Conclusion: What Are We Trying To Explain
Despite theoretical changes in the study of autism in the last few decades, the goals of horizontal and vertical integration continue to be pursued. Primary symptoms are still elevated above secondary symptoms and core underlying biological mechanisms are still sought to explain these primary symptoms. These assumptions are part and parcel of the way that causal models have traditionally been formulated for developmental disorders, but in the new movement away from domain-specific, localized and innate explanations, I propose that we avoid the temptation to swing completely back in time to an exclusive focus on the sensory-repetitive clinical symptoms and non-social cognitive processing as primary symptoms.
Autism And Intellectual Disability
About 1% of the general population is thought to have intellectual disability, and about 10% of individuals with intellectual disability have Autism Spectrum Disorder or autistic traits. However, a much higher percentage of individuals with ASD have intellectual disability3.
The incidence of autism is 1 in 68 births in the United States. The occurrence is about 4.5 times more common in boys with a 1 in 42 incidence rate and girls have a rate of 1 in 1892.
About 1 in 6 children in the United States had a developmental disability in 2006-2008, ranging from mild disabilities such as speech and language impairments to serious developmental disabilities, such as intellectual disabilities, cerebral palsy, and autism2.
Early Start Denver Model
ESDM is an approach that works best for 12- to 48-month-olds and follows the practices of ABA. The sessions revolve around natural play and joint activities with therapists and parents. Singing could be used to encourage a child with ASD to vocalize, or a mimicry game could be used to teach the child to identify body parts. ESDM focuses on creating positive social interactions, enhancing communication and cognitive skills in the process.
Its important for you to be involved in your childs ESDM sessions. Fortunately, the sessions are flexible enough to take place at a clinic or in your own home. A therapist can guide you through what you need to know. Studies, including brain scan research, suggest that ESDM improves language and communication skills as well as adaptive behavior.
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Sample : Preschoolers With Community
For the sample of 23 preschoolers with ASD, a significant association, of large effect size, was evident between ASD symptoms and cognitive AE scores assessed concurrently at Time 1 ; r=0.49, p= 0.010, d= 0.9. Longitudinally, a significant association, of larger effect size, was evident for this sample between Time 1 ASD symptoms and gains in cognitive AE made between Time 1 and Time 2 assessments; r=0.65, p= 0.001, d= 1.2. Average cognitive AE scores increased from 21.4 months to 30.4 months over the 1-year period, representing an average growth of 9 months within this time. The results from the correlational analyses indicated that those preschoolers with more severe ASD symptoms also presented with lower concurrent cognitive ability. Moreover, they also had fewer gains in cognitive ability over the following year. Figures 1 and 2 present individual data-points for these associations.
Figure 1. Scatterplots for 23 preschoolers with community ASD diagnoses presenting associations among Time 1 ASD symptoms and concurrent cognitive age-equivalence scores.
Figure 2. Scatterplots for 23 preschoolers with community ASD diagnoses presenting associations among Time 1 ASD symptoms and gains in cognitive age-equivalence over a 1-year follow-up period.
Empirical Arguments For The Association Of Id And Asd
If the notion that ID is a comorbid feature of ASD is correct, then measures of ASD severity and of cognitive abilities should be independent in the ASD population, so that a child could have mild ASD with severe ID, or severe ASD with mild ID. Empirical data, however, appear more consistent with our reasoning, showing that ID is more likely to be present in children with more severe ASD symptoms than in those with milder presentations. A review by Dykens and Lense using diagnostic categories from DSM-IV-TR indicates that IQ levels vary substantially across diagnoses under the umbrella of the Pervasive Developmental Disorders , with more severe forms associated with lower cognitive scores. Furthermore, a recent longitudinal study by Gotham et al. , involving a sample of 345 participants, documented that individuals with more severe autism symptoms had lower IQ, leading the authors to conclude that autism characteristics and cognitive functioning are not entirely independent features.
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Limitations And Future Directions
There were several limitations of the current study. First, we do not have data on participants adaptive behavior level, which form part of the criteria required for the diagnosis of ID. Second, whilst all of the children involved in this study would likely have been enrolled in community early intervention programs, we have not collected details on the specific programs the children were involved in, nor on the amounts of intervention being received. As such, this potentially critical factor mediating the impact of ASD severity on cognition could not be taken into account in the current study. Future research will involve collecting data on adaptive behavior and participation in intervention in order to build on the results from the current study.
Whilst the aim of this proof of principle study was to test the notion that the severity of ASD symptoms has a negative influence on cognitive development, it is important to mention various other risk factors that are known to affect cognitive development in other groups of children. These include demographic factors, preterm birth, maternal age and education, and birth weight, among others . In order to disentangle the relative importance of ASD symptom severity from that of other potentially significant factors on cognitive development, more empirical research is needed that utilizes prospective research designs and includes larger sample sizes.
Theoretical Arguments For The Association Of Id And Asd
The notion of ID and ASD as independent clinical entities reflects a modular conceptualization of cognition, according to which one processing domain/module can be selectively disrupted without negative repercussions on the rest of cognitive system . According to this framework, pure autism is the exemplification of a modular impairment involving selective difficulties with social processing, while in the situation of autism confounded by ID, additional processing domains happen to be disrupted as well, albeit for a different reason . However, an alternative to this account on the relationship between ID and ASD can be advanced within a developmental neuroscience framework . Recent research emphasizes the experience-dependent nature of early brain development , pointing to the crucial role of early exposure to social experience opportunities for cognitive development. For example, education and active engagement in a socially rich environment is associated with both structural and functional brain changes, whilst rearing in minimally stimulating environments has a negative impact on brain functioning .
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Systematic Review To Extract Relevant Studies
The 51 studies were extracted, following the PRISMA statement for systematic review. Table 1 presents the names of authors, year of publication, participants groups, the ultimately analyzed participants, diagnoses within the paper, number of cases, the mean age and age range of the target group, mean FSIQ, and the tests conducted. The ultimately analyzed participants refer to the group that met all selection criteria , and thus, were included in the final analysis. These 51 studies were published between 1970 and 2017, and the total number of participants ranged from 9 to 166 . There were 4 WISC studies, 17 WISC-R studies, 23 WISC- III studies, and 10 WISC- IV studies. The Participant Groups refer to the groups that the studies include, multiple participant groups, which were separated into categories by diagnoses, test versions, and intellectual levels. For studies in which the same authors had assessed the same participants, only one was adopted. Finally,14 studies including mixed WAIS results were excluded, and another nine studies were removed because they did not include all the mean scores of six subtests of interest. Readers are encouraged to refer to the detailed reasons for exclusion that are stated below in Table 1. The studies by Bölte and Poustka , Koyama et al. , Kumazaki et al. , and Calero et al. included results obtained after categorizing participants into groups by either gender or treatment response. However, these results were treated as one group.
What To Say & Not To Say
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People with intellectual or developmental disabilities may find it hard to do many things most of us take for granted.
These disabilities can mildly or profoundly limit their ability to learn, socialize and take care of their everyday needs.
You may not be able to know that someone has this disability unless you are told, or you notice the way they act, ask questions or use body language.
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Additional Support For Cognitive Accessibility
Some cognitive accessibility user needs are not addressed in existing W3C standards.
W3C is actively working to provide additional guidance on cognitive accessibility, including:
- updating supplemental guidance beyond what fits into accessibility standards now
- developing additional requirements to be included in future versions of WCAG
- developing standards for personalization, which is a key aspect of cognitive accessibility
Much Deeper Than Mirror Writing
The idea or myth mentioned abovethat dyslexia is simply a learning disability where children reverse letters and numbers and see words backwardsmade dyslexia seem like a visual disturbance or challenge. This was proven in a study where findings indicated that even teachers upheld the prevailing myth that dyslexia is a visual processing disorder encompassing mirror writing and word reversal rather than a phonological processing disorder.
In contrast, a study mentions the cognitive basis of dyslexia. The authors refer to dyslexia as a language disorder with specific deficits in phonological processing.;
The same study by Shaywitz et al. feels evidence of disruptions in the neural systems serving reading has far reaching implications for the acceptance of dyslexia as a valid disorder.
The difficulties caused by dyslexia cant be denied, but diagnosing the condition has always been difficult. Some studies feel the existing definitions of dyslexia are to blame for unreliable diagnosis, possibly due to the fact that definitions of the disorder rely on a single indicatorfor example deficits in decoding.
A holistic way of evaluating dyslexia may also be of importance when diagnosing a child with autism who shows such symptoms. Rather than focusing on a single indicator, like the above mentioned letter reversal, it is important to look at the childs symptoms, medical history, comorbidities and any other relevant factors to obtain an accurate diagnosis.
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Asd Diagnostic Assessment Of Individuals With Id
When considering if and how to make a diagnosis of ASD in an individual with ID, it is imperative that severity of ID be considered carefully. The mental age associated with ID in the severe to profound range of ID may not exceed 18 months, an age before which it may not be possible to assess certain abilities . Thus, while there is no agreed-upon mental age that automatically triggers the exception described in the DSM-5 criterion E that disturbances are not better explained by intellectual disability or global developmental delay , diagnosticians need to keep in mind the possibility that severe ID might prevent valid assessment of certain ASD symptoms.
A common approach in research has been to proceed with an abundance of caution by restricting the participation of individuals with ID, although this reduces the generalizability of results. However, research on genetic syndromes cannot realistically employ mental age cutoffs for inclusion. They can employ minimum mental age cutoffs for individuals they deem capable of completing ASD diagnostic instruments, and apply even more stringent thresholds regarding whether scores from diagnostic instruments should be considered valid , but these practices have not been consistently adopted up to this point.
Parents And Schools Need To Be Aware That Standard Iq And Other Assessments Of The Cognitive Function Or Mental Processing Of Children With Autism Pdd Or Aspergers Syndrome May Provide Inaccurate Results
By David A. Sherman, Special Education Attorney and author of Autism: Asserting Your Child’s Right to a Special Education
Assessing the child with autism, PDD or Aspergers Syndrome using standardized instruments has been criticized from a number of perspectives. Many tests have not been proven reliable or valid with special populations and modifications of the instrument are often required to accommodate the child, which may alter the reliability and validity of the instrument. If the child has difficulties in language comprehension, compliance or cooperation, these difficulties may interfere with measuring the cognitive abilities the assessors are targeting. The measurement of intelligence is complex, thus requires innovative interpretation and careful examination. The clinical judgment of a highly skilled psychologist or neuropsychologist may be required.
Many children with autism, PDD or Aspergers Syndrome posses a wide spectrum of strengths and weaknesses. Some children are cognitively impaired as a component of their autism, but practitioners and parents should not readily assume severe impairment without substantial confirmation.
David A. Sherman, is a special education attorney. This article on autism and cognitive function is copyright to David A. Sherman and excerpted with permission from his book, Autism: Asserting Your Child’s Right to a Special Education.
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Intellectual Disability And Developmental Delays
Intellectual disability can be diagnosed when a child who is six years or older has an below 70 as well as difficulties with daily tasks. In children under six years, the term developmental delay is used when children have significant cognitive and language delays.
Intellectual disability varies from person to person. Autistic children with intellectual disability might have uneven skills, so there might be some things that theyre quite good at and others they find hard.
In most cases, autistic children have more trouble with verbal skills like talking, listening and understanding than with non-verbal skills like doing puzzles or drawing.
How common is intellectual disability in autistic children?In the past, it was thought that 50-60% of autistic children had intellectual disability or developmental delays. But its now thought to be 20-30%, with another 20-25% having borderline intellectual disability with an IQ of 71-85.
This drop might be because IQ testing for autistic children has improved, support and education is better at addressing autistic children’s learning needs, and more children without intellectual disability are being diagnosed with autism.
Some researchers have argued that some childrens developmental delays might be caused by their social learning difficulties, rather than being a separate condition.
Find out moreIntellectual disability
Diagnosis And Testing For Learning Disabilities And Disorders
Since diagnosing a learning disability isnt always easy, dont assume you know what your childs problem is, even if the symptoms seem clear. Its important to have your child tested and evaluated by a qualified professional. That said, you should trust your instincts. If you think something is wrong, listen to your gut. If you feel that a teacher or doctor is minimizing your concerns, seek a second opinion. Dont let anyone tell you to wait and see or dont worry about it if you see your child struggling. Regardless of whether or not your childs problems are due to a learning disability, intervention is needed. You cant go wrong by looking into the issue and taking action.
Keep in mind that finding someone who can help may take some time and effort. Even experts mix up learning disabilities with ADHD and other behavioral problems sometimes. You may have to look around a bit or try more than one professional. In the meantime, try to be patient, and remember that you wont always get clear answers. Try not to get too caught up in trying to determine the label for your childs disorder. Leave that to the professionals. Focus instead on steps you can take to support your child and address their symptoms in practical ways.
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The Blurred Line Between Autism And Intellectual Disability
Doctors often conflate autism and intellectual disability, and no wonder: The biological distinction between them is murky. Scientific progress depends on knowing where the conditions intersect and part ways.
by Emily Sohn;/;15 April 2020
Soon after Patrick Kelly started school at age 5, his teachers told his parents he belonged in special-education classes. His academic performance was poor, and his behaviors were disruptive: hand-flapping, rocking, hitting his head with his wrists and tapping his desk repeatedly. He often seemed as if he was not paying attention to people when they spoke to him. He would stare off into the distance, head turned to the side.
Kellys teachers assumed he had intellectual disability, known at the time as mental retardation. Then when he was around 9, a routine eye exam at school revealed that he could barely see. With glasses, he went from underperforming to outperforming his peers in every subject but English in just two years. And it turned out that he had been listening in the classroom all along. Finally, at age 13, a psychologist diagnosed him with pervasive developmental disorder-not otherwise specified, a form of autism.
Reading Linguistic And Verbal Comprehension
Some individuals have difficulties understanding text, ranging from minor challenges to a complete inability to read any text. Although web developers cannot fully accommodate the entire range from non-readers to genius readers, we can try to write as simply and clearly as is feasible, taking into account the primary audience and including those who may have difficulty with some of the content. An estimated 15-20% of the population has some sort of language or text comprehension difficultyâincluding many prominent high achievers like Emma Watson, Richard Branson, and Whoopi Goldberg.
Here is one example of a reading problem. Note that it may be one of perception or of processing. See if the associated accessibility fix helps you.
What is being said in this phrase?
Tob eornot obe
Now check the power and importance of embedded graphics as a way to enhance the context of the written word by looking at the phrase with a graphic.
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