The canon · Neurodiversity & belonging
“High-functioning” and “low-functioning” sort people into a rank. Cognitive ecology refuses the cut.
The deficit model loves a ladder. It takes the enormous variety of how people are supported through their lives and squeezes it into a single vertical line: high-functioning at the top, low-functioning at the bottom, everyone else somewhere on the rungs between. It feels informative. It feels almost kind — a way of saying “this person needs more help, that person needs less.” It is neither. It’s a ranking of human beings dressed up as a description of them, and it gets nearly everything backward.
Start with what the labels actually do to the people wearing them. “High-functioning” is used to withdraw support from people who plainly still need it — you seem fine, so you’re on your own — while quietly erasing how much invisible effort “seeming fine” costs. “Low-functioning” is used to withdraw something worse: presumed competence, the assumption that there’s a full person in there with preferences and a mind of their own. One label strips the help; the other strips the personhood. Neither describes a rank of worth, because there is no rank of worth. They just distribute two different kinds of neglect.
Here’s the error underneath the ladder. It treats “functioning” as a fixed trait you carry around, like height — a number stamped on you that holds steady wherever you go. But functioning is never a property of a person alone. It’s a property of a person in a setting, in a relationship, on a given day, with a given amount of support and demand. Change the conditions and the “level” moves, sometimes dramatically. The same person is high-functioning in a quiet room with the right tools and low-functioning in a fluorescent open-plan office, and nothing about *them* changed at all.
You are not high- or low-functioning. You are a particular person meeting particular conditions — and the ladder was always measuring the fit, then blaming the climber.
This is just cognitive ecology applied to the word. If a mind and its conditions are one system, then “how well someone functions” is a fact about that whole system, not a score belonging to the person inside it. The ladder commits the field’s original sin: it locates in the individual what actually lives in the relationship between the individual and their environment. Then it ranks people by it, as if they’d earned their rung.
The hierarchy isn’t just inaccurate; it’s actively harmful, and it splits a community that should be whole. It pits people against each other — the “high” end told they’re not disabled enough to belong, the “low” end talked over and decided for. It lets institutions ration support by label instead of by actual need. And it makes a lie feel like realism: that some minds are simply more capable of a full life than others, when what’s really true is that some minds have been met by their conditions and others have been abandoned by them. I have been called both labels, in the same year, by people describing the same me.
That last fact is the tell. If a label can flip while the person holds still, the label was never about the person. It was about the room they were standing in and how much it chose to help.
Some of you will be thinking of the clinical levels — Level 1, 2, 3, the “requires support / requires substantial support” language from a diagnostic manual. I want to be precise rather than dismissive here. Those levels are clinical instruments. They exist to help allocate services and structure clinical decisions inside clinical systems, and in that narrow setting they can do a real job. The trouble starts when they walk out of the clinic and become identities — when “I’m a Level 2” turns into a rank a person carries through every room, or a ceiling placed on what anyone expects of them.
This is not a clinical space, and it doesn’t run on a hierarchy of need. We don’t sort people into tiers here, because the moment you do, the tier starts doing the talking — it decides in advance how much someone can contribute, how much they should be listened to, how full a life they’re assumed to want. A level is a snapshot taken in one setting for one purpose; it was never meant to be the whole picture of a person, and we won’t treat it as one. Bring the clinical language with you if it’s useful to you. Just know that inside this house it buys you no rank, and costs you none.
The alternative already exists, and it’s better in every way: talk about support needs, specifically and in context, without ranking them. Not “he’s low-functioning” but “he needs communication support and a predictable environment.” Not “she’s high-functioning” but “she manages well with flexible hours and needs real backup in sensory-heavy settings.” Support needs are plural, specific, situational, and changeable. They describe what would actually help, which is the only thing worth knowing. And crucially, they carry no ranking of worth — needing more support is not being less of a person, any more than needing glasses makes you less of a reader.
Refusing the hierarchy isn’t pretending everyone’s needs are identical; they obviously aren’t. It’s refusing to convert difference in need into difference in standing. Everyone’s needs get met as a matter of course, at whatever level they actually are, without anyone having to audition for the privilege by proving they’re near the top of a ladder that should never have been built. Name the need. Meet it. Skip the rank. There was never a hierarchy here — only a community the deficit model kept trying to cut in half.