Is intelligence an indicator of prognosis in high functioning autism?
Posted Jun 18 2009 11:19pm
Yet, still on the same subject that was started by the recently published study of Isabel Souleries, I have yet some new thoughts that have been on my mind. When I questioned the statement of Michelle Dawson that she hoped that the effect of her 2007 paper on Raven's vs. Wechsler would have the practical effect of autistic persons not being written off I was challenged by one of the most prolific commenters on this blog, Lorene Amet (AKA SM69). She asked me how I could say that since if the intelligence and capabilities of persons with autism were questioned this would influence the prognosis and the likelihood of success. This is sort of similar to the thesis of the Mottron group which states that their research will help prove how capable many autistics are by showing where their abilities lie. Lorene also questioned my statement that an autistic brain is diseased and/or defective. She seemed to think that nothing was wrong with the brains of persons with autism but only some peripheral physiology that affected their brains. I responded to her comment, but in retrospect I feel I could have given her a better response and my response was far from complete, so I would like to write about this now.
The issues involved in Souleries, Dawson's, Boelte's etc. studies are whether or not intelligence in autistics has been underestimated. This might be due to the fact that the Wechsler is not a valid IQ test for testing autistics due to their unique way of being. The Raven's or some other instrument might be more valid. If so, then we can do a better job of teaching autistics and their overall prognosis might not be as poor.
Part of the problem with the Souleries study was that the autistic participants, as measured by the Wechsler are reasonably intelligent on average to begin with.
The average full scale IQ was 100.87 with a range of 85-121. The average verbal IQ was 99.20 with a range of 81-121 the average performance IQ was 102.8 with a range of 95-120. Therefore the majority of these subjects were likely of average or better intelligence to begin with.
But let's dispense with all of this and get to the real nitty gritty. What if the Mottron group is correct in their assertions that intelligence in autistics has been underestimated. What if many if not most autistic people are truly intelligent? Aside from the obvious fact that it is quite possible the autistic with an IQ of greater than 100 will have a more favorable prognosis than one with an IQ of less than 70, lets just confine the question to higher functioning autistics, lets say those with a verbal IQ of 100 or higher. Or even some persons with autism who seem very intelligent to me based on my subjective perception of interacting with them on the internet without knowing how well they might do on a standardized test.
At the risk of immodesty, I count myself in this category. I believe that I am an intelligent person. I am able to express my thoughts well and write a reasonably good blog post. At the age of 11 my reading ability was tested at a tenth grade level. This is in spite the of the fact that at this time I had never received a mainstream education of any kind. I also managed to graduate from college, something some neurotypicals have not been able to do. Yet, I had to give up working, I have had problems with funny movements, motor impairments, inability to completely care for myself and immense problems with social relationships and phobias. My voice is uncontrollably loud. Autism has made my life hard and has incapacitated me, except for being able to write some of these blog posts. This blog has actually given my mundane life some meaning.
Moving onto other people, I see glimmers of intelligence of a number of my blog readers with autism. First there is Jake Crosby who spent a fair amount of time in self-contained special education classes. He probably was not able to receive the same educational opportunities as some other children who were not on the autism spectrum. At age 20 he currently attends Brandeis, a major university. He writes very articulate and thoughtful posts on the Age of Autism blog. This is to the chagrin of neurodiversity proponents who complain about autism speaks and other organizations they don't like not putting autistics in positions of power or allowing their voices to be heard. Yet when age of autism put this autistic individual on their editorial board at an extremely young age, they immediately cried "token autistic". Also condescending statements and attitudes towards Jake due to his age were at times expressed. Jake seems well read to me on a variety of autism issues and has shown intelligence to me. Roger Kulp, another one of my readers with autism, also seems to show a high level of intelligence based on some of the comments he has written on my blog and others. There is no question that this individual's intelligence is more than intact. Stephanie Lynn Keil is yet another example of this. In addition to this 21-year-old young woman being an extremely talented artist, she also has an IQ which may be in the genius or near genius level. In spite of spending much time in institutions during her childhood, she has managed to become educated enough to read psychiatric textbooks and understand them with great precision.
I offer apologies in advance to any of the above-mentioned individuals if I made any factual errors about them or they were not happy about me mentioning them in a blog post.
What do these three (four including me) intelligent individuals with autism have in common. We all hate our autism. We don't subscribe to the neurodiversity philosophy and wish we could be cured. Why must that be if we are so intelligent?
In Jake's case, he got a poor grade on one of his history papers because he was too disorganized and lacked the executive function to cite references properly. His autism has made it difficult for him to plan and do things that he wants.
Roger Kulp's behavior has regressed at various times in his life. He has not worked and has had to be on SSI. He has had problems with elopement and other problems with autism that have made his life difficult in spite of having an intact intelligence.
Stephanie is also on SSI and has had problems with self-injury and other issues. She lived in institutions for a number of years but fortunately was able to live with her father at his house where I think she still lives.
How can these persons have all these problems when they are intelligent, yet, according to Mottron and to others intelligence in autistics means a good prognosis and means we should not regard them as write-offs? Perhaps the answer is that intelligence does not necessarily mitigate the problems of autism in most persons with this affliction. A score on the Wechsler, the Ravens or any other standardized test, the ability to solve problems rapidly in an fMRI scanner probably does not correlate with the ability to pay the rent, have social relationships or control difficult behavior.
Perhaps it is time to rethink our view of recognition of intelligence being a salvation for those on the spectrum who are high functioning (at least intelligence-wise).
I hope none of the above individuals takes offense at my writing about them.