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by | May 25, 2018 | News & Views | 2 comments

Please note – this older blog has been superseded by a more recent blog on autistic communication issues, repetitive behaviours or thought patterns, and sensory issues. You may also find our blog on autism diagnostic criteria useful…

Autism was previously defined by the famous ‘triad of impairments’, a concept introduced in the late 1970s. (Wing and Gould.) Undertake any course of further learning about autism or read a reference book, and you will come across it, perhaps being referenced as the gold standard of diagnosis, regarding autism spectrum conditions (ASCs).

Our musing is – many organisations STILL reference the concept – but Autism’s Triad Of Impairments is now very dated…

The Triad of Impairments was a tool describing ASC limitations – it included the three elements of Communication, Social Interaction and Flexible Imaginative Functions (including repetitive or obsessive behaviours; sometimes, the third element referred to ‘flexibility’ and / or ‘imagination’.)

The triad has also been described as impairments in theory of mind and executive dysfunction, and a propensity to ‘detail-focused’ behaviour.

However, with revisions to diagnostic manuals, the sub-types of autism have been amalgamated into Autism Spectrum Disorders (ASDs) / ASCs, with key elements including impaired social communication and social interaction, restricted behaviour/flexibility, and sensory challenges. (Please read our more recent blog on communication issues, repetitive behaviours or thought patterns, and sensory issues.)

Let’s look at the negative implications of ‘autistic impairments’

A 2009 Study states: “Exceptional pioneering work in the late 1970s gave rise to the concept of the triad of impairments: impaired communication, impaired social skills and a restricted and repetitive way of being-in-the-world. This allowed a new way for professionals and families to understand autism; this was a transitional idea.”

Experts have moved away from the triad, which was seen as a single explanation for the symptoms of autism – as found in the articleTime to give up on a single explanation for autism’.

The authors state: “Despite half a century’s research into ASD, there is little evidence regarding the unity of the three core areas of impairment [as described in the triad]. The triad of impairments can be fractionated, and should be studied separately.”

 

Continuing to reference the triad could do two NEGATIVE THINGS:

(1)Inhibit the development of research into strategies to help autists. The same article states: “If different features of autism are caused by different genes, associated with different brain regions and related to different core cognitive impairments, it seems likely they will respond to different types of treatment.” This is why the authors recommend studying the key autistic elements separately, rather than looking for SOMETHING that causes all the so-called ‘triad’ elements.

(2)Support the notion that autism requires a cure. Again the article, which supports the idea of focusing on each element of the triad, instead of clubbing together the three traits, states: “Abandoning the search for a single cause [for] autism may also mean abandoning the search for a single ‘cure’ or intervention.”

The link with genes

An interesting 2008 study asked whether key autistic-like traits are mirrored at the genetic level; with separate genes contributing to each so-called impairment? The authors found that: ‘Each aspect of the [so-called] triad is highly heritable.’

The authors stated that the ASC triad could have multiple causes, at genetic, neurological and cognitive levels, meaning that autism can result when a number of independent ‘impairments’ co-occur. The authors suggested that: “Some avenues of (ASC) research may be best pursued WITHIN, rather than across triad domains,” e.g. focussing on each element of the triad, rather than looking at the triad itself, as a non-negotiable platform.

There are other issues with the triad too. Does it take into account age and gender? Not really. A 2014 study hinted at ambiguity, and stated: “Findings regarding gender differences in the core triad of impairments seen in ASD remain ambiguous.”

Also, it should be noted that the triad did need to incorporate sensory issues in autists, e.g. their over-or under-sensitivity to sounds, touch, light, temperatures etc, as this is a major element or factor for people with autism.

Impairment or the autie advantage?

Let’s look further at the term impairment – an objective term. A ‘New Scientist’ article states: “Auties, as some people with autism call themselves, don’t merely think differently: in certain ways they think better. Call it the autie advantage.”

A blog on SEN Assist sums our question of ‘impairment’ up well, with author Adele Divine stating – “The ‘triad’ [was] a helpful tool in that it highlights difficulties, which are common to those with a diagnosis of autism, but I have an issue with the word ‘impairment’. The dictionary definition of impairment is: ‘The result of being impaired; a deterioration or weakening; a disability… ‘The Triad of Differences’ would be less harsh. Differences may lead to difficulties, but with the right structures and supports differences can also lead to great discoveries. Many of the difficulties represented in the triad can also be positive character traits. The word ‘impairment’ does not suggest this.”

Focussing on autism’s positives

The triad focussed on impairments where an autistic person is concerned, but as we touched upon in our blog: ‘Tony Atwood’s theory of ‘discovering’ the strengths of Asperger’s instead of diagnosing traits and disorders’, we (as a group of interested parties) should focus more on positive autism traits, described by Professor Atwood as including aspects like consideration of details, a determination to seek the truth, and an original, often unique perspective in problem solving? (For interest, see Professor Atwood’s books HERE.)

As described on a blog for workshop provider, Autism Awareness Centre, autist John Simpson has created his own, more positive triad for the autism spectrum, which is:

*The need for predictability

*The need for motivation

*An uneven cognitive profile (splinter skills)

A little disclaimer – here at Spectra.blog we don’t claim to be experts about Autism Spectrum Conditions / Disorders; the information we post here is based purely on our own exposure and experiences.

2 Comments

  1. Paul

    The triad of impairments has been changed, so your knowledge seems outdated, look at the DSM-5 for up to date info.

    Agree some terminology is a bit odd. ASD is ‘disorder’ and probably the most out of step with the pc world we are in. As for impairments, that is the reality of aspects of autism, and the study is generally aimed at understanding these as primary research.

    From that the secondary research can be done, which as you put forward, can be far more positive.

    Reply
    • admin

      Thanks Paul, yes you’re right, the post was dated – we have since updated the phrasing, and directed readers to the more recent post on the key diagnostic areas, which can be found at – https://spectra.blog/news-views/autism-social-communication-sensory-issues-and-repetitive-thought-patterns-or-behaviours/. However it is worth keeping the ‘Triad’ article live, as there are some interesting points and links; and in fact, some info-providers (one current provider of an autism qualification, for example) do still refer to it in their material. It’s interesting isn’t it that so much stems from medical research, where ‘disorders’ and ‘impairments’ are the chosen language; but that this does sit uncomfortably with many of us! (Even though autism can leave an autist feeling ‘dis-ordered’, eg. without order.) Fortunately there are many vloggers and bloggers using much more positive terminology about themselves which is filtering through. Thanks for commenting.

      Reply

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