Autism Spectrum Disorder and Intellectual Disability: A Necessary Divorce!

There is a reality for children with Autism Spectrum Disorder (ASD), which is that approximately 35 out of every 100 of them have comorbidity with Intellectual Disability, and 25 out of every 100 have an IQ between 71 and 85 (borderline), according to prevalence studies. However, it is essential to emphasize the word COMORBIDITY because, although the DSM-5-TR (2023) has improved its description of ASD and now the levels are linked to the need for support, it does not emphasize that ASD is not the same as Intellectual Disability.

What establishes a diagnosis of ASD has nothing to do with intellectual capacity. As indicated in the DSM-5-TR (2023), the criteria for diagnosis are: impairments in Communication and Social Interaction, Repetitive and Restrictive Patterns (behaviors, interests, and/or activities), the presence of these impairments in the Early Stages of Neurodevelopment which might not have been noticeable until social demand appeared, or were masked by the person's compensatory strategies, and all of the mentioned cause an Impact on Social, Occupational, or other areas of life. As you can see, none of the criteria are related to having a specific level of intellectual capacity.

This is important because I frequently hear children, adolescents, and adults express concern that having an ASD diagnosis will make others assume they have difficulties in their intellectual capacities, even though a percentage of them do not.

ASD is a disorder where what is impacted is SOCIAL functioning and development, COMMUNICATION, sometimes exclusively pragmatic language, which is precisely the use of language in social contexts, and those REPETITIVE PATTERNS which are often interests or activities and not necessarily behaviors like SELF-STIMULATION or movements of the hands, fingers, spinning, etc., as is commonly thought.

Not less crucial is that, in some cases, the diagnosis is MASKED for many years until SOCIAL DEMAND arrives or the person's ABILITIES to adapt are SURPASSED.

The latter is essential to convey because many people do not understand, cannot explain, or do not believe that the person has ASD because they "don't see it." But BEWARE, because even if they don't "see it," it can exist, be there, be MASKED, and cause suffering and difficulties, preventing that person from making that internal CLICK that tells them what is happening with them and allowing them to UNDERSTAND and ADVANCE!

Written by:

Dr. Sigem Sabagh S.

Ph.D. in Applied Cognitive Neuroscience.

Master in Neuropsychology.

@neurosabagh