I'm a 62yo autistic man. I get why your gen finds the "high functioning" label offensive. Still, in medical terms it has a very specific meaning.

It means you are capable of unattended self care.

That's it. You can dress yourself, toilet yourself, and feed yourself. You know your name, how old you are, your birthday, your address, and what year it is. That's all it takes to be "high functioning" in medical terms to a neurologist.

All the other stuff you mentioned is crap society has come to associate with autism over the last 40 years. In the 60's being "high functioning" meant you were able to do the bare minimum it takes to be considered a functional human being. Nothing more.

The term is not just applied to autistics. It's also used to triage stroke and brain injury survivors. If you are capable of unattended self care and can do the things I listed, then you are considered "high functioning".

That's how low that bar is.

Everything you can do in addition to that is considered a bonus. You should be grateful.

I know this, because it's what the neurologist told my wife. After she had mild brain damage as a result of sepsis five years ago.

That's what "high functioning" means in medical terms. The term is highly distorted in popular usage when it comes to autistics. For that reason it should probably be discarded.

Still, what terminology would you use to describe the line between those capable of unattended self care and those who are not? That used to be the cut line between being institutionalized or not.

It's a painful thing to think about but it's also a painful physical reality of autism. Is there a preferred term that people should be using?

Not sarcasm. I would like to know. You are the fourth autistic to write about their dislike of the "high functioning" term that I have read on Medium in the last 2 years.

You're eloquent about why you dislike the term. What would you replace it with?