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Support needs labels ​
Last edited on: 2-6-2026
DISCLAIMER
I'm not a professional and am not formally educated in the area. The information here has been written in line with the truth as much as possible, but there might be things that aren't completely sound. Always try to do your own research.
I'm not a professional and am not formally educated in the area. The information here has been written in line with the truth as much as possible, but there might be things that aren't completely sound. Always try to do your own research.
Contents:
On this page, the support needs labels will be explained in more detail.
Support needs labels are labels that disabled people can give themselves. The terms most commonly used are LSN (low support needs), MSN (medium/moderate support needs), and HSN (high support needs). There are also less commonly used terms like L/MSN (support needs on the border between LSN and MSN) and H-MSN (higher MSN).
I also wrote a deep-dive on the framework I developed for the support needs labels. Click here to read it.
What are support needs labels? ​
Support needs labels are unofficial terms that can be self-assigned or assigned to someone close to the person (e.g. parent, caregiver). There are no official criteria for when you fall under which label, but there are general agreements about it within the disability community. Usually the labels are based on how much support you need with practical adaptive functioning skills, the Activities of Daily Living (ADLs). Sometimes people take a broader approach than only the ADLs and take all adaptive functioning into account. Go to this page for a more in-depth explanation of what adaptive functioning and the ADLs entail.
There are different opinions about the context in which you should use to assign yourself a label. In my opinion, you should look at your baseline over a longer period of time, between about 9 months to 2 years, and you should look at the support you need to have a good quality of life.
The labels are always in comparison to other disabled people, not non-disabled people. Someone with low support needs only has low support needs because their need for support is compared to all disabled people, including those with high support needs.
Important: Do not use the text below as a checklist to discover which label you fall under. The support needs labels are too complex to be able to do that. Besides that, what you should look at when determining your support needs label differs greatly between those with only physical disabilities, only mental disabilities, and when you have a combination of the two. For example, someone with exclusively physical disabilities can still be HSN while needing little to no support with conceptual and social adaptive functioning because their support needs for practical functioning are very high.
Low support needs (LSN) ​
I'll explain how I interpret LSN here. I'm always talking about an adult.
Important: The explanation I give here is simplified. The reality is more complicated, so keep this in mind.
General ​
People with low support needs need less support compared to other disabled people. This doesn't mean they don't need any support; they can still struggle a lot because of their disabilities. It's just not as much compared to those with moderate or high support needs.
Practical functioning ​
People with LSN are usually able to physically do their basic ADLs (e.g. personal hygiene, toileting, eating) independently. They might needs support in the form of alarms, a visual schedule, or other relatively less invasive help or support. They usually do need support with 1 to a few instrumental ADLs (e.g. preparing a meal, household chores, managing finances). For example, a parent or caretaker who helps them with keeping their finances organized.
Conceptual functioning ​
People with LSN usually experience difficulties with certain parts of conceptual functioning. These parts are usually the more complex skills (e.g. planning, problem-solving), but it's also possible for them to struggle with the simpler skills (e.g. understanding the concept of time and money). They usually need support with this, but this can usually be given in a relatively less invasive way compared to the support people with MSN or HSN need. For example, they might needs a calculator for every-day use, or developed and use intricate mental systems to remember or plan for things.
Social functioning ​
People with LSN usually struggle with social functioning and need support for it. However, this support is usually less intense and invasive compared to the support those with MSN and HSN need. Examples are needing support with learning social rules, or needing someone to check a message before you send it. People with LSN can usually camouflage their social deficits to varying degrees, which makes their support needs in this area less outwardly noticeable.
In practice ​
Living ​
People with LSN can usually live fairly independent, if needed with a support worker coming by once or twice a week. Some of them could need supported living, but this is usually temporary and with the goal to "graduate."
Work ​
People with LSN can often work part-time, and sometimes even full-time. A considerable amount of them do need support in finding and keeping a job. People with LSN can often work for "regular" employers, if needed with quite a bit of support. There are people with LSN who need a different kind of employer, or who might not be able to work at all, but those are more often than not an exception.
Camouflaging disability ​
When it comes to camouflaging their disabilities, the ability to do so between different people with LSN vary greatly. Some can camouflage so well you don't suspect they're disabled looking from the outside. But others might struggle more with camouflaging, or aren't able to do it at all.
When support disappears ​
For people with LSN, the consequences of their support disappearing are very serious. Often people with LSN who aren't supported well are in a constant state of overexertion, which usually leads to burnout. In time this has very serious negative consequences on the mental and physical health of the person. Sometimes they even need to be admitted to a hospital because of it, or they lose skills they used to have.
Medium/moderate support needs (MSN) ​
I'll explain how I interpret MSN here. I'm always talking about an adult.
Important: The explanation I give here is simplified. The reality is more complicated, so keep this in mind.
General ​
People with MSN have support needs between people with LSN and HSN. The support needs vary greatly from person to person with MSN.
Practical functioning ​
The ability to physically do their basic ADLs (e.g. personal hygiene, toileting, eating) of people with MSN vary greatly.
On one side you have people who can do their bADLs physically independently, but do need the kind of help that can only be given by another person with a few bADLs. For example, someone who help you initiate showering, or who asks you if you need to go to the bathroom because you don't notice it yourself when you have to.
On the other side you have people who do need physical help with 1 to a few bADLs, but not that much that they would fall under HSN. For example, these people might not be able to wash their own hair or brush their teeth, and need someone to do that for them.
People with MSN usually need support with most of their instrumental ADLs (e.g. preparing a meal, household chores, managing finances). This can vary from someone doing the task with them, to someone doing the task for you.
Conceptual functioning ​
People with MSN usually have difficulties with conceptual functioning. Because of these difficulties they need substantial support in the form of multiple different, often invasive, methods. For example, they might need help from someone with breaking up a task, or someone who helps them plan their day. They need the help because they can't do it without it.
Social functioning ​
People with MSN usually have difficulties with social functioning. Because of these difficulties they need substantial support in the form of multiple different, often invasive, methods. These can vary from techniques and tools they implement themselves, to someone who need to go with them to e.g. the supermarket. They need the help because they can't do it without it.
In practice ​
Living ​
People with MSN usually can't live (fully) independently. They usually need supported living or live with their parents/caregivers out of necessity. Sometimes they can live with a partner or roommates, but those would often have to take on a caregiving role to make sure the person with MSN is well supported.
Work ​
People with MSN usually can't work full-time. They can sometimes work part-time, but often this is only possible with intensive support. A lot of people with MSN can't work at all and are reliant on disability benefits. Sometimes they'll go to a day program for disabled people during the day, or do some volunteering.
Camouflaging disability ​
People with MSN often struggle more with camouflaging their disabilities, but the differences between different people are big. Some people can't camouflage at all, while others can camouflage to the point of only seeming a bit "off" or "weird" to others.
It's important to remember that the amount of effort someone puts into camouflaging isn't always noticeable by just looking at them. Someone can really try their hardest, but their attempts might not be as successful.
When support disappears ​
If the support of someone with MSN disappears, it would have very serious consequences. These consequences are often noticeable after a few days to a couple of weeks, and can consist of severe neglect of themselves and their physical surroundings, skill regression, and psychiatric crisis. In time admission to e.g. a hospital is often needed to save their lives. This can be because of the negative effects of the neglect, as well as the possible psychological effects of the lack of support (like psychosis, suicidality, and other forms of severe psychological decompensation).
High support needs (HSN) ​
I'll explain how I interpret HSN here. I'm always talking about an adult.
Important: The explanation I give here is simplified. The reality is more complicated, so keep this in mind.
General ​
People with HSN have the highest support needs within the disabled community. They often need the most intensive and invasive kinds of support to be able to live and function.
Practical functioning ​
People with HSN often need very intensive support for their basic ADLs (e.g. personal hygiene, toileting, eating). This can vary from someone who helps them with every step of a task, to someone fully doing the task for them.
People with HSN almost always need support with all the instrumental ADLs (e.g. preparing a meal, household chores, managing finances). This support is usually very invasive, like someone doing the task for them.
Conceptual functioning ​
People with HSN usually have profound issues with conceptual functioning. Because of these issues they need very substantial support in the form of multiple different, often very invasive, methods. For example, they might needs someone to simplify information for them, or someone who takes full control of their finances.
Social functioning ​
People with HSN usually have profound issues with social functioning. Because of these issues they need very substantial support in the form of multiple different, often very invasive, methods. For example, they might need someone to always be with them when they leave the house to ensure their safety, or someone who gives intensive support when communicating with others.
In practice ​
Living ​
People with HSN can't live independently. They often need someone with or near them for 24 hours a day, 7 days a week to make sure they're safe and healthy. It depends on the individual person with HSN how long they can be left alone, but this is often not more than a maximum of a few hours to 30 minutes. A lot of people with HSN can't be left alone for even a moment. They need permanent supervision to ensure their safety.
Work ​
People with HSN often can't work in any way, shape, or form. They usually need disability benefits as income. Sometimes they can work for a few hours per week, but only with very intensive support. More often people with HSN go to a program for disabled people during the day, as long as they can be well supported there.
Camouflaging disability ​
People with HSN often camouflage too, but this usually looks different from those with MSN or LSN. Because the support needs of those with HSN are so high, camouflaging to the point of people not noticing they're disabled is often not realistic. They can often still put a lot of effort into camouflaging, but it's often still obvious they're disabled to other people.
When support disappears ​
For people with HSN, the consequences of support disappearing are the quickest to be noticed and the most impactful. Often the result is noticeable within a few hours. When people with HSN go without support for a few days, this often leads to hospitalization or even the passing of the person.
Alternative labels ​
Besides the labels described above, there are alternative labels. These are often used when someone feels like the more commonly used labels (LSN, MSN, HSN) don't fit their situation well enough.
Border labels ​
These are the labels L/MSN and M/HSN. These labels are used by people who feel like their support needs are on the border between 2 labels.
More specific labels ​
Quite a few labels fall under this category. I've written them all down:
L-LSN, M-LSN, H-LSN,
L-MSN, M-MSN, H-MSN,
L-HSN, M-HSN, H-HSN.
These labels are used when someone feels like e.g. only MSN isn't precise enough. Someone can then say that they have support needs on the lower end of MSN (L-MSN), the middle of MSN (M-MSN), or the higher end of MSN (H-MSN).
Minimal support needs (MiSN) ​
This term was coined by The Angry Autist. It can be used by people who are disabled, but of whom the effects of their disability are largely to fully compensated by small and relatively non-invasive methods. Examples are people who are vision impaired but of whose sight is fully corrected by glasses, or people who only need a medicine with minimal side-effects to live a normal life.