"You're So High-Functioning!" (And Other Things People Say That Make Me Want to Disappear)

Why Being Treated Like a Child Is One of the Most Painful (and Least Talked About) Experiences of Being An Autistic Adult

One of the things I can't stand most is when someone treats me like I'm incapable, or like I'm a child. It isn't always obvious. Sometimes it's the overly simplified language, the assumptions that I don't understand what's being discussed, or people talking about me instead of to me. Other times it's the belief that because I'm autistic, I couldn't possibly know what's best for myself.

My dad used to do it. He would dismiss my opinions, second-guess my decisions, or assume he knew what I was thinking or feeling better than I did. Over time, those moments sent a quiet but powerful message: that my judgment couldn't be trusted simply because my brain worked differently. Whether intentional or not, that kind of treatment can slowly chip away at your confidence. You start questioning yourself, staying quiet, or feeling like you have to constantly prove that you're competent. That's why infantilizing autistic adults can be so harmful—it doesn't just change how other people see you; it can change how you begin to see yourself.

And this is honestly one of the main reasons why I went on to get five degrees. To prove to my dad I was more competent than he thought I was.

What Is Infantilization, Actually?

Infantilization happens when someone treats an adult as though they have the cognitive and emotional capacity of a child without their consent, without evidence, and often without awareness.

It can look like:

• Speaking in a slower, louder, more simplified tone than usual

• Making decisions on someone's behalf without consulting them

• Expressing surprise when they demonstrate competence ("Wow, you did that yourself?")

• Dismissing their preferences as things they "don't really understand"

• Framing their very real expertise or insight as "cute" or "impressive for someone like you"

• Constantly offering help they didn't ask for and don't need

• Talking about them to others in their presence as though they aren't there

  
  

For autistic adults (myself included), this happens consistently. In workplaces. In medical offices. In families. In romantic relationships. And even in therapists' rooms.

And it causes genuine harm.

The Science of Why This Happens (And Why It Isn't a Compliment)

To understand why autistic adults get infantilized so consistently, we need to look at what's happening in the minds of the people doing it. Not to excuse it, but to understand why they do it.

The Thin-Slice Problem

Research by Sasson and colleagues (2017) found that neurotypical people form negative first impressions of autistic adults within seconds — before any meaningful interaction has taken place. In this study, these quick judgments, based on brief exposure to autistic communication styles, led neurotypical participants to rate autistic people as less likeable, less trustworthy, and less desirable as social partners.

Here's what makes this particularly infuriating: the autistic people hadn't done anything "wrong" in this study. They'd simply communicated in an autistic way. But the neurotypical participants interpreted difference as deficiency.

That misread — difference as deficiency — is where infantilization begins.

The Double Empathy Problem

Milton's (2012) Double Empathy Problem framework reframes how we understand autistic-neurotypical miscommunication. For decades, the deficit was located entirely in the autistic person. They were described as lacking theory of mind, lacking empathy, lacking social understanding.

Milton's work showed something more honest: both parties struggle to understand each other across neurotype. Neurotypical people are not, in fact, naturally gifted at reading autistic people. They simply assume they are — and that assumption is part of the problem.

When a neurotypical person can't read an autistic adult accurately, they tend to fill the interpretive gap by reaching for the nearest available cultural script. And in most cultures, the script for "person who communicates or processes differently" is "child."

This isn't conscious. It isn't usually malicious. But it's wrong, and it's damaging.

The Competence-Warmth Trade-Off

Social psychology research has long documented what's known as the competence-warmth trade-off — the tendency to perceive people as either competent or warm, but rarely both. People perceived as needing help or accommodation are frequently assigned to the "warm but low competence" category automatically — a pattern documented in research on disability and stigma more broadly.

For autistic adults, this plays out in a specific way. When someone discloses an autism diagnosis, the listener often unconsciously shifts their assessment of that person's competence downward — even if everything they've observed about that person up to that point suggested high capability. The label activates a stereotype, and the stereotype overwrites the evidence.

The "High-Functioning" Myth Does Real Damage Here

The language of "high-functioning" and "low-functioning" autism, though falling out of clinical favor, remains deeply embedded in public consciousness — and it creates a particularly cruel double bind for autistic adults.

If you are visibly struggling, people assume you cannot manage independently and act accordingly.

If you are managing well — because you've spent decades developing coping strategies, masking, and compensating at enormous personal cost — people assume you don't "really" need support, and dismiss your difficulties as exaggerated.

Neither response treats you as a whole adult. One denies your capability. The other denies your struggle. Both deny your autonomy.

What It Actually Feels Like

To the Person Doing It

They genuinely believe they're being kind. Helpful. Accommodating. They've absorbed cultural messaging that autism means childlike cognition, limited understanding, and a need for supervision. They're acting from that script.

They may feel protective. Virtuous, even.

They often have no idea they're causing harm.

To the Autistic Adult Receiving It

It feels like being made invisible inside your own life.

It feels like proof that disclosing was a mistake.

It feels like having your years of expertise, your education, your accomplishments, your inner life — quietly, smilingly set aside.

It can feel like humiliation dressed up as compassion.

And because it usually comes from people who mean well, there's often no clean way to respond to it. Getting upset makes you seem oversensitive. Explaining yourself calmly requires doing significant emotional labour to manage their comfort about their behavior. Saying nothing means it keeps happening.

It's a trap. And it's exhausting.

The Masking Tax on Top of Everything Else

Here's a layer that rarely gets discussed in conversations about infantilization: by the time many autistic adults are in the situations where this happens, they've already been masking — suppressing their natural communication style, monitoring their tone and body language, performing neurotypicality — for hours.

Then someone treats them like a child anyway.

All that effort. All that energy spent trying to "pass." And it didn't protect them. It didn't earn them the respect they were working so hard to secure.

Research consistently links chronic masking to burnout, anxiety, depression, and reduced sense of authentic identity (Cassidy et al., 2018; Evans et al., 2023).

Infantilization adds an additional layer to this: it communicates that even your most successful performance of competence is not enough to be treated as a full adult.

That message is crushing in a way that's hard to articulate to people who haven't lived it.

In Medical and Clinical Settings: The Stakes Get Higher

Infantilization in social settings is painful. In medical and clinical contexts, it can be dangerous.

Research on healthcare interactions with autistic adults documents patterns of clinicians over-simplifying information, speaking to accompanying family members rather than the patient directly, dismissing autistic patients' self-reported symptoms as likely misperceived, and failing to adequately explain treatment options under the assumption that the patient won't understand or can't meaningfully consent.

This is not neutral. When clinicians assume reduced competence, autistic patients receive less information, have less input into their own care decisions, and are more likely to leave appointments without understanding their diagnosis or treatment plan.

The cost of being underestimated isn't just emotional. It's health.

What Can Actually Help

For Autistic Adults

Name it, when you have capacity to do so. You aren't obligated to educate everyone who infantilizes you. But when you have the energy and the relationship supports it, naming the dynamic — calmly and specifically — can interrupt it. "When you explain things to me that way, it feels like you're assuming I won't understand. I do understand. Can we talk normally?"

Decide in advance how you'll handle it in different contexts. You might respond differently with a close family member than with a colleague or a doctor. Having a loose script ready reduces the real-time cognitive load of having to figure out what to say while also managing the emotional impact.

Validate your own anger. Being infantilized is dehumanizing. Feeling angry about it is appropriate. You don't have to perform gratitude for someone else's patronizing behavior.

Find your people. Research on neurotype-matching by Crompton and colleagues (2020) found that autistic people experience significantly more natural rapport, ease, and mutual understanding when interacting with other autistic people. The relief of being in spaces where you are not constantly misread is real and restorative. Seek those spaces actively.

Know your rights in clinical settings. You have the right to receive information directly, to ask questions, to have things clarified, and to be addressed as the decision-maker in your own healthcare. If a clinician is speaking to someone else in the room instead of you, you are allowed to redirect them. "I'd prefer you speak to me directly, please."

For Neurotypical People Who Want to Do Better

Pause before "helping." Ask yourself whether the person has asked for assistance, or whether you're assuming they need it. If they haven't asked, don't offer — or at most, offer once and accept the answer.

Match your register to theirs. If the autistic person you're talking to is using sophisticated vocabulary, complex reasoning, and nuanced analysis, respond in kind. Don't simplify your language just because you've learned they're autistic.

When in doubt, ask. "How do you prefer I communicate with you?" is a sentence that costs nothing and respects everything.

Check whether your "accommodation" was requested. Genuine accommodation is something a person asks for. What you're imposing without being asked is not accommodation — it's assumption.

Listen when you're told you've caused harm. If an autistic person tells you that your behavior felt patronizing, the response is not to explain that you didn't mean it that way. The response is to hear it, believe them, and adjust.

The Deeper Grief Underneath All of This

For many autistic adults — especially those diagnosed later in life — infantilization lands on top of an existing wound.

Many spent years being told their difficulties weren't real. That they were too sensitive. That they were dramatic. That if they just tried harder, they'd be fine. And then they received a diagnosis that finally explained their experience. Finally gave them language. Finally made sense of decades of confusion and exhaustion.

And then someone smiled that smile at them.

After everything it took to be understood, the diagnosis became another reason to be dismissed.

That grief is real. It deserves to be honored, not explained away.

You Are Not a Child. You Never Were.

You are an adult with a different neurotype — one that has been systematically misread, mischaracterized, and underestimated by a world built for a different kind of mind.

Your differences are not evidence of diminished capacity. They are evidence of a different architecture. One that comes with genuine challenges, yes. But also with capacities that the narrow lens of neurotypical assessment has rarely been designed to capture — depth of focus, pattern recognition, perceptual acuity, passionate expertise, radical honesty.

You deserve to be treated as the full adult you are.

In your relationships. In your workplace. In your doctor's office. In your own family.

Not Sure Where You Are on This Journey?

If any of this resonated — if you've spent years feeling misunderstood, dismissed, or talked past — it might be worth taking a closer look at whether autism is part

of your story.

The Ritvo Autism and Asperger Diagnostic Scale (RAADS-14) is a validated screening tool designed for adults. It takes only a few minutes and can be a meaningful first step toward understanding yourself more fully.

And if you're ready to talk to someone who won't treat you like a child, our team at the Adult Autism Assessment Center offers free consultations. We work with adults. We listen. We don't simplify.

You can also book a free consultation with one of our therapists. We specialize in seeing the whole picture, not just the highlight reel. 

And if you're tired of being mistranslated, our team of neurodiversity-affirming clinicians at the Adult Autism Assessment Center would love to meet you, the real, warm, deeply-feeling you. You can book a free consultation with any of us anytime.

Our clinic She Rocks The Spectrum is centered around women and girls, while our clinic Therapy 4 Autistic Men is focused on men and boys.

Warmly,

Michelle Karth, PhD, PhD Behavioral Neuroscience 

Autism Advocate 

Scientific Advisor

Adult Autism Assessment Center

Science Resources

References

Cassidy, S., Bradley, L., Shaw, R., & Baron-Cohen, S. (2018). Risk markers for suicidality in autistic adults. Molecular Autism, 9, 42.

Crompton, C. J., Ropar, D., Evans-Williams, C. V. M., Flynn, E. G., & Fletcher-Watson, S. (2020). Autistic peer-to-peer information transfer is highly effective. Autism, 24(7), 1704–1712.

Evans, J. A., Krumrei-Mancuso, E. J., & Rouse, S. V. (2023). What you are hiding could be hurting you: Autistic masking in relation to mental health, interpersonal trauma, authenticity, and self-esteem. Autism in Adulthood, 6.

Milton, D. E. M. (2012). On the ontological status of autism: The 'double empathy problem'. Disability & Society, 27(6), 883–887.

Sasson, N. J., Faso, D. J., Nugent, J., Lovell, S., Kennedy, D. P., & Grossman, R. B. (2017). Neurotypical peers are less willing to interact with those with autism based on thin slice judgments. Scientific Reports, 7, 40700.

Sheppard, E., Pillai, D., Wong, G. T. L., Ropar, D., & Mitchell, P. (2016). How easy is it to read the minds of people with autism spectrum disorder? Journal of Autism and Developmental Disorders, 46(4), 1247–1254.