One of the enduring mysteries of autism is that the syndrome is just as often associated with the increased likelihood of genius as it is mental retardation. How is it possible that one disorder could take people to both extremes?
Historically, most patients with ASD were viewed as also having below-average intelligence. The limitation of past methods of IQ testing was that it was based solely on verbal communication skills. As more sophisticated tests were developed, it soon became evident that previous assumptions about intelligence and ASD were flat wrong in many cases. Still, the Center for Autism Research puts the rate of ASD patients with IQ scores below 70 at around 40 percent.
But it’s also long been known that a subset of ASD patients will show extraordinary gifts in mental acuity and computation. These autistic savants exist at the other end of the spectrum, exhibiting feats of mental intelligence that the neurotypical can only marvel at.
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Of course, the syndrome results from alterations to brain structure that still aren’t well understood. The potential for those structural changes to yield genius or below-average intelligence is also still shrouded in mystery.
Handling Extremes of Autistic Intelligence
For applied behavior analysts, this creates a challenge in adapting to enormously different types of behavior from patients at either end of the spectrum.
Although the behavioral issues of all ASD patients tend to fall into similar categories, such as communication challenges, difficulty in social interaction, and repetitive behaviors, a 2015 study suggests that the underlying issues may vary according to the intelligence of the patient.
The study found that high-IQ autism patients consistently under-performed neurotypical patients in the same IQ range on cognitive tests, while low-IQ ASD patients performed on par with their neurotypical counterparts.
The importance of that finding for ABAs is that the cognitive deficits in high-IQ ASD patients may have underlying causes that are not rooted in the syndrome itself. They may benefit more from therapies targeting cognitive skills specifically.
But the study also cautions against equating high-IQ ASD with high-functioning autism. ASD patients with any IQ can have different functional capabilities, which is part of the reason that ABAs routinely conduct individual functional behavior assessments (FBAs) of their patients, regardless of any other test the patient may have undergone in the past.
Dealing with low-IQ ASD patients creates other challenges, but challenges that the ABA toolset is well-equipped to confront. Patients of this sort may be less responsive to conditioning that requires astute perception and understanding, but many ABA therapies, such as discrete trial training, can break down the therapy into as many simple steps as are required.
At the end of the day, the ABCs of applied behavior analysis (Antecedent – Behavior – Consequence) can be applied even with profoundly low-IQ ASD patients. The ultimate improvement they’re capable of achieving may be far lower than it is for high IQ patients but the technique remains the best treatment for autism available.
Autism Extremes Result From Imbalances In Intelligence
ABA is not just used to treat ASD, however, and ABAs with non-ASD patients might have noticed something curious about some of them: even geniuses without full-blown ASD often have an unusual number of the symptoms of autism.
A 2011 study of eight child prodigies found a number of parallels between them and autistic children (three of the prodigies were, in fact, autistic themselves) including an inclination toward obsession, late development of verbal skills, and difficulties with social interaction.
Even more interesting, for a syndrome with known genetic links, half of the participants were found to have family links to ASD. In the general population, only about one percent of people have family histories of autism.
All of this suggests that perhaps the autism spectrum runs further in either direction than the current diagnostic criteria specify—or that autism itself is a condition rising largely from atypical developments in regions of the brain responsible for intelligence.
This theory was advanced in a 2016 article in Frontiers in Neuroscience Magazine, which hypothesizes that autism is the result of enhanced, but imbalanced, components of intelligence. In this view, intelligence in ASD patients is a process that has run amok… in some cases becoming unbalanced to the point of retardation, and in others tipping toward genius.
Since the study is recent there has been little exploration of the implications of this suggestion and it remains, as of mid-2017, merely a hypothesis. But ABAs working with individuals across the ASD spectrum and outside it can benefit from understanding the apparent relationship between intelligence and the behavioral symptoms they are presented with.