Beyond Kanner and Asperger – Part 4

Doctor Coplan continues his discussion of his revolutionary way of looking at ASD.

Beyond Kanner and Asperger – Part 4

In this post I will begin to address items 3 and 4 on my list of basic principles:

• General Intelligence (IQ) is a separate property from atypicality.

• Atypicality of any degree can co-exist with any level of general intelligence.

The definition of autism is silent on the subject of intelligence. On the one hand, this is as it should be; ASD is defined by impaired social skills, impaired pragmatics and prosody (communication and speech inflection), repetitive thoughts and behaviors, and unusual sensorimotor traits, not impaired intelligence. On the other hand, long-term outcome for a child with ASD has everything to do with intelligence. Numerous follow-up studies (reviewed in Appendix II of my book have reinforced the truth of Bartak and Rutter’s initial observation.[1]

Philosophers and psychologists have argued for thousands of years over how to define and measure “intelligence.” It would be nice if we could sidestep that question, and say that we will use IQ, as measured by a standardized test of intelligence, as our benchmark. However, life is not that simple. The grand paradox of IQ testing is that the instruments themselves have been developed and refined based on normal subjects, but then they are used on persons with special needs – a population they were never designed to serve. If administered strictly “by the book,” this can be manifestly unfair for people who are highly skilled, but “differently-abled.” In fact, IQ testing of persons with special needs is an art form all its own. The examiner starts with the standard tools, but the means of administration and the choices of which items to include in the final score must be adapted to the situation. For example, persons with ASD typically have strong rote memory skills but limited social reasoning ability. The examiner needs to avoid “inflator scores” on IQ testing that simply tap rote memory. By the same token, the examiner may opt to exclude tasks that hinge on social reasoning (the “Comprehension” task on the WISC is a good example) from the final IQ score. (The same discrepancy plays itself out during academic achievement testing: the child with ASD may have superior decoding skills – the ability to convert the printed word to speech – but extremely weak reading comprehension. This pattern gets its own name: hyperlexia. Many children with ASD do relatively well academically in Kindergarten, 1^st, and 2^nd grade, cruising along on the strength of their strong rote memory. Their ships run aground in 3^rd grade, when the academic curriculum shifts from rote memorization of basic facts, to tasks that require comprehension and inference.) Read the rest of this entry »

Beyond Kanner and Asperger – Part 3

Dr. Coplan continues his discussion of a new paradigm for thinking about ASD.

Last time, I listed seven basic principles upon which my way of looking at ASD rests. In this post, I’ll deal with the first two:

1. Atypicality (i.e., “autistic behavior”) exists in various degrees, from profound to minimal.

2. There is no clear boundary between atypical and “normal.” Rather, atypical traits are distributed throughout the entire population

Contrary to the DSM5, Mother Nature does not put people into two mutually exclusive cubbies: Autistic, and Non-Autistic. Rather, each of the traits or behaviors we associate with ASD can also be found in the “normal” population. It’s all a matter of degree. Did you ever get a song stuck in your head? Did you ever fail to understand a joke? Do certain sensations (e.g., fingernails across a blackboard) bother you? The fact that most of us experience things like this doesn’t necessarily mean we have “repetitive behavior,” “impaired theory of mind skills,” or “unusual responses to sensory stimuli.” Rather, these are traits / behaviors we all share. However, when these and other traits or behaviors become impediments to daily life, they turn into “symptoms of a disorder.” Exactly where that boundary lies, however, is partly a matter of context. A normal behavior at one stage of development becomes a “symptom” if it persists into later life. Conversely (as Steve Silberman points out in his book), a “symptom” in one setting may be an asset in another. The person with a hyper-acute sense of smell may be bothered by scents that other people cannot even detect. This can be a useful trait for a wine taster. Thus, there is not a bright line between “normal” and “autistic.” Read the rest of this entry »