# 5.1. Diagnostic Framing and the Myth of Functioning Labels

## 5.1. Diagnostic Framing and the Myth of Functioning Labels

Current diagnostic language surrounding autism continues to reflect an externalized, behavior-first paradigm that prioritizes observable traits over internal cognitive structure. Terms like high-functioning, low-functioning, or Level 1–3 support needs flatten the complexity of autistic experience into a perceived relationship to independence, productivity, or compliance—none of which reflect the actual cognitive mechanisms at play. These frameworks implicitly assess individuals against a norm-centered scale of deviation rather than recognizing structural divergence in cognitive orientation.

The term profound autism, recently introduced in some research and advocacy circles, compounds this issue. While it purports to differentiate individuals with higher support needs, it instead reinforces the misconception that greater external challenges signal a deeper or more severe form of autism. In reality, many of the struggles seen in individuals labeled “profoundly autistic” may result not from autism itself, but from co-occurring intellectual disability, environmental trauma, nonspeaking presentation, or inconsistent access to meaningful support. The Monotropic Expansion model helps clarify that autism is not a scale of function or a measure of deficit—it is a directional cognitive orientation that exists independently of the challenges layered upon it.

Support needs should therefore be framed in terms of inertial mismatch between a person’s cognitive directionality and the demands or expectations of their environment—not as a metric of internal limitation. In this light, the most useful diagnostic reform would center structural cognition over behavioral comparison and abandon terms that imply internal hierarchy or progression.

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