Showing posts with label CPA. Show all posts
Showing posts with label CPA. Show all posts

Saturday, July 02, 2011

TIME Promotes Myth That Many With Autism are Highly Intelligent


In Could Amanda Knox Have an Autism Spectrum Disorder? TIME adds its influential voice to those who propagate the  myth that "many with autism are highly intelligent".

Amanda Knox is the 23-year-old American college student who was convicted of sexually assaulting and killing her roommate, Meredith Kercher, in Italy in 2007.  The TIME article makes a plausible case for the proposition that some of the evidence used to convict Ms Knox, including a forced confession, and some seemingly callous behavior, may indicate an un-diagnosed Asperger's Disorder condition rather than evidence of guilt. That possibility has become particularly important in light of revelations that DNA trace evidence used to convict Ms Knox may, after review by independent experts, be considered unreliable.  

In elaborating on the Asperger's Disorder possibility,  and explaining some aspects of Ms Knox's behavior including the confession, the TIME article states:

"like many autistic people, Knox was highly intelligent but also extremely naïve and gullible:
"She's the smartest person you'd ever know" but "dumb as a rock" when it comes to "street sense," [her stepfather said]. In conversations with her friends and family, a portrait emerges of a person with a childlike innocence. She was, as her mother, Edda, puts it, "oblivious to the dark side of the world.""

If the above quote said like many people with Asperger's Disorder", Knox was highly intelligent it might be an accurate statement.  Under the DSM-IV an Asperger's Disorder is excluded where the person has no cognitive development issues:

"E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour (other than in social interaction), and curiosity about the environment in childhood."

The lack of clinically significant cognitive developmental delay does not necessarily mean that a person has high intelligence but it does leave that possibility open. The article provided no studies to indicate that many persons with Asperger's are highly intelligent.

Where the article is flat out wrong though is in stating that many persons with "autism" are highly intelligent.  That information is contradicted by the Canadian Psychological Association 2006 brief to a Canadian Senate Committee stated that:


Cognitive impairment is present in about 80% of persons diagnosed with Autism and general intellectual functioning is most often below average.  Persons diagnosed with Asperger’s Disorder have average to above average intellectual functioning. [underlining added]


As noted above the CPA reference to autism is a reference to the autism spectrum disorders except Asperger's.

The United States Centers for Disease Control, the CDC,  has conducted two surveys which looked at the entire spectrum of autism disorders, including those with Aspergers and found that:

"Data show a similar proportion of children with an ASD also had signs of intellectual disability than in the past, averaging 44% in 2004 and 41% in 2006."

Contrary to the view, expressed by TIME,  that many persons with autism are highly intelligent, the US National Institute of Mental Health states with respect to Autism Spectrum Disorders in the section titled Problems That May Accompany ASD:

"Mental retardation. Many children with ASD have some degree of mental impairment. When tested, some areas of ability may be normal, while others may be especially weak. For example, a child with ASD may do well on the parts of the test that measure visual skills but earn low scores on the language subtests." [underlining added]

If Amanda Knox does in fact have an Asperger's Disorder, and if the Disorder casts doubt on the confession obtained from her and provides an alternative explanation for the behavior that was used to convict her then I certainly hope the issue is fully explored.  To that end TIME's powerful voice could be of substantial value in overturning a possible wrongful conviction for murder.  That would be a great accomplishment if all those developments play out as indicated.  In reaching such a conclusion though it is unnecessary for TIME to proceed by promoting the myth that many persons with autism are highly intelligent.  This myth, while pleasant for many to embrace, in fact obscures the very serious challenges faced by the vast majority of persons with Autistic Disorder who in fact are also cognitively impaired or intellectually disabled.

TIME with its great influence should be more careful in how it portrays autism, including Autistic Disorder, and the challenges, including intellectual disabilities,  faced by persons with Autistic Disorder, to the world.

Monday, June 14, 2010

Autism's Vast Majority Was Hurt By The DSM-IV. Next Comes the DSM-5 and the New Autism Spectrum Disorder




"But the autism umbrella has since widened to include milder forms, says Dr. Marshalyn Yeargin-Allsopp, a medical epidemiologist at the CDC. For example, it now includes Asperger syndrome, where the sufferer is socially impaired, but experiences typical language development.

Another difference between past and present autism diagnosis involves the presence of intellectual disabilities,
adds Yeargin-Allsopp. During the 1960s and 1970s, the vast majority of those diagnosed with autism had an intellectual disability but today, only about 40% have one."

CDC Autism Expert Dr. Marshalyn Yeargin-Allsopp

In the above noted quote the CDC's autism expert Dr. Yeargin-Allsopp did not try to get too precise with the numbers of persons on the "autism spectrum of disorders" who also have an intellectual disability. Two recent CDC surveys estimated that 44% and 41% of persons with ASD have an intellectual disability not 40% but it is difficult to be precise, even for the CDC autism expert,  with large survey figures.  The results of such surveys are expressed with terms like "about" or "approximately" so there is nothing added to our understanding of autism by KWibbling over whether the correct figure is 41% of 44%.  Nor is there any reason based on the CDC approximate figures to KWibble over the Canadian Psychological Association's 2006 estimate that 80% of those with autism, distinguished from Aspergers, also have an intellectual disability. The CPA figure is accepted as consistent, by this humble Dad, until the CPA, or an equally credible, authoritative source says otherwise. 

What we need to do is understand,  as revealed in the quote above from Dr. Yeargin-Allsopp,  that the clear association between autism and intellectual disability was downplayed by the American Psychiatric Association in the DSM-IV revisions.  We should understand the harm these revisions have caused to public understanding of the realities of autism disorders and the further harm that will be done when the "autism spectrum" is again expanded and watered down.  We should understand now and begin to explore the connections between  Intellectual Disability and "classic" autism,  currently called Autistic Disorder,  before the APA plunges ahead with its New Autism Spectrum Disorder in the DSM-V,  which it will do notwithstanding any public commentary or criticism.

This humble father of a 14 year old son with Autistic Disorder and Intellectual Disability is not going to KWibble over the CPA's math unless a credible authoritative source takes issue with the CPA figures and demonstrates that they are wrong.  I am not ashamed of my son's Intellectual Disability and I do not subscribe to the romanticization of  autism and other serious neurological disorders  under the offensive Neurodiversity ideology which describes these disorders variously as cultures,  natural differences or preferences. Nor am I a  "professor of psychology" at a community college or university with the qualifications to take issue with a national professional governing body like the Canadian Psychological Association.

Dr. Yeargin-Allsopp's comments are those of a CDC autism expert telling us in plain language that prior to the DSM-IV revisions which grouped autistic disorder with Aspergers and PDD-NOS the Vast Majority,  not a 50% plus 1 majority, but the Vast Majority of those with autism also had an intellectual disability. That strong and compelling piece of information about the reality of autism as a neurological disorder was obscured by simple definition changes  in the DSM-IV. 

There are some "autism experts" who publish several articles a year, and conduct studies of "autism" involving only high functioning autistic subjects and persons with Aspergers.  They do not make the effort to study the most seriously disabled of all persons with "autism spectrum" disorders ... Autistic Disorder's Vast Majority... those with Intellectual Disabilities.  They routinely publish studies involving HFA and Aspergers studies which invariably get reported in the mainstream media as demonstrating that persons with  autism have hidden, perhaps even superior, intelligence.  That type of feel good reporting obscures our understanding of the realities faced by those who are members of Autistic Disorder's Vast Majority ... those  with an Intellectual Disability,  With the further merger of the PDD's into one New Autisim Spectrum Disorder in the DSM-5, and the further watering down of what constitutes autism, the figure of 40% cited by the CDC's autism expert will, once again, be magically reduced and obscured ... hidden from public consciousness.

Does everyone really think it is just a coincidence that 80% of those with Autistic Disorder, or not to KWibble ....  the Vast Majority, are intellectually disabled?  Unfortunately the American Psychiatric Association is about to  get the DSM-V, and the New Autism Spectrum Disorder, in place to further obscure  and further reduce the impetus to research, explore and understand autism as an intellectual disability.   The vast majority of those with classic autism who are intellectually disabled will not be helped by the DSM-V changes. Their reality will be further obscured and hidden behind an increasingly glossy portrayal of autism in our public discussions.  

Time to order a new set, a DSM-5 version,  of rose colored glasses  with which to look at the New Autism Spectrum Disorder.

Monday, May 03, 2010

Autism Disorders and Intellectual Disability: Claim that 75-80% of Persons with Autistic Disorder are Intellectually Disabled is Based on Credible Authorities

UPDATE: Alan Griswold is in very deep denial. I have now provided 3 credible sources to support the 75-80% range of persons with Autistic Disorder as also being Intellectually disabled - the ICD, the CPA and the CDC and Mr. Griswold can only repeat  his opposition to an association between Autistic Disorder and Intellectual Disability.  Of course accepting this information would require Mr. Griswold to reject his contribution to the world's discussion of autism disorders, his book Autistic Symphony which rejects autism as a medical disorder:  


"Autistic Symphony offers a unique look at the fascinating subject of autism. Challenging the psychiatric and scientific perspectives that focus exclusively on disabilities and impairments, Autistic Symphony celebrates the challenges and rewards experienced by every autistic individual, and argues that far from being a medical monster, autism is one of our culture's greatest strengths."
 
As I mentioned in my previous post Alan Griswold of Autistic Aphorisms is one of those comfortable with speculation that Jesus Christ may have been autistic but is not comfortable with the fact that many persons with Autistic Disorder are Intellectually Disabled.  Mr. Griswold and Astrid at at  Astrid's Journal disagree with my numerical references and wrongly describe them as self constructed.

My claim is not that 75-80% of all persons with an Autism Spectrum Disorder are also Intellectually Disabled as Astrid in particular seems to think. My assertion is that credible authorities have stated that 75-80% of persons with Autistic Disorder are intellectually disabled.  I stand by that assertion and, once again, for those who actually read before reacting, offer the sources:

1. Canadian Psychological Association    Autism Brief to the Standing Senate Committee on Social Affairs, Science and Technology November 9, 2006.

In that brief the CPA refers to 2 separate categories "Autism" and Asperger's":

"Cognitive impairment is present in about 80% of persons diagnosed with Autism and
general intellectual functioning is most often below average
. Persons diagnosed with
Asperger’s Disorder have average to above average intellectual functioning.



...

In sum, persons with ASD present with a wide range of impairments in cognition, language and
behaviour which present in some common but reliably distinct ways between Autism and
Asperger’s disorders
."

2. Center for Disease Control Counting Autism 

CDC’s most recent data show that between one in 80 and one in 240 children with an average of one in 110 have an ASD. This is a prevalence of about one percent of children. These results reflect data collected by CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network in multiple communities throughout the U.S. in 2006.

Estimates are based on health and education records from participating communities, which includes eight percent of the U.S. population of eight year olds. All children in the studies were eight years old because previous research has shown that most children with an ASD have been identified by this age for services.



...


Cognitive Functioning (from the pdf version)

2004
 

From 37.9% (Arizona) to 63% (Alabama) (overall average: 43.8 %) of the children identified with an ASD also had an intellectual disability (an IQ ≤70, at the sites that had test results on intellectual ability for at least 75% of the children identified).

2006
 

From 29.3% (Colorado) to 51.2% (South Carolina) (overall average: 41.0 %) of the children identified with an ASD also had an intellectual disability (an IQ ≤70, at the sites that had test reults on intellectual ability for at least 75% of the children identified)

The CDC figures of 41-44% for all persons on the Autism Spectrum having an intellectual disability are consistent with the 80% figure for those with Autism EXCLUDING Aspergers cited by the CPA. These figures and sources are my authorities for the upper end of the 75-80% range of persons with Autistic Disorder having an Intellectual Disability.  That is not a self constructed figure.
The lower end of the range I cite is the figure based on older sources like the 1992 ICD diagnostic criteria for Autism:
3.The ICD-10 Classification of Mental and Behavioural DisordersWorld Health Organization, Geneva, 1992


F84.0 Childhood Autism


A pervasive developmental disorder defined by the presence of abnormal and/or impaired development that is manifest before the age of 3 years, and by the characteristic type of abnormal functioning in all three areas of social interaction, communication, and restricted, repetitive behaviour. The disorder occurs in boys three to four times more often than in girls.


...


All levels of IQ can occur in association with autism, but there is significant mental retardation in some three-quarters of cases.


F84.1 Atypical Autism


A pervasive developmental disorder that differs from autism in terms either of age of onset or of failure to fulfil all three sets of diagnostic criteria. Thus, abnormal and/or impaired development becomes manifest for the first time only after age 3 years; and/or there are insufficient demonstrable abnormalities in one or two of the three areas of psychopathology required for the diagnosis of autism (namely, reciprocal social interactions, communication, and restrictive, stereotyped, repetitive behaviour) in spite of characteristic abnormalities in the other area(s). Atypical autism arises most often in profoundly retarded individuals whose very low level of functioning provides little scope for exhibition of the specific deviant behaviours required for the diagnosis of autism; it also occurs in individuals with a severe specific developmental disorder of receptive language. Atypical autism thus constitutes a meaningfully separate condition from autism.


Includes:
* atypical childhood psychosis
* mental retardation with autistic features
These three authorities are the primary sources for my assertion that 75% (3/4 in the ICD) to 80% (CPA, CDC) of persons with Autistic Disorder also have intellectual disability.  Those are not self constructed figures as claimed by Alan and Astrid.  They are figures provided by credible authorities.