IQ Tests and Exceptions to The Rule

For most individuals, intelligence Quotient (IQ) tests have relatively high predictive validity. Scores are also likely to remain consistent across the lifetime of individuals. However, as with medical tests, there are always patients that display exceptions to this general rule.

At age 6, I displayed a 40 point discrepancy between my verbal and performance IQ on the WISC (Wechsler Intelligence Scale for Children). with my verbal IQ in the high average range and my performance IQ in the borderline range. When retested at age 12, my performance IQ was in the average range and my verbal IQ was in the superior range. Sometimes, children with learning disabilities are able to use their areas of strength to compensate for their weaknesses. For instance, I learned to verbalize my way through visual-spatial tasks. The psychologist administering the test noted that I spoke aloud to myself as I solved the non-verbal portions of the test.

The high predictive validity of IQ tests still stands for the general population. However, predicting an individual's future (especially when making decisions that will have a major impact such as choosing to place a child in a special education class) should be done with extreme caution. In addition to cases with children with learning disabilities, there is also some controversy about IQ testing with children who are recent immigrants or who have low socioeconomic status. For instance, a child may do poorly on the verbal section of a test due to lack of general knowledge about Canadian culture or a language barrier rather than a learning difficulty.

Except in the case where cognitive disability is fairly certain, limiting a child's educational opportunities by placing them in an educational program that will not give them full access to academics may put an artificial cap on the potential of the child. In some cases, a child will simply need accommodations such as extra time to complete tasks and additional instruction in order to perform at grade level. In other instances, modifications to the child's home environment can make a difference. Modifications to the core outcomes of the academic curriculum should be a last resort.

The best use of an IQ test with children with disabilities or other barriers to learning such as poverty is to determine their current strengths and weaknesses so professionals can best determine ways to help children overcome or compensate for these difficulties. As a child, my parents and therapists spent time coaching me in how to use self-talk to convert visual information into words. That and my already strong verbal skills allowed progress much farther than predicted in visual-spatial abilities. I was even able to interpret curves in first year University calculus with the help of a tutor. However, as predicted by that initial test at age six, residual difficulties still remain. For instance, I have problems with direction and orientation in space, thus taking many trials before I learn a route. The intent of this post is not to discount the predictive validity of IQ tests, but rather to state that humans are a diverse population and that not every individual in this population will perform as predicted. Therefore efforts should be made to aim for the best possible outcome rather than the predicted outcome.

Asperger's + Illness = ?

When I get sick, I usually don't run a fever and I have a relatively high pain tolerance. The first signs that I'm coming down with something are usually dizziness and exaggerated sensory processing difficulties (often severe enough that I cannot tolerate crowds and public places), and agitation. I also often get chills and extreme exhaustion. In severe cases, I am not able to focus on any activity.

I know from some of the literature I've read that illness detection and diagnosis is often more difficult for individuals on the autism spectrum. Parents should watch their children for changes such as more tantrums or self-stimulatory behaviour. Adults on the spectrum should monitor themselves for signs such as being more tired or agitated than usual (this can be difficult to determine because those with ASD are often tired from the daily social interaction of school or work).

If you or a family member with ASD is feeling "off" for more than a few days without an obvious environmental cause, visit your family doctor and get some lab work. Don't always assume it's something emotional.

I was having extreme exhaustion and dizziness last week to the point I was unable to study for my exams. It wasn't until early this week that tests from my doctor revealed the cause. I've missed most of this week of school.

Do you or your family members with ASD display atypical symptoms when ill?

The Mind That Never Stops

Even though life is going well for me right now overall, there is always something to worry about. That is just a fact of living in an imperfect world. The problem with that and Asperger's is often my mind doesn't know how to let go and enjoy all the positive things around me.

Obsessing about things that cannot be changed is a time waster and a good way to put yourself in a negative mood. What I try to do is when I find myself in a situation where I'm obsessing is ask if there is something I can do about it (e.g. help a person in need). However, if there is nothing I can do, I try to force myself into other activities. Once I get engaged in an activity, especially something relaxing like playing with my dogs, is hard to think of negativity.

I personally find meditation doesn't help much because it is difficult to hold that position for three minutes (I tend to stiffen). However, I like swinging and listening to music, jumping on my trampoline, white noise when I'm going to sleep, and spending time with my family and animals.

Over time, I am coming to realize that I can help others and do the best I can both with my family and people outside, however, I cannot take on the problems of the world. I am only human myself.

Respond to this post with your personal solutions for dealing with negative/obsessive thinking.

Water and Let Grow

Yesterday, I was reading a biography about a family raising a young boy with autism in the 1970s (entitled "Mixed Blessings.") Then, very little was known about autism. Some people told the family that the boy was "retarded" and recommended that he be "kept away from 'normal' children as it would frustrate him." Other people said exposure to other children with disabilities would harm him and that this little boy had the potential to be "normal." Overall, there was very few resources available to this family, even though the father was a well known actor in the television show, MASH.

Even when I was a child (I was born in 1985) a lot less was known about children with disabilities than what is known today. For instance, as a six-year-old I showed a 40 point discrepancy between my verbal and performance IQ in favour of the verbal. Experts predicted that I'd have difficulty learning to read and write due to probable issues with symbol recognition and that higher level math would be out of the question. As of now, I make mostly As in my psychology courses, passed calculus (a C- but a lot for somebody who was never supposed to do higher level math), and have never learned to read or write cursive writing well even though I have no problem reading printing. I take notes and write exams on computer at university because even though I can print fairly neatly, my letters consist of drawn block letters and take away the focus from the content of my writing. On computer, I write very fluently.

Sometimes I get emails or questions from parents wondering how their young child with a certain profile will turn out when they are older. In my opinion (and I am not a medical expert), we know a lot more than twenty, or even five years ago, but prognosis is still a major guessing game.

For instance, Ned, the boy in 'Mixed Blessings" had a very advanced vocabulary and could write the letters of the alphabet as a toddler, but never really grasped the concept of structured conversation and has severe difficulties even as an adult.

I know of another individual from the town where I used to live, who didn't speak until he was seven and displayed many autistic tendencies, but grew up to be a prominent professional.

In the advice of a neurologist who evaluated me at age four, the best thing you can do for children with special needs is "water and let grow." Give them every opportunity to reach their full potential and see what they will become.

To Label or Not

One of the major concerns with the DSM-IV TR is the lack of a clear distinction between normal variations in human behaviour and psychological disorders. According to the DSM, in order for something to be considered a psychiatric disorder, it must cause the affected individual clinically significant impairment. However, it is difficult to create an operational definition for clinically significant impairment.

For instance, in the case of those who meet the DSM-IV criteria for Asperger's Disorder (AS), by definition, these individuals will have impairments in non-verbal communication. However, if a person with AS is able to find a career that is information-based that does not rely heavily on social skills and obtains enough rudimentary non-verbal communication skills to function independently in society, should they still be considered to have the condition? Those with AS who are able to be financially independent usually still have difficulties in their personal life. For instance. they may have few or no friends. However, if they desire to spend much of their time alone, does this constitute a dysfunction?

In the small town where I lived as a child, there was a prominant professional who did not speak until he was seven or read until he was ten. As a teenager he showed an obsession towards genetics and interacted little with his peers. He also showed the stereotypical body language of an Autism Spectrum Disorder. As an adult, he was married with a family, but received some accommodations in the workplace, including guidance from coworkers when he made social errors. In his personal belief, he had autism as a child, but no longer had a disorder. Did he really no longer qualify for a diagnosis of autism, or was he simply living in an environment that allowed him to compensate for his disability?

I volunteered in settings with individuals with diagnoses of Asperger's Syndrome and High Functioning Autism. Some of the people I worked with had normal to near normal intelligence, but could not focus on a simple task for more than a few minutes without engaging in self-stimulatory behaviour. Their conversation skills were limited to citing obscure facts or asking questions irrelevant to the situation. These people could not function in society without a large amount of support.

Optimal functioning is achieved by very few individuals. Even people who do not have any diagnoses have strengths and weaknesses, along with times in their lives when they are unhappy. Bill Gates shows some stereotypical autistic gestures such as rocking. However, it is doubtful that he has difficulties in his everyday life. It would be unlikely that he would be diagnosed with Asperger's syndrome because there is no clinically significant impairment.

It is difficult to determine a cut-off point at which normal variation becomes a disorder, especially in cases where functional impairment is present, but not severe enough to incapacitate an individual. Diagnoses from the DSM are simply nomenclature. There are not enough labels to cover the vast array of individual differences. If someone meets the criteria for a diagnosis and could benefit in the form of treatment or community resources from receiving a diagnosis, the diagnosis should be applied. If someone is not in need of services to help them function, there is no need for a diagnosis. This eliminates the need to make the artificial distinction between normal and non-normal.

The Voice from Within

Individuals with disabilities often have life experiences unique to their particular condition. For instance, a wheelchair user may be more aware of the effects of building acessibility than a person from the general population. As an individual with Asperger's Syndrome, I believe I am more aware of and able to emphasize with the social and sensory challenges faced by individuals with Autism Spectrum Disorders than a member of the general population.

Psychology students may be able to read a textbook description of self-stimulatory behaviour such as rocking and even proposed reasons behind it. However, they do not have the direct experience to appreciate the regulatory functions of such behaviours. Similarly, an individual with Asperger's syndrome can read about body language and learn how to use it efficiently, but it is almost never natural to them. A college researcher can study aspects of a culture such as the Aztecs, but since they have never directly experienced life in the particular society they are studying, they cannot go beyond inferences.

Each individual is unique (even those with the same diagnosis). However, someone who is a member of particular disability group has a greater understanding of the group as a whole than someone from outside the group.

Just as we need women to research and advocate for woman's issues and ethnic minorities to research and advocate for their culture, our society also needs high-functioning individuals with disabilities to be advocates and researchers in the field of their disability.

This is one of the many reasons I plan a future career in autism research.

Out in the Cold

This post is not specific to Asperger's Sydrome, but addresses the potential fate of many Albertans who struggle with mental illness or neurological conditions that cause psychiatric symptoms. Edmonton's Alberta Hospital is potentially closing many of its beds for patients with mental illness. As of now, only the most severe cases are hospitalized. These are people who cannot meet their basic needs, and will likely be non-compliant with medical treatment such as necessary psychiatric medications or even antibiotics.

Much of Edmonton's homeless population already consists of people with mental illness. Although many of these people receive AISH (a form of government disability funding that covers basic living expenses), these people are not able to effectively manage this money to meet their needs. They may self-medicate with illegal drugs and are often evicted from any housing they may find.

The aim to deinstitutionalize patients with mental illness began several decades ago. I am a strong supporter of community living when individuals are able to have their needs met in the community. This may mean being closely monitored by medical professionals, living in a group-home setting, or living with family. This only works in cases where people are going to be compliant with treatment or have strong family advocates. This cost cutting is not "community living" but throwing helpless people out on the street to fend for themselves.

The university I attend is encouraging all psychology students to sign a petition to stop this closure of beds. If you are a resident of Alberta and would like to become involved, write to your MLA. If you are a student or a health professional in the psychological field, see what opportunities your school or work have for getting involved in stopping this potential disaster.