Severity of Impairment in Autism
Trenton State College
Autism is a puzzling disorder. It is considered a severe psychopathology of development, but consensus on the characterization of that severity has eluded researchers ( Gillberg, 1990; Waterhouse, Wing, & Fein, 1989). Current models define autism as a behavioral syndrome of multiple genetic and nongenetic etiology, determined by a neurological deficit or deficits whose locus is uncertain ( Rapin, 1991). The severity of impairment lies in aberrant social affect, aberrant social cognition, aberrant social communication, and impairment in associated intellectual, motor, and vegetative functions ( APA, 1987).
The goal of this chapter is to explore the significance of the severity of diagnostic and nondiagnostic behaviors in understanding the nature of the syndrome. The chapter has four sections. The first section presents definitions and indices of severity in autism. The second section explores the question of a developmental shift in the severity of symptoms. The third section considers the implications of variation in symptom severity for constructing brain-behavior inferences. The fourth section suggests a methodological change for exploring patterns of severity in autistic symptomatology, and proposes a new theoretical model as a framework for interpreting neural deficits associated with autism.
There are at least seven ways in which clinicians and researchers document the severity of individual cases of autism. One way is by measuring the degree of developmental lag on normative scales of behaviors within a specific domain, such as language or play ( Fein et al., 1991; Sigman, Mundy, Ungerer, &