Within the category of Neurodevelopmental Disorders suggested by the DSM-V (Diagnostic and Statistical Manual of Mental Disorders-Fifth Version), we find two subcategories that are especially popular and sometimes confusing: Intellectual Disability (ID) and Autism Spectrum Disorder (ASD)
While they belong to the same category, ADD and ID share some characteristics. For example, their origin is early childhood and they present limitations in specific or global areas of adaptive behavior. That is, in both cases the person who has the diagnosis has difficulties developing in the personal, social, academic and occupational spheres in the way that is expected for their chronological age. However, both its diagnosis and its intervention have some important differences.
In this article we will review the differences between Intellectual Disability and autism (or, rather, the construct of Autism Spectrum Disorders).
5 differences between ADD and Intellectual Disability
Intellectual Disability and ASD frequently coexist, that is, after making the corresponding evaluations Both things can be diagnosed at the same time (in this case we speak of a comorbidity between ADD and ID). In other words, it is very common for people with ASD to also present some manifestations of Intellectual Disability, and vice versa.
However, both are experiences that differ in some issues, which is necessary to know to access timely intervention.
1. Intellectual skills vs Social communication
Intellectual Disability manifests itself in tasks such as reasoning, problem solving, planning, abstract thinking , decision making, academic learning or learning from one’s own experience. All of this is observed on a day-to-day basis, but it can also be evaluated using standardized scales.
In the case of Autism Spectrum Disorder, the main diagnostic criterion It is not the intellectual area, but the area of ​​social communication and interaction ; which manifests itself in the following way: little socio-emotional reciprocity; little willingness to share interests, emotions or affections; the presence of a qualitative alteration in communication (for example, lack of verbal or non-verbal communication, or stereotypies in language); and a difficulty in adapting behavior to the norms of different contexts.
2. Adaptive behavior
In the case of Intellectual Disability, the difficulty in achieving the level of personal independence expected according to chronological age is notorious. That is, without the necessary supports, the person has some difficulties participating in daily life tasks, for example at school, work, and the community.
This is not due to a lack of interest, but because the person with ID may need constant repetition of social codes and norms to be able to acquire them and act in accordance with them.
For its part, the adaptive behavior of ASD is manifested through little interest in sharing imaginative play or a lack of willingness towards imitative play It is also reflected in the little interest in making friends (due to the little intention to interact with their peers).
This little interest originates because many of the things that are in their immediate surroundings can cause high levels of stress and anxiety which they alleviate through restrictive, repetitive or stereotyped patterns or interests and activities.
3. Following standards
In relation to the above, the following of social norms in the case of ASD can be hindered by the presence of restricted interests , which can range from simple motor stereotypies to the insistence on maintaining things in a way that does not vary, that is, an inflexibility towards changing routines. Children with ASD often feel conflicted when their routines are changed.
On the other hand, in Intellectual Disability, following instructions or rules may be made difficult by the way in which logical processing, planning, or learning from one’s own experience works (for example, there may be significant difficulty in recognizing behaviors). or risk situations without the necessary support).
4. The sensory experience
Something that is also important in the diagnosis of ASD is the presence of sensory hyporeactivity or hyperreactivity For example, there may be negative responses to some sounds or textures, or behaviors of excessive fascination with smelling or touching objects, or with observing objects with lights or repetitive movements with great attention and fixation.
In the case of Intellectual Disability, the sensory experience does not necessarily present itself in an exacerbated way, since it is the intellectual experience that manifests itself most strongly.
5. The evaluation
To diagnose Intellectual Disability, Previously, quantitative scales were used to measure IQ However, the application of these tests as diagnostic criteria is ruled out by the DSM itself.
Currently, it is recommended to evaluate intellectual abilities through tests that can offer a broad vision of how, for example, memory and attention, visuospatial perception or logical reasoning work; all of this in relation to adaptive functioning, so the ultimate goal of the evaluation is to determine the need for supports (which according to the DSM, can be a mild, moderate, severe or profound need).
When the boy or girl is too young to be evaluated using standardized scales, but his or her functioning is noticeably different from what is expected for his or her age, clinical evaluations and a diagnosis of Global Developmental Delay can be determined (if it is before 5 years old).
In the case of ASD, the diagnosis occurs mainly through observation and clinical judgment of the professional. To standardize this, several diagnostic tests have been developed that require specific professional training and that can begin to be applied when the child is 2 years old.
They are currently very popular, for example, the Autism Diagnostic Interview-Revised (ADI-R) or the Autism Diagnostic Observation Scale (ADOS).