anomalies—they’re part of how neurodivergent brains naturally work.

What Causes a Spiky Profile?

Spiky profiles are shaped by a variety of neurodevelopmental and environmental factors, such as:

1. Executive Functioning Challenges

Many neurodivergent individuals experience differences in executive function: planning, organizing, shifting attention, and controlling impulses. These skills don’t follow a consistent curve, and difficulties can fluctuate depending on energy levels, environment, or stress.

2. Sensory Processing Differences

Sensory sensitivities—common in autism, ADHD, and other forms of neurodivergence—can make certain environments distressing or overwhelming. A person might cope well in a quiet room but feel completely unregulated in a loud supermarket.

3. Co-occurring Conditions

Neurodivergence rarely exists in isolation. Conditions like dyspraxia (affecting motor coordination), dyslexia, or anxiety disorders can significantly impact how someone processes information, interacts physically with the world, and maintains focus or emotional balance.

All of these contribute to a person’s variable ability, which can’t be neatly labeled as “high” or “low” functioning.

A Spectrum, Not a Hierarchy

It’s important to emphasize that neurodivergence is a spectrum—not a scale from less to more “affected.” Just like the neurotypical population, neurodivergent people vary in their skills, needs, personalities, and coping strategies.

Some neurotypical individuals struggle with organization or social skills. Some thrive in high-pressure jobs but fall apart in emotional relationships. Neurodivergent people are no different in that respect—they simply experience these differences in more pronounced or atypical ways.

The danger of functioning labels is that they flatten this complexity. They assume a static level of ability across time and context, ignoring the reality that many factors affect how someone is functioning on any given day.

Neurodivergence Is Dynamic, Not Static

Functioning is not a fixed state—it is fluid and often influenced by external and internal circumstances. A person’s ability to cope, interact, or self-regulate can vary due to:

Stress levels
Tiredness or sleep quality
Burnout (common in neurodivergent adults who’ve masked for years)
Changes in routine
Social pressures or demands
Environmental factors like lighting, noise, or temperature

For example, a person labeled “high-functioning” may suddenly find themselves unable to speak or perform basic tasks when burned out and overwhelmed. This doesn't mean they’re “faking” or “getting worse”—it means their capacity has been stretched beyond what’s sustainable.

Why “Low-Functioning” Is Also Harmful

At the other end of the spectrum, the term low-functioning is equally damaging. It often leads to:

Infantilization
Exclusion from decision-making
Low expectations or limited opportunities
Assumptions about intelligence or competence

Many non speaking or intellectually disabled individuals understand far more than they are given credit for. The inability to communicate in a typical way does not mean an inability to think, feel, or contribute meaningfully. These individuals often face systemic bias, lack of autonomy, and social invisibility due to the assumptions wrapped into the “low-functioning” label.

It is important to remember we DO NOT know what someone is experiencing internally, and strive to provide different forms of communication to help the individual be involved in decision making.

Language Shapes Perception—and Access

Words are not neutral. They influence how people are treated, whether they receive support, and how they see themselves. Labels like high-functioning and low-functioning:

Reinforce harmful stereotypes
Oversimplify a person's needs
Deny access to appropriate accommodations
Increase stigma within and outside neurodivergent communities

They uphold ableist norms by framing someone’s worth through productivity, communication, and conformity. The result is a system where many suffer silently while others are written off before they’re even heard.

Language is entirely personal to each individual, some people prefer the term ‘Autistic person’, others may prefer ‘person with Autism, and others may prefer a more generic term such as ‘neurodivergent. The term Aspergers has also been reflected upon, and the terminology used to describe Autism. The term Autism Spectrum Disorder (ASD) is now increasingly used instead to reflect the full diversity of autistic experiences without imposing divisions and categorizations.

Toward More Accurate and Compassionate Language

Here are some alternative frameworks that honor the full humanity of neurodivergent people:

1. Describe Support Needs

Instead of a ranking by function, describe what someone needs to thrive and navigate the world. For example:

“Needs assistance in unstructured environments”
“Benefits from sensory accommodations such as…
“Struggles with executive tasks without reminders”

These are generic examples, but provide an idea of the individual differences in presentations of ASD.

2. Acknowledge Spiky Profiles

Highlight strengths and challenges as part of a unique profile, not as deficits. Someone may excel in pattern recognition but struggle with verbal communication—that doesn't make them high- or low-functioning, just different skill sets in different areas.

3. Use Identity-First Language (If Preferred)

Many neurodivergent individuals prefer terms like “autistic person” rather than “person with autism” as a way of owning their identity. Let individuals define how they want to be described. Again, this is subjective and no one size fits all with terminology.

4. Emphasize Flexibility and Context

Recognize that performance is situational. Functioning levels fluctuate, and that’s normal. We all have bad days, better days, and environments where we thrive.

Final Thoughts

Functioning labels don’t help us understand people—they help us judge them. They obscure the complexity of spiky profiles, reinforce stigma, and push individuals into boxes that don’t fit. Worse, they often deny people the support they desperately need—or force them to hide their struggles to maintain a “high-functioning” façade.

Neurodivergence is not a flaw to fix. It’s a difference to understand, accommodate, and celebrate. Whether someone is verbal or nonverbal, organized or chaotic, steady or inconsistent, they deserve the same respect, autonomy, and support.

We are neurodivergent, not broken.

Neurodivergent, Not Broken: Exploring “Functioning Labels”