Invisible Autistics: Intellectual Disability and the CDC's New Autism Figures

co·mor·bid·i·ty (kmôr-bd-t) 

n.

A concomitant but unrelated pathological or disease process.

medical-dictionary.thefreedictionary.com

Intellectual Disability is rarely mentioned in public discussions of autism spectrum disorders.   It is sometimes mentioned dismissively as a co-morbid condition, an unrelated condition which coincidentally occurs in some cases of autism. In fact Autistic Disorder and Intellectual Disability also known as Mental Retardation and Cognitive Impairment, are just different aspects of the- same disorder.

Intellectual Disability is also hidden from public view by a mainstream media (CBC, CNN, the New Yorker, Time, Newsweek etc) that like to focus on the feel good stories with features about persons with Aspergers and High Functioning Autism,  all very intelligent people who communicate very well.  What the "feel good about autism" mainstream media don't like to do is actually visit institutions where some severely autistic persons live out their lives.  What the mainstream media does not like to do is present to the world the truth about the severely autistic , the Intellectually Disabled reality,  of Autistic Disorder. 

Professionals don't expressly mention Intellectual Disability as a factor in diagnosing autism disorders. High functioning autistic persons and persons with Aspergers for whom "autism" is a way of life, something to belong to, don't like to associate themselves with Intellectual Disability.  They prefer to associate autism, and thereby themselves, with Einstein, Van Gogh,  Mozart and every other historical figure of exceptional talent or ability.

All these groups scarcely mention autism and intellectual disability in the same breath and when they do they refer to autism as an occasionally coexisting but unrelated condition.  All are  hiding  the truth. All are  obliterating from public understanding of autism disorders the reality that autism, as in actual Autistic Disorder, and Intellectual Disability,  also know as mental retardation, or cognitive impairment, are in fact related aspects of Autistic Disorder.

Intellectual disability, mental retardation or cognitive impairment, are not listed as express diagnostic features in the DSM definition of autism disorders although it is mentioned by implication in the definition of Aspergers disorder.

1. no significant delay in language development
2. no significant delay in cognitive development, self-help skills or adaptive behaviors (other than social interaction)
   

The reason the DSM found it necessary to mention that there must be an  absence of any delay in cognitive development and language development before an Aspergers Disorder diagnosis can be made is that  so many persons with Autistic Disorders in fact have serious intellectual and communication  deficits. It is these factors which distinguish Aspergers from Autistic Disorder.

When an Ari Ne'eman or an Alex Plank purport to speak on behalf of autistic people and say We Don't Want to be Cured they are speaking on behalf of people who often have severe intellectual and language difficulties  that persons with Aspergers do not share.  They want to speak on behalf of these people because they identify with the word "autism" but they don't want to be associated with Intellectual Disability, Cognitive Impairment or Mental Retardation.

The number of persons with Autistic Disorder and Intellectual Disability  is extremely high.  They are far too high for the two conditions to be characterized as separate, coincidental, unrelated disorders.  This is clear from the recent CDC autism prevalence report which reported that between 29.3 to 51.2% of children with Autism Spectrum Disorders also had an Intellectual Disability:

"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 results on intellectual ability for at
least 75% of the children identified)."

 

The range of 29.3 to 51.2% refers to children with Autism Spectrum Disabilities who also had an Intellectual Disabilty defined as IQ less than 70%. The ASD includes children with Aspergers Disorder who, by definition, do not have intellectual disabilities.   If  children with Aspergers are excluded  from the calculation then it is likely that children with actual Autistic Disorder and Intellectual Disabilities will range somewhere from 60% to 100%.

As startling as that last estimate may sound it is consistent with previous estimates of the number of persons with Autistic Disorder and mental retardation, intellectual disability or cognitive impairment.  The Canadian Psychological Association in its autism brief to the Canadian Senate Committee examining autism issues, Autism Brief to the Standing Senate Committee on Social Affairs, Science and Technology November 9, 2006, stated that the number of persons with autism (Autistic Disorder) and Intellectual Disabilities (Cognitive Impairment) was 80% :

"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."

The CPA 2006 estimate that 80% of persons with Autism (Autistic Disorder) also have intellectual disabilities is consistent with the  new CDC range of estimated intellectual disabilities of persons with ASD which, once adjusted by removing Aspergers Disorder, places the CPA estimate right in the middle of the CDC range of 60-100%.

It is time to end the prejudice against autistic persons with intellectual disability. It is time to end the intellectual dishonesty of pretending that it is just a coincidence that so many persons with Autistic Disorder also have Intellectual Disabilities. It is time to stop treating persons with Autistic Disorder like invisible autistics.  Their intellectual disability is part of their autistic disorder, a very serious, disabling part which makes their lives much different than the high functioning media stars who wrongly pretend to speak on their behalf. 

It is time to stop hiding the truth about autistic disorder and intellectual disability. It is time to start including the Invisible Autistics, the intellectually disabled persons with severe Autistic Disorder, in public discussions of "autism".

autism