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Cited by 331Autism Spectrum Disorder ResearchChild Nutrition and Feeding IssuesDown syndrome and intellectual disability research

The DOI matches its Crossref record; 48 of the 48 references it cites were found in a registry or an index.

The misnomer of ‘high functioning autism’: Intelligence is an imprecise predictor of functional abilities at diagnosis

Open access
Alvares, Gail A, Bebbington, Keely, Cleary, Dominique, Evans, Kiah, Glasson, Emma J, Maybery, Murray T, Pillar, Sarah, Uljarević, Mirko, Varcin, Kandice, Wray, John, Whitehouse, Andrew JO·2020·Autism
DOI 10.1177/1362361319852831
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Abstract

‘High functioning autism’ is a term often used for individuals with autism spectrum disorder without an intellectual disability. Over time, this term has become synonymous with expectations of greater functional skills and better long-term outcomes, despite contradictory clinical observations. This study investigated the relationship between adaptive behaviour, cognitive estimates (intelligence quotient) and age at diagnosis in autism spectrum disorder. Participants ( n = 2225, 1–18 years of age) were notified at diagnosis to a prospective register and grouped by presence ( n = 1041) or absence ( n = 1184) of intellectual disability. Functional abilities were reported using the Vineland Adaptive Behaviour Scales. Regression models suggested that intelligence quotient was a weak predictor of Vineland Adaptive Behaviour Scales after controlling for sex. Whereas the intellectual disability group’s adaptive behaviour estimates were close to reported intelligence quotients, Vineland Adaptive Behaviour Scales scores fell significantly below intelligence quotients for children without intellectual disability. The gap between intelligence quotient and Vineland Adaptive Behaviour Scales scores remained large with increasing age at diagnosis for all children. These data indicate that estimates from intelligence quotient alone are an imprecise proxy for functional abilities when diagnosing autism spectrum disorder, particularly for those without intellectual disability. We argue that ‘high functioning autism’ is an inaccurate clinical descriptor when based solely on intelligence quotient demarcations and this term should be abandoned in research and clinical practice.

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Research works printed but not linked: 8

  1. Bowen S. E., 2014, Autism spectrum disorders (ASD): State of the states of services and supports for people with ASD
  2. Danaher J., 2011, Eligibility policies and practices for young children under Part B of IDEA
  3. Griffiths R., 1996, The Griffiths mental development scales from birth to 2 years. Manual. The 1996 revision
  4. Luiz D., 2004, Griffiths mental development scales-extended revised (GMDS-ER) administration manual
  5. National Collaborating Centre for Women’s and Children’s Health (UK), 2011, Autism: Recognition, referral and diagnosis of children and young people on the autism spectrum
  6. Sparrow S. S., 1984, Vineland adaptive behavior scales
  7. Wechsler D., 2003, Wechsler Intelligence Scale for Children–Fourth Edition (WISC-IV)
  8. World Health Organization, 1992, The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines

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Metadata

Authors
Alvares, G. A., Bebbington, K., Cleary, D., Evans, K., Glasson, E. J., Maybery, M. T., Pillar, S., Uljarević, M., Varcin, K., Wray, J., & Whitehouse, A. J.
Affiliations
  • The Kids Research Institute Australia (AU)
  • Stanford University (US)
  • Government of Western Australia Department of Health (AU)
Corresponding author
Alvares, Gail A
ORCID
Venue
Autism
Publisher
SAGE Publications
Published
2019-06-19
Volume
24
Issue
1
Pages
221-232
ISSN
  • 1362-3613 (ISSN-L)
  • 1461-7005
DOI
10.1177/1362361319852831
OpenAlex
W2950856395
Cited by
331
References
48
Citations by year
2026: 107 · 2025: 40 · 2024: 32 · 2023: 37 · 2022: 47 · 2021: 44 · 2020: 19 · 2019: 5
FWCI
16.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Autism (publishedVersion)
  • PubMed (publishedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion)
  • Griffith Research Online (submittedVersion, other-oa)
Funders
  • Raine Medical Research Foundation (RPG103-18)
  • National Health and Medical Research Council (APP1077966)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
Keywords
high-functioning autism, autism spectrum disorder, intellectual disability, intelligence quotient, adaptive behavior, functional capacity, age at diagnosis, Vineland Adaptive Behavior Scales, diagnostic terminology
MeSH terms
Autism Spectrum Disorder, Activities of Daily Living, Adaptation, Psychological, Adolescent, Age Factors, Child, Child, Preschool, Cognition Disorders, Female, Humans, Infant, Intelligence, Intelligence Tests, Male, Western Australia

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