In the category of neurodevelopmental disorders suggested by the DSM-V (Diagnostic and Statistical Manual of Mental Disorders – Fifth Version), we find two particularly popular and sometimes confusing subcategories: Intellectual disability (ID) and autism spectrum disorder (ASD).
Since they belong to the same category, ADD and ID share some characteristics. For example, their origin is infancy and they have limitations in specific or global areas of adaptive behavior. In other words, in both cases, the person diagnosed finds it difficult to develop in the personal, social, academic and professional contexts as one would expect due to his chronological age. However, both their diagnosis and their intervention retain important differences.
In this article, we will review the differences between intellectual disability and autism (Or, rather, the construction of autism spectrum disorder).
5 differences between ADD and intellectual disability
Developmental disabilities and ASDs often coexist, which means that after completing the appropriate assessments they can diagnose both at the same time (In this case, we are talking about a comorbidity between ADD and DI). In other words, it is very common for people with ASD to also have certain manifestations of intellectual disability, and vice versa.
However, time and again these are different experiences on certain issues, which you need to know in order to access early intervention.
1. Intellectual skills vs social communication
Intellectual disability manifests itself by tasks such as reasoning, problem solving, planning, abstract thinking, Decision making, academic learning or learning from own experience. All of this is observed on a day-to-day basis, but can also be assessed using standardized scales.
In the case of autism spectrum disorder, the main diagnostic criterion this is not the intellectual realm, but the realm of social communication and interaction; which manifests itself as follows: little socio-emotional reciprocity; little willingness to share interests, emotions or affections; the presence of a qualitative impairment in communication (for example, lack of verbal or non-verbal communication, or stereotypes in the language); and a difficulty in adapting behavior to the norms of different contexts.
2. Adaptive behavior
In the case of intellectual disability, the difficulty of achieving the level of personal independence expected according to chronological age is notorious. In other words, without the necessary supports, the person has difficulty participating in the tasks of daily life, for example at school, at work and in the community.
It is not for lack of interest, but because the person with an ID may need the constant repetition of codes and social norms to be able to acquire them and act accordingly.
For its part, the adaptive behavior of the AME manifests itself through the little interest in sharing imaginative play or a little disposition towards imitative play. This is also reflected in the lack of interest in making friends (due to the lack of intention to relate to their peers).
This little interest stems from many things that are in your immediate surroundings they can be caused by high levels of stress and anxiety, That they mitigate by patterns or interests and restrictive, repetitive or stereotypical activities.
3. Supervisory rules
In relation to the above, the monitoring of social norms in the case of TEA may be hampered by the presence of restricted interests, Which can range from simple motor stereotypes, to the insistence on keeping things in a way that does not vary, that is to say an inflexibility to change the routine. Children with ASD often feel conflicted when their habits change.
On the other hand, in the case of intellectual disability, following instructions or rules may be difficult due to the functioning of logical processing, planning or self-learning (for example, there may be a significant difficulty in recognizing risky behaviors or situations without the necessary supports.).
4. The sensory experience
Something that is also important in diagnosing ASD is the presence of hyporeactivity or sensory hyperresponsiveness. For example, there may be negative responses to certain sounds or textures, or behaviors of undue fascination with feeling or touching objects, or with observing objects with great attention and fixation with lights or repetitive movements.
In the case of intellectual disability, the sensory experience does not necessarily present itself in an exacerbated way, because it is the intellectual experience that manifests itself most strongly.
To diagnose intellectual disability, previously, quantitative scales were used to measure IQ. However, the application of these tests as a diagnostic criterion is excluded by the DSM itself.
It is currently recommended to assess intellectual abilities by means of tests which can provide an overview of their functioning, for example, memory and attention, visuospatial perception or logical reasoning; all in relation to adaptive functioning, so the ultimate goal of the assessment is to determine the need for supports (which the DSM says may be mild, moderate, severe, or profound).
When the child is too small to be evaluated on standardized scales, but their functioning is noticeably different from that expected for their age, clinical evaluations are carried out and can determine a diagnosis of global developmental delay (If it is before 5 years).
In the case of AME, the diagnosis mainly involves observation and the clinical criteria of the professional. To standardize this, several diagnostic tests have been developed which require specific professional training and can begin to be applied from the age of 2 years.
They are currently very popular, for example, the interview for a revised autism diagnosis (ADI-R, for its acronym in English) or the observation scale for the diagnosis of autism (TS, also for its acronym in English).
- Documentation center for studies and oppositions (2013). DSM-5: News and diagnostic criteria. Accessed May 7, 2018. Available at http://www.codajic.org/sites/www.codajic.org/files/DSM%205%20%20Novedades%20y%20Criterios%20Diagnósticos.pdf.
- Martínez, B. and Rico, D. (2014). Neurodevelopmental Disorders in DSM-5. AVAP conference. Accessed May 7, 2018.Available at http://www.avap-cv.com/images/actividades/2014_jornadas/DSM-5_Final_2.pdf.
- WPS. (2017). (TS) Calendar of observation of the diagnosis of autism. Accessed May 7, 2018.Available at https://www.wpspublish.com/store/p/2647/ados-autism-diagnostic-observation-schedule.