Title: Brief Report: Data on the Stanford–Binet Intelligence Scales (5th ed.) in Children with Autism Spectrum Disorder
Source: Coolican, J., Bryson, S.E., Zwaigenbaum, L. (2008). Brief Report: Data on the Stanford–Binet Intelligence Scales (5th ed.) in Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders , 38(1), 190-197.

In 2003 the Stanford-Binet-Intelligence Scales published a new edition (The SB-5). The SB is one of the most commonly used IQ scales for the assessment of children with special needs because it is believed to provide a more valid estimate of the child’s cognitive capacities. Although such assertion is still debated, in my experience working at several outpatient and hospital settings, the SB was always the tool of choice when conducting assessment with children with autism. Now, the problem that clinicians and researchers encounter is that when a new version of the test is launched, there is little information, apart for what is provided by the publisher, about how children with specific neurodevelopmental disorders are expected to perform. Thus, a team a Dalhousie University in Canada provided this brief report on the performance on the SB-5 by children with ASDs. The study included 63 children (12 girls and 51 boy) who have received a diagnosis of Autism, Asperger’s, or PDD-NOS via ADI or ADOS evaluation. The final count included 32 children with autism, 20 children with Asperger’s, and 11 children with PDD-NOS. Here are the most relevant results: Age was not significantly associated with performance as expected. This means that when compared to very large population sample of peers of the same age, younger children and older children perform at the same level in relation to their peers. Thus, differences between these children and the population sample do not change with age. The average full scale IQ scores using the entire SB-5 for the groups were 67.75 for Autism, 105.60 for Asperger’s, and 82.18 for PDD-NOS. When using an abbreviated version of the SB-5, the results were slightly higher but this varied significantly by individual. When comparing the Verbal vs. Non-Verbal subscales, it was surprising that in all three groups the scores in these scales were very similar, without any major discrepancy between verbal and non-verbal performance. This is surprising because traditionally children with Asperger’s show a pattern of performance consistent with a Non-verbal learning disability. That is, you would expect a significant discrepancy with much higher verbal scores as compared to non-verbal scores.

Commentary: The issue of IQ and intellectual assessment in children with Austim is highly controversial. However, the controversy is largely political and outside the research and clinical world. I want to address two issues that seem to be commonly debated in the autism community. First I want to briefly explain when, why and how an intellectual assessment test is used. An intellectual assessment is never, or should never, be provided in isolation. That is, an IQ test for the sake of knowing an IQ score provides no clinical utility. IQ scores, outside the larger scope of a full neurocognitive or educational evaluation conducted to answer specific clinical questions, are simply meaningless. Instead, an intellectual assessment is provided as part of a larger evaluation to understand the specific patterns of relative neurocognitive strengths and weaknesses with the ultimate goal of providing recommendations for services, treatment, accommodations, etc , which will maximize the functional capacities of the child and will facilitate growth and improvement. Second, there is usually a debated as to whether these intellectual assessment tools truly reflect the capacities of the child. This is a very, very, very important question. For example, performance in these types of tests is highly influenced by social desirability (wanting to please). A typically developing child may be attentive to instructions in order to please the clinician. But what if the child simply has other priorities at that particular moment than to listen to the clinicians explain how to do this clearly boring task? Does poor performance on this task reflect limited capacity in the area of functioning assessed? That is, did the child performed poorly because he/she couldn’t do it, or simply because he/she didn’t want to do it? So to the extent that IQ tests measure TRUE capacity, or are reflective of the child’s TRUE abilities, we simply have to say we don’t know. We hope that our assessment tools tap and real capacities as much as possible, but it is nearly impossible to ascertain why someone did not perform well in a particular task. HOWEVER, what the test does, at least more accurately, is to assess for FUNCTIONAL capacity. From a purely theoretical perspective, we can say that it does not matter why the child performed poorly if such performance generalizes into other contexts and affect the functional capacity of the child (not being able to do school work, difficulty keeping a job, etc). Thus, to the extend that neurocognitive assessment tools reflect functional capacities and help us provide recommendations that result in REAL benefits for the child, then I see these tests as important tools if used correctly for the right reasons and in the right context.

Update – Clarification: I was asked to clarify the statement “the controversy is largely political and outside the research and clinical world”. I apologize and agree that I should have been more precise about what I meant with that statement. I did not mean to imply that there is no controversy regarding the relative utility or appropriates of particular instruments (SB vs. WISC vs. TONY vs. other non-verbal assessment tool, etc). I was making a commentary about the commonly accepted position that in the right context, intellectual assessment as part of a comprehensive evaluation provides useful clinical information that could benefit the child or adult with autism. In my experience, the utility of using intellectual assessment tools has not been an issue of major controversy in any of the clinical settings I have worked in, including large university-based hospitals and autism clinics. In addition, I just conducted another superficial review of the two top journals in autism during the last 24 months and I was unable to find articles that provide appropriate empirical support for the idea that intellectual assessments should not be conducted in children with autism, although there are compelling articles discussing the appropriateness of specific tests. However, I accept that it is possible that the controversy in the research and clinical arena about this issue could more pronounced than how I characterized it, and if that is the case I stand corrected.

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6 Responses to Autism, IQ, and the Stanford–Binet

  1. Maddy says:

    So how come I haven’t come across your blog before I wonder?
    Cheers

  2. Re “the controversy is largely political and outside the research and clinical world.”

    That’s a surprise to me (as are some of your other statements), and might surprise the editors who’ve accepted our papers.

    I’d be very interested in how you reached this conclusion.

  3. Dear Michelle Dawson, your point is well taken. I should have been more clear about what I meant with that statement. I did not mean to imply that there is no controversy regarding the relative utility or appropriates of particular instruments (SB vs. WISC vs. TONY, etc). I was making a commentary about the commonly accepted position that, in the right context, intellectual assessment as part of a comprehensive evaluation provides useful clinical information that could benefit the child or adult with autism. In my experience, the utility of using intellectual assessment tools has not been an issue of controversy in all the clinical settings I have worked on, including large university based hospitals and autism clinics. In addition, I just conducted another superficial review of the two top journals in autism during the last 24 months and I could not find a single article providing appropriate empirical support for the idea that intellectual assessments should not be conducted in children with autism. I understand that you have a particular position against a specific type of clinical approach and research focus adopted my many researchers and clinicians, including myself. I respect your opinions and admire your tenacity in defending your professional positions. Nestor.

  4. Just to make a further clarification. I am familiar with the research from you laboratory and see it as compelling. The hypothesis that current instruments, such as the WISC, underestimate the intellectual capacity of people with autism is solid. This underscores the need for the creation of more valid instruments or the selection of more appropriate tests when assembling an assessment battery. This specific issue (the appropriateness of specific tests) is of controversy and I completely agree with you.

  5. Many thanks for the clarifications.

    I was surprised because there are many, major and totally unresolved issues at the level of “IQ and intellectual assessment” in the science. This includes matching issues in cognitive science/neuroscience, the use of instruments in intervention research, etc., apart from the primary issue of how to measure autistic intelligence.

    You wrote,

    “I understand that you have a particular position against a specific type of clinical approach and research focus adopted my many researchers and clinicians, including myself.”

    I have no idea what your clinical approach and research focus in autism is. My position is that autistics deserve to benefit from and be protected by recognized standards of science and ethics. E.g., I think autistics deserve good experimental design. My position would be regarded as boringly mainstream in any non-autism field.

  6. Dear Michelle Dawson, thank you for your comment. I completely agree that there are many unresolved issues in regards to the concept of intellectual assessment in austism. I think we were referring to two different issues completely. I was in error since my original statement was too general and oversimplified a very complex issue. I also agree with you about the need for more rigorous scientific processes. Nestor.

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