Thursday, June 18, 2009

Is intelligence an indicator of prognosis in high functioning autism?

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.


Marius Filip said...

Level of intelligence is not a very good indicator of success in life for neurotypicals, either.

I've read somewhere that most people labeled as "most successful" by the society at large (in terms of money, relationships, influence, fame, recognition and personal satisfaction) have an IQ between 125 and 135 - if my memory serves me well.

People falling in the range of gifted and genius ranges (over 135 and over 150 respectively) actually have more problems than benefits - and only a fraction of them find fulfillment in niche careers (scientists, for instance).

Regarding people who are at the real top (IQ greater than 175), who are just about two dozens in the whole world, they are nothing near the level of achievement that their IQ level might suggest.

Bottom line is this: the IQ level reflects only a potentiality. It represents very high proficiency in a few skills that have been determined by psychologists as essential for the cognitive processes that humans have.

A high IQ is no guarantee for anything (starting from making a living and ending to experiencing personal happiness) except for ... having a high IQ.

Stephanie Lynn Keil said...

I say it's because I question the validity of many of these "autistic" people. For example, I really don't believe Katie Miller has Asperger's and I don't think any respectable doctor would diagnose her with AS.

I question where these autistic people get their diagnoses. If from a private psychologist than I definitely understand: I can get diagnosed with anything I want from a doctor I call up from the yellow pages.

I have my diagnosis from a medical university and a team of experts, not just one person. And my current psychiatrist is a very well respected doctor with an MD and PhD from the same medical university where I got my diagnosis.

What you see with us are real high-functioning people with ASDs. Autism severely impairs social ability, communication and causes restrictive and repetitive behaviors. Most people I see with AS, especially those in the ND movement, appear to be pretty socially competent, which goes against everything that autism is.

And I also agree about IQ. I test very high on nonverbal tests (in the genius/near-genius range) but on the Weschler/Standford-Binet I am much more average. So yes, I can say that my intelligence is underestimated by these tests, but I was ALREADY high-functioning to begin with. A higher non-verbal IQ is to be expected in people with HFA; Jessy Park has a higher nonverbal IQ than verbal IQ as well; I believe her nonverbal IQ is also in the "genius" range. But her IQ is average otherwise.

Roger Kulp said...

As I have said before,most recently on Ms.Dawson's blog,I do not think that developmental delay,and regression is taken as seriously as it should be in the diagnosis,or evaluation of disability.

Parents and those autistics who old enough to be aware of it,know that intelligence,and levels of autistic functioning can vary greatly, depending on the severity of coexisting medical problems.It can be obvious stuff like bowel disease,heart problems or seizures, but not always.I have always had issues with being cold all my life. There is a discussion going on currently in one of my mitochondrial groups about how in those with mitochondrial disease, feeling overly hot or cold when you shouldn't,makes autism symptoms worse.This is just one little example.

Not only do the researchers largely exclude those with comorbid disease,but the ND types have carried this to the extreme,saying that everything that isn't Aspergers related,intellectual disability,self mutilation,you name it,is comorbid.

You've read it yourself Conor Doherty isn't autistic,he's retarded.Hannah Poling isn't autistic,she has mitochondrial disease,with "features of autism".

(Dr.Marvin Natowicz,of The Cleveland Clinic certainly wouldn't agree with that.)

No,only someone who is as verbal, and has social skills as advanced as Ari Ne'eman or Michelle Dawson can be autistic.

Not only have I been diagnosed with dyscalculia,and other NVLDs I didn't know I had,I have also been tested as having a verbal IQ much lower than my nonverbal IQ.I suspect this is more common than a lot of researchers would want to admit.You will notice that most of these studies do not differentiate between the two.I should think this would be a very important factor in deciding intelligence.You have to ask if this is because they want to have a study that presents autism as ND wants you to see it.

Jake Crosby said...

My overall view: autism, being the communicative-related disorder that it is, prevents us from utilizing our full potential of intelligence, whatever that may be, including our performance on standardized tests. In this respect, I don't even think these tests, however well we do on them, and however more our potential is reflected in them from the real word, still are not reflective of our actual performance.

Nevertheless, a better way for Mottron et al. to interpret these tests would be to compare how we are doing in real-life to how we did on these tests to access how much our autism is holding us back, rather than saying our prognosis must be good because we scored high on one or more of them.

Ender said...

Ummm real quick, I am a highly intelligent aspie (not trying to be rude, just saying, probably an IQ slightly over 135, very good logic skills, slighly less good with other stuff), a regular poster here, and don't want a cure. Why not mention me at all?

jonathan said...

Ender: The point of the post was to show that in spite of the fact that some persons have apparently tried to correlate intelligence in autistics with a favorable prognosis there are some highly intelligence autistics that post on here but do feel that their autism is not a gift and has impaired their lives.

As you say, you are a regular poster, here, but there seems to be an underlying message in essentially 100% of your posts that everything is hunky dory with autism and asperger's and autism are great gifts and a blessing to humanity so there is really no point in mentioning you, since you feel you are just fine with your AS.

Ender said...

You made it sound like everyone here with above average intelligence and autism hates it, always helps to add a contridicting viewpoint.

jonathan said...

Not at all, Ender, I was just giving some examples of people of high intelligence who are impaired with their autism, not to say that everyone feels that way. Considering that the internet is innundated with a sea of neurodiversity websites with persons such as yourself proclaiming that most autistics don't want to be cured, the least I can do is point some attention to the fact that there are in fact some pro-cure autistics who are also denizens of the internet and their numbers continue to grow.

One suggestion, I have for you is that maybe you could either post something on the hating autism blog or email John Best asking him to write something about you, so you can get the plug you obviously covet so much. Perhaps you will have better luck there than you have had here.

Foresam said...

All people who have been recognized as having any mental impairment deserve to be helped by those of us who do not have any mental impairment.

The fact that people like Ender do not have the mental capacity to understand the problem does not mean we should not help them. Because they have been perverted by Neuroinsanity to rant against sanity, our duty to humanity has been made more difficult.

Ender said...

John Best would never let me post there and he knows absolutely nothing about me other then the fake name I gave him years ago. Beyond that at least quote my stance right, I believe that most high functioning autistics don't want a cure, and I have more then 3 examples to support my side. I see nothing wrong with one "curing" themselves, just having that cure forced on them is wrong (and John illistrates that position quite nicely). Self-determination is such a ***** isn't it Johnyboy?

jonathan said...

I am not proposing to force a cure on any consenting adult. If you don't want a cure that is fine. The problem is I don't believe it is possible for you to be cured of an autism spectrum disorder because from what you have said on wrong planet a few years ago, it would appear you have a traumatic brain injury disorder and not asperger's:

And I think I am aspie but I dont know if I could ever get dxed with it because I wasnt this way from birth. See I had a car accident when I was 7 (well 6 and 363 days) and ever since then I have been like this. It sorta seems like "a rose by any other name" to me but Im not the one who makes the DSM IV stuff so they will probably just call me tramically head injuried

I suggest you explain all this in light of this post you made on wrong planet a few years ago what would qualify you to talk about an ASD from personal experience. autism happens when someone is before the age of 3. Asperger's certainly does not come from head trauma due to a car accident. Unless you can explain this, Ender, I don't think you should be including yourself as an "aspie who does not want a cure" because you are not one or so it would seem from your post.

Ender said...

Explain it something that happened when I was 7? Okay fine, by that time I had already been diagnosed with three disorders comorbid with asperger's (hyperlexia, ODD, and ADHD). It was 1993 before Asperger's was even on DSM-IV. I was showing signs of obsessions, especcially with math and sports (already new multiplication for examples, the only one in first or second grade at my school who can say that. Etc. Obviously I don't remember much from my first grade year but I was certainly showing signs of Asperger's. Beyond all that they don't say its impossible that I never had asperger's, just its hard to determine 12 years after the fact without knowing me then.

jonathan said...

According to your post you were 19 years old in late 2005. This means you were born in 1986. So, you were 7 in 1993. Asperger's therefore was in the DSM when you were 7. How could hyperlexia result from a head injury from an automobile accident? That sounds far fetched to me. Perhaps you could show me any evidence in the medical literature or anywhere else that asperger's can be caused by head trauma.

There is little doubt that you don't have any sort of ASD and you never did. You are just an "aspie wannabe" who came up with their own self-diagnosis because it is more chic and interesting than just a dull old traumatic brain injury. So, uh, no, you have no credibility at all with me in claiming that you are qualified to state that because you have an ASD that person's with autism should not be cured.

I don't buy the "rose by any other name" alibi whatsoever. It is totally inconsistent with anything you have said in these posts.

You are welcome to comment here and try to claim some affinity with persons with autism but whenever you do i am going to bring up this tacit admission you made that you don't have any type of autism spectrum disorder whatsoever. You certainly were never diagnosed by any clinician, you just came up the the diagnosis yourself. Nice try, Ender.

Ender said...

LOL like I was saying I was diagnosed with all of those things before the accident, not afterwards. And asperger's generally can't be caused by head trauma just made a bit more extreme by it (there is some literature out there somewhere about that). I am contending that I was asperger's before the accident, hence why I showed it so well afterwards. I am not sure when it was exactly added, but I it was still lesser known in 1993.

And what do I care about my credability with you, you can't even read otherwise you wouldn't have quoted me so out of context. And I say I have always had this diagnosis just not been diagnosed yet. How many times have you seen people who ended up being diagnosed with asperger's who started out by being diagnosed with disorders like ADHD and ODD and who were hyperlexic. Seems like its probably pretty common to me. So relax about things you can't know anything about.

Ender said...

P.S. I have been diagnosed with Nonverbal Learning Disorder by a licensed doctor at one of the best hospitals in the country. She just couldn't give me the Asperger's diagnoises because of my accident. Being more then a decade after that makes it sortof hard to determine if I had it before then. But seeing as how I showed so many signs before then, I think it is quite likely. As you said, asperger's can't be caused by a car accident, so I would have had it before then right?

P.S.S. I can get you that paper if you desire, I am pretty sure its around here somewhere.

jonathan said...

Ender, I provided a link to not only the whole post on wrongplanet that you made a few years ago, but the entire thread as well. Anyone who wishes can read this and decide for themselves. It is apparent to me you are admitting you don't have asperger's at all or anything like it, but I guess anyone else who reads this can make up their own mind but I am not going to argue with you endlessly

Ender said...

The entire thread was 4 posts long, how about you provide a link to every one of my posts. Including those where I mention the comorbid disorders. 3 comorbid disorders and its impossible that I could have had
asperger's before then. Nice one.

Next you are going to tell me I never had anything. Its just a coincidence I was reading by the age of 3 (something quite common amoung aspies). Its just a coincidence that I was doing high school math in 4th grade, something also quite common amoung aspies. Yep, I guess it must be. I have worked with many who think I am an aspie, including some I can invite here. But you must be right based on one post 4 years ago. Listen, stop being so obsessed about me and looking through 2000 posts of mine to find one. It really makes you look pathetic.

Just That Girl said...

Wow, you ppl are really hell bent on dispelling conditions you clearly know nothing about. Here's a thought: If you don't know what you're talking about, have a nice hot cup of STFU.

Marius Filip said...

Reading before age 3 and high-school math in IVth grade quite common in Aspies. That's a good one!

No wonder there are so many self-diagnosed Aspies out there.

And Einstein was an Aspie, toooooo ...

Ender said...

Wait, now your going to censor me everytime someone calls me a liar? How sweet of you

jonathan said...

Ender, I did not publish your last two posts because you were only repeating information that you have said multiple times in this thread only. Like someone with Asperger's, you tend to be very perseverate and argue nonstop and the argument has to end sometime. Before I found out about your revelation on wrong planet a few years back, I really thought you did have AS because of this behavior. Now it does seem unlikely you have AS in terms of this revelation. If you are referring to Marius' last post, he certainly did not call you a liar, he just meant that being gifted at academics at a young age does not equate with asperger's. He also talked about self-diagnosed aspies which you unquestionably are.

This is not censoring you. The argument has to stop at some point and i am not going to have a longwinded nonstop argument on this blog.