Intellectual development in autism spectrum disorders: new insights from longitudinal studies

Abstract

The presence/absence of Intellectual Disability (ID) is considered to be the most critical factor affecting outcomes in individuals with Autism Spectrum Disorders (ASD). However, the question of the specific nature of ID in ASD has received little attention, with the current view being that ID is a comorbid condition (i.e., one that is unrelated in etiology and causality from the ASD itself). Recent advances in developmental neuroscience, highlighting the importance of early exposure to social experiences for cognitive development, support an alternative view; that ID in ASD might emerge as a consequence of severe social-communication deficits on the experience-dependent mechanisms underlying neurocognitive development. We tested this prediction in two independent samples of young children with ASD (Ns = 23 and 60), finding that children with greater ASD severity at an initial assessment were more likely to present with poorer cognitive outcomes at a later assessment, irrespective of initial cognitive level. The results of this proof of principle study suggest that ASD symptom severity contributes to the extent to which the environmental input required to support "typical" brain development can be processed by the individual, so that the risk of developing ID increases as the number and severity of ASD social-communicative impairments increase.

Keywords: autism; cognitive development; comorbidity; developmental cognitive neuroscience; intellectual disability.

Figure 1

Scatterplots for 23 preschoolers with community ASD diagnoses presenting associations among Time 1 ASD symptoms and concurrent cognitive age-equivalence scores.

Figure 2

Scatterplots for 23 preschoolers with community ASD diagnoses presenting associations among Time 1 ASD symptoms and gains in cognitive age-equivalence over a 1-year follow-up period.

Figure 3

Scatterplots for 60 toddlers with ASD identified via developmental surveillance presenting associations among Time 1 ASD symptoms and concurrent cognitive age-equivalence scores.

Figure 4

Scatterplots for 60 toddlers with ASD identified via developmental surveillance presenting associations among Time 1 ASD symptoms and gains in cognitive age-equivalence over a 2-year follow-up period.