"High Functioning"

I was just curious is the term “high functioning” considered offensive or crass in the Down Syndrome community?

Would someone who works with DD people ever use that term while referring to them?

I’m not sure you’re going to find a “Down Syndrome community” to poll.

Deb worked for over ten years for an organizattion that provided care to MRDD and severely handicapped kids along with support for people in homes who did not require institutional care. I recall the staff using “high functioning” to refer to the folks (older kids and young adults) who were able to hold jobs outside the home.

There may be some places where the term is an insult, (some of this stuff moves in waves as people who do not work with the handicapped latch onto words and turn them into insults), but it was not (yet) an insult in Northeast Ohio a couple of years ago when Deb was still in that field. It was simply a description that distinguished between those who could live with little to no direct supervision, as opposed to those who needed constant supervision or constant care.

You’re pretty much right on Tomndebb . I’ve been retired a little over a year now but I don’t think much has changed in that little time.

" high functioning" always meant someone who required little or no supervision. Certainly it would refer to someone who could hold down a job ( and there are more of these people than one would think ).

I have never heard it referred to as an insult and would not want to. A lot of higher functioning clients also make the case workers job easier as well. They can be a dreat help and very enjoyable people to be around.

My friend’s brother cannot live or work unsupervised, but he has a job. I think he would be considered medium-functional. It is a very useful term and I don’t think it would be considered an insult to refer to his level of functionality. He is what he is…a very loving person who will never be more than about six years old. But he loves his job and the responsibility it gives him.

From the " Gosh Amight, retards do loves them some Huey Lewis" thread ( can’t find, not enough coffee…aging hamsters. I blame Al Gore.) and my limited experience with this segment, is that they shoot from the hip with what they say. As if they are lacking an ‘edit’ button or Five Second Internal Delay From Foot In Mouth problem.

Oh…hate to break it to you but “High Functioning” is becoming a bit of an insult.

That’s why I was curious to see if it was actually used by people who work with developmentally disabled.

And there is Down Syndrome community. Just google it and you’ll find many sites about it. I just really didn’t want to pop onto their message boards and ask this.

Could you explain the context in which it is perceived to be an insult? It doesn’t make sense to me. I read mostly practicioner research and documents on developmental disabilities, not flaming message board communities, and it’s used in a purely professional manner as otherwise described in this thread. However, if in the next few years it’s going to evolve into an insult, I’d like to know about it so I can be sensitive to that fact around clients’ families.

Well, now I’m confused. Why did you come here and ask if you already had some inside information the rest of us who work in the field are apparently not privy to?
I don’t know about Hollywood but up here in my little part of Canukland the message hasn’t arrived yet. Nowhere in any of the literature i’ve seen, is there any indication that the term is an insult.Please feel free to prove me wrong.

And Shirley , there was something about your post that left a bad taste in my mouth. I don’t think there was any untoward meaning in it, perhaps just seeing “retard”. It always gets my hackles up.

Just sayin, yhats all.

“High Functioning” is used as an insult to non-retarded people, or to non-schizophrenic people, depending on the context. It compares the insultee to a retarded or schizophrenic person, albeit a high-functioning one. As Tom surmised, it is used by people who do not work with the retarded or menatlly ill. The OP was asking if the term was really used by people who do, in a clinical sense. He also said he knew there were boards for people who worked in this area, but didn’t want to drop this question on one of them, as it would be pretty offensive to those people. The answer, by the way, is yes.


In general, any term selected to identify or describe those whose mental capacities leave them at a disadvantage in society will become an insult once the general public comes to recognize it, since questioning one’s intelligence is a pretty basic insult and an easy way to question one’s intelligence is to associate one with a group identified as less intelligent.

In this case, I’d be curious to know the context where it has become an insult. My point was simply that it does not (yet) appear to be an insult among those who work in the field of assisting such people. (I was even cautious enough to specify a geographic location and a time frame, since I know this stuff floats around quite a bit.)

Mental Retardation was a term coined to avoid the stigma of “feeble minded” and other earlier phrases, and it soon showed up on playgrounds across the country in the catcall “REEtard”! Half a century, or so, later, the care providing community for those folks have still never come up with a more appropriate phrase–and many of them have come to recognize that any such phrase would be corrupted, anyway. (Consider all the permutations of “challenged” that appeared when some well-meaning, but lingusitically clueless people tried to impose that nomenclature in the 1980s.)

There are, of course, also fads in language within groups of care providers. The change from “Down’s Syndrome” to “Down Syndrome” was made based on a change in general terminology in naming diseases that was presented as a “logical” change even though the logic was not blindingly obvious to everyone. (Basically, it was noted that since Down did not suffer from the condition he described and Hansen did not suffer from leprosy, the possessive ending should not be used in such names. It is an arguable position, but not a clear-cut one.) However, following that decision, I saw bloody fights between people who demanded that the possessive suffix be dropped and people who noted that it had not been dropped in the (then current) publication of the DSM-IV.

So, in response to your assertion that “high functioning” has become an insult already, I would ask whether you have seen this among the general populace or whether this is an intra-group issue?

FWIW , I agree heartily, Tom . This may be the latest attempt by certain focus groups to open a new round of political correctness. I hope not. The phrase has value and has served both clients and caregivers well. To attempt to denigrate it now in any way serves no one.

saoirse , you make me curious. In 35 yrs. of psych. nursing I have never heard the term “high functioning” in reference to Schizophrenia. Either in a clinical sense or as an insult. Schizophrenia is controlled in many clients in varying degrees but this phrase indicates none of the varying gradients. It doesn’t make any sense even as as insult.

I also don’t understand the reluctance of the OP to go to a message board on this subject and ask the question. There is nothing offensive in the question and I highly doubt anyone with a sincere interest in the subject, would find it so. If they did, I would find that offensive.

Exactly and thank you for making it clear.

I’ve heard it in reference to both schizophrenia and MR, as well as autism/Asperger’s syndrome and bipolar disorder. And no, I’ve never heard it as an insult, I don’t even fully get the gist of saoirse’s explanation. Wouldn’t calling a “normal” person high-functioning be like calling them a genius, or a really well adjusted person? I guess I shouldn’t try to apply logic to insults.

P.S. I am not a nurse or caretaker, just a regular-functioning person who wanted to chime in.

I have been looking for the thread I refer to and I swear it was in MPSIMS this summer. Here. I swear. It was a link to an article written by a person who works daily with the mentally challenged and it was really well done. I was just quoting their words.

I did not mean anything derogatory by it.

I also have heard “high functioning” used to refer to less-disabled people with a variety of potentially disabling mental disorders, used by my (I believe) J.D./M.B.A. professor in Mental Health Law this semester.

Fortunately, since it’s being used as an insult for people without any disorders, we don’t have to worry about insulting our patients/clients, this time. :slight_smile:

If possible, would someone please drop in here and explain what is insulting about the original question? And why, specifically, someone on a Down Syndrome messageboard would find it so? I would think they would be glad to explain and welcome anyone who showed such interest.

There are many terms and phrases in medicine and moreso in psychiatry that are used in improper context, even by professionals in the field. However," high functioning " is, for the most part, not one of them.

Again, it has been my experience to have never heard this term used to reference schizophrenic patients and certainly not bipolar patients. Nowhere. Never. In any context. As well, I would look askance at anyone who did, not to mention, questioning their competence in the field.

And I really would appreciate the OP answering my question because this whole “insulting” thing is totally baffling to me.

And of course I meant J.D/M.D. Letter overload.