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What is the difference between autism spectrum disorder with intellectual impairment vs autism spectrum disorder comorbid with intellectual disability? Are they the same?

I am a high school senior planning to study psychology and and facinated by ASD. I would like to understand the difference between these two specifiers.

Thank you comment icon These answers are great, but I have to wonder how a clinician would make this distinction. Is it based on subjective assessment or are there objective measures? Even if this distinction can be made reliably, what are the implications for intervention(s)? If there are no distinct interventions, then does the distinction matter? I don't have answers but I find these questions interesting. Is more research needed? Does neuroscience provide any answers? One last point: I believe that clinical diagnosis should rely more on neuroscience to find root causes but I realize this is not always possible (yet). We still have a lot to learn about the brain. Ken Gish

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Lirio’s Answer

Hi Tyson, the difference between autism spectrum disorder with intellectual impairment and autism spectrum disorder comorbid with intellectual disability is how the intellectual challenges are seen. In the first case, the intellectual impairment is considered part of the autism itself. In the second case, the person has both autism and an intellectual disability, but the intellectual disability is seen as a separate condition that happens alongside autism. So, the main difference is whether the intellectual challenges are part of the autism or an additional issue.
Thank you comment icon Very insightful, thanks Lirio! Tyson
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Chinyere’s Answer

Hi Tyson!

That's a great question, and it's obvious that you're already thinking like a future psychologist.

Let's break it down: Professionals use specifiers to give a clearer picture of an individual's profile because Autism Spectrum Disorder (ASD) can present with a wide range of strengths and challenges. The terms "ASD with intellectual impairment" and "ASD comorbid with intellectual disability" sound similar, but they're used and interpreted slightly differently.

A person's intellectual difficulties are seen as a component of their autistic presentation when they are diagnosed with ASD with intellectual impairment. In this instance, it is believed that both illnesses are part of a single diagnostic picture and overlap. In diagnostic manuals such as the DSM-5, this formal specifier is used to provide further information on the individual's cognitive profile, specifically that they have adaptive functioning issues and below-average IQ scores.

ASD comorbid with intellectual disability, on the other hand, indicates that the person has two separate diagnoses: one for intellectual disability and one for ASD. When two conditions co-occur but are assessed and treated relatively independently, the term "comorbid" is frequently used. In studies or clinical conversations where both illnesses are being examined independently, this wording may be more common.

Practically speaking, people who have both autism and cognitive deficits are frequently referred to by these two terms. But it's the framing that makes a difference. While "comorbid with intellectual disability" defines it as a distinct but co-existing illness, "with intellectual impairment" highlights it as a feature of the ASD diagnosis.

In the world of psychology, your interest in autism spectrum disorder is extremely significant and helpful. As you research and eventually engage with people on the spectrum, being aware of differences like these will help you think critically and compassionately.

Best wishes!
Thank you comment icon Thank you for the in-depth review. Tyson
Thank you comment icon You're welcome! Chinyere Okafor
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Chiquria’s Answer

Great question! This difference is crucial in psychology and clinical practice, and your interest is spot-on for someone eager to study psychology.

Autism Spectrum Disorder (ASD) With Intellectual Impairment
When someone is diagnosed with autism spectrum disorder with intellectual impairment, it means:

- The intellectual challenges are part of the ASD diagnosis.
- The person's intellectual abilities are much lower than average, usually an IQ below 70, along with struggles in daily life skills.
- This term is used in the DSM-5, the guide for mental health professionals. Common phrases include:
- Autism spectrum disorder with intellectual impairment
- Autism spectrum disorder without intellectual impairment

Autism Spectrum Disorder Comorbid With Intellectual Disability
When someone is described as having autism spectrum disorder comorbid with intellectual disability, it means:

- They have both ASD and a separate diagnosis of intellectual disability, based on clinical evaluation.
- "Comorbid" means both conditions exist at the same time but are diagnosed separately.
- In some clinical or research settings, both ASD and intellectual disability may be noted as two co-occurring disorders for clarity.

Are They the Same?
In practice and on a clinical level:

- These terms often refer to the same individuals—those who meet criteria for both ASD and intellectual disability.
- "With intellectual impairment" is the DSM-5 way to show ASD comes with intellectual disability.
- "Comorbid with intellectual disability" might be used interchangeably, especially in research or older diagnostic methods, but it notes two separate diagnoses.

Key Point:

- The difference is mostly in wording and how clinicians describe the diagnosis for clarity, research, or coding.
- Both terms show the presence of autism and significant intellectual challenges.
Thank you comment icon Thank you so much for taking time to answer me in a lengthy, in-depth manner. This was very helpful! Tyson
Thank you comment icon No problem! This question is near and dear to me as my son has level 3 autism! I love that your interesting in learning more about autism! Chiquria Willis
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