Differentiating Intellectual

Disability, Autism Spectrum

Disorder, and Specific Learning

Disability

Michael E. Gerner, Ph.D., P.C.

President, Consulting Psychologists

Flagstaff, Arizona, USA

<mgernerpsy@aol.com>

Special Thanks: Alpha to Omega Learning Centre, DSM-5 and ICD-11, and Drs.

Richard Woodcock, Dawn F. Flanagan, Kevin McGrew, Nancy Mather, and the

American Association on Intellectual & Developmental Disabilities (AAIDD)

What We Will Discuss

Learning Disability

Autism Spectrum

Disorder

Intellectual Disability

NORMALLY DEVELOPING CHILDREN:

SHOW INTEREST IN THE HUMAN

FACE

HAVE THE CAPACITY TO IMITATE

SEEK PHYSICAL COMFORT

DEVELOP IMAGINATIVE PLAY

ATTACH TO CARETAKERS

DEMONSTRATE PREFERENCE FOR

SPEECH SOUNDS

Most Fundamentally an Autism

Spectrum Disorder is:

Qualitative Impairment in

Social Interaction,

Communication, and

Restrictive/Repetitive/Stereotyp

ed Patterns of Behavior,

Interests & Activities.

People with ASD may have problems with

social, emotional, and communication skills.

They might repeat certain behaviors and

might not want change in their daily

activities. Many people with ASD also have

different ways of learning, paying attention,

or reacting to things. ASD begin during early

childhood and last throughout a person’s

lifetime.

What are some of the signs of ASD?

Not so rare. A new landmark study indicates

that Autism may be surprisingly widespread

--American Journal of Psychiatry (2011)

Discovering the true prevalence of Autism

requires a large scale study of a population – not

just who shows up at a doctor’s office or clinic.

Every child 7-12 screened in a region of South

Korea; yielded a total sample of 56,266.

Results: the rate of ASD was 2.64% or 1 in 38,

not 1 in 110, which was former U.S. estimate.

NORMALLY DEVELOPING CHILDREN:

BEGIN TO LEARN TO READ AT 4-5

ENJOY PRINTING & WRITING

DEVELOP A POSITIVE IDENTITY

AS A LEARNER

ENJOY GOING TO SCHOOL

SHOW READING/MATH SKILLS

SIMILAR TO VERBAL ABILITY

Most Fundamentally a Learning

Disability is:

Unexpected Underachievement

NOT DUE… to Lack of Instruction/Poor Teaching

A Sensory (Low Vision/Hearing) or Health Problem

Intellectual Disability (Mental Retardation)

Cultural/Linguistic, or Economic Difference Factors

Prevalence of specific learning disabilities among

primary school children in a South Indian city

Indian J Pediatr. 2012 Mar;79(3):342-7. doi: 10.1007/s12098-

011-0553-3. Epub 2011 Sep 2. Mogasale, et al.

RESULTS:

The prevalence of specific learning

disabilities was 15.17% in sampled

children, whereas 12.5%, 11.2% and 10.5%

had dysgraphia, dyslexia and dyscalculia

respectively.

WHO:

Children 8-11 from third and

fourth standard.

Ms. K.’s learning profile indicates that she is

“twice exceptional,” that is, she is an adult who

is both verbally gifted and who has a reading

disability.

1st Exceptionality: Verbal intelligence in the

Upper Extreme or Gifted/Talented range and

that surpasses 98% of adults nationally.

2nd Exceptionality: Her Dyslexia is manifested

by slower reading speed that exceeds only 9%

of a national sample when she reads longer

passages of connected text.

ADULT SLD/2e MEDICAL SCHOOL STUDENT

•Received “As” on all “Clinicals” in Medical School.

It’s not just about test results:

Collateral evidence for students w/SLD

•Ms. K was granted time extensions on medical school tests

and she earned “A” and “B” grades (time extensions

have not been allowed on the Licensing Exam ).

•Observations in medical school of consistently quick and

insightful verbal/visual decision making.

•Reported by friends, student colleagues, and instructors to

have superior social and interpersonal skills.

•Significantly weak spelling and slow acquisition of reading

skills in elementary school.

•By high school & college reading accuracy was established,

reading speed continued to an issue.

•Parent Observation throughout childhood, adolescence, and

early adulthood.

3rd grade paper sent by Ms. K’s parents after approval for time extensions on the Medical Licensing Exam

Like These Stairs in India, Intelligence is Complex

John Horn (1985) on the concept of “g”

“…despite the prevalence of belief in

general intelligence, despite the emotional

intensity with which this belief is held, and

despite the fact that this belief is

proclaimed as true by some of the high

priests of our science, the belief should be

cast out—or at least put far away from

research and clinical practice” (p. 273).

CHC Ability

Reading Achievement

Math Achievement

Writing Achievement

Gf Inductive (I) and general sequential reasoning

(RG) abilities play a moderate role in reading

comprehension.

Inductive (I) and general sequential (RG)

reasoning abilities are consistently very

important at all ages.

Inductive (I) and general sequential reasoning

abilities is related to basic writing skills primarily

during the elementary school years (e.g., 6 to 13)

and consistently related to written expression at all

ages.

Gc Language development (LD), lexical knowledge

(VL), and listening ability (LS) are important

at all ages. These abilities become increasingly

more important with age.

Language development (LD), lexical knowledge

(VL), and listening abilities (LS) are important

at all ages. These abilities become increasingly

more important with age.

Language development (LD), lexical knowledge

(VL), and general information (K0) are

important primarily after age 7. These abilities

become increasingly more important with age.

Gsm Memory span (MS) is important especially when

evaluated within the context of working

memory.

Memory span (MS) is important especially when

evaluated within the context of working

memory.

Memory span (MS) is important to writing,

especially spelling skills whereas working

memory has shown relations with advanced

writing skills (e.g., written expression).

Gv Orthographic Processing May be important primarily for higher level or

advanced mathematics (e.g., geometry, calculus).

Ga Phonetic coding (PC) or “phonological

awareness/processing” is very important

during the elementary school years.

Phonetic coding (PC) or “phonological

awareness/processing” is very important

during the elementary school years for both

basic writing skills and written expression

(primarily before age 11).

Glr Naming facility (NA) or “rapid automatic

naming” is very important during the

elementary school years. Associative memory

(MA) may be somewhat important at select ages

(e.g., age 6).

Naming Facility (NA); Associative Memory (MA) Naming facility (NA) or “rapid automatic naming”

has demonstrated relations with written

expression, primarily the fluency aspect of

writing.

Gs Perceptual speed (P) abilities are important

during all school years, particularly the

elementary school years.

Perceptual speed (P) abilities are important

during all school years, particularly the

elementary school years.

Perceptual speed (P) abilities are important

during all school years for basic writing and

related to all ages for written expression.

Summary of Relations between CHC Abilities and Specific Areas of

Academic Achievement (Flanagan, Ortiz, Alfonso, & Mascolo, 2006)

See McGrew and Wendling (2010) for an extension of this work

Cognitive Abilities Most Likely to be

Suppressed with Students Who Have a

Specific Learning Disability

Cognitive

Efficiency

(CE)

Processing

Speed

(Gs)

Short-Term

Memory

(Gsm)

Cognitive Abilities

Most Likely to be

Suppressed for

Culturally/

Linguistically-

Different

Migrant

Economically

Disadvantaged

Children and

Students

Verbal/

Crystallized

(Gc)

Auditory

Processing

(Ga)

Reading and

Writing

(Grw)

Quantitative

Knowledge

(Gc)

AbilityThe power to perform some specified mental act or task

Cognitive AcademicRequires suitable,

unimpaired processing of

mental information for

successful performance

General abilities that result

more from informal, non-

school related experiences

Specialized abilities that result

more from formal, school

related experiences

Gt Gs Gsm Glr Gv Gf Ga Gc Grw Gq

Ability Continuum

Copyright 2002 Allyn & Bacon. In Flanagan et al. The Achievement Test Desk

Reference: Comprehensive Assessment and Learning Disabilities.

Responsive Accommodations

1. Oral testing in lieu of traditional paper/pencil

reading and/or writing intensive tests.

2. Supplemental oral testing for missed or unfinished

items.

3. Extended time on tests (time+one-half; double time).

4. Reduced assignments/workload, but not the range (i.e.,

every other item; selection from begin/start/end).

5. Allowing all or portion of written work done orally.

6. Books on tape to take advantage of verbal

fluency/listening comprehension as opposed to slow

reading speed and weak reading comprehension.

NORMALLY DEVELOPING CHILDREN:

COME TO SCHOOL READY TO

LEARN

SOCIALIZE WITH PEERS EASILY

MASTER PRACTICAL SKILLS

ASSUME MORE DUTIES AT

HOME

SCHOOL SKILLS = PEERS

DEVELOP GREATER INDEPENDENCE

Most Fundamentally an Intellectual

Disability (ICD-11 Intellectual

Developmental Disorders) is:

Significant Limitations in

Intellectual Functioning and

Adaptive Behavior

Defined as 2SD below the Mean taking into

account the standard error of measurement.

At least one Area/Domain of Adaptive Behavior

is approximately 2SD below the Mean.

The Definition of Intellectual Disability

Five Assumptions Regarding

the Definition

“…the kids are

tougher than ours,

they had to be

(o chavorro na

biandola

dandencar, the

saying

goes—the child is

not born with

teeth.”)

Five Assumptions Regarding

the Definition

Conceptual Framework of Human

Functioning

I. Intellectual

Abilities

II. Adaptive

Behavior

III. Health

IV. Participation

V. Context

Ethical “Musts” for the Assessment of

Intellectual Disability (Mental Retardation)

1. Always consider how poverty, socio-

economic, and/or cultural factors may suppress

cognitive ability test scores.

2. Always assess adaptive behavior. If the

child/student/adult is not low functioning in the

community, the individual does not have an

intellectual disability.

3. Never let access for educational services

(program in place) be the factor that decides if a

student has an intellectual disability.

COMMON THEMES IN SLD, ID, ASD EVALUATIONS

1-REQUIRES EXTENSIVE DATA AND THE

BEST INSTRUMENTATION WITH CLINICAL

JUDGEMENT. NOT A “CUT-POINT”

EXERCISE IN PSYCHOMETRY.

2-CULTURAL AND LINGUISTIC DIVERSITY

MUST BE RIGOROUSLY TAKEN INTO

ACCOUNT.

3-USE A “STRENGTHS-BASED” APPROACH;

WHAT A PERSON CAN DO IS CRITICAL FOR

INTERVENTION.

COMMON THEMES IN SLD, ID, ASD

EVALUATIONS, CONTINUED

4-ALWAYS INVESTIGATE SOCIAL-

EMOTIONAL FUNCTIONING. SLD, ID, &

ASD ARE DISABILITIES THAT IMPACT

ADJUSTMENT AND SELF-CONCEPT.

5-ACCESS TO AND AVAILABILITY OF

“SUPPORTS” IN THE ENVIRONMENT

DETERMINE EXTENT OF DISABILITY.

AND LET US ALL REMEMBER…