According to James Coplan, MD, a developmental pediatrician and researcher specializing in autism, intelligence tests for children with autism should be administered by "someone who's comfortable with and capable of working with kids who are off the map. Who understands what makes the kid tick. Some reports look like they're written off a computer disk." It's important to note that some research also suggests that children with autism are simply less motivated to take or do well on an IQ test and that providing additional motivators, such as small prizes for compliance, can make a big difference in test outcomes.
Since young autistic children are often nonverbal or have significant processing language and responding verbally, Dr. Coplan notes that verbal responses may not be a good measure of IQ, nor a child's ability to manage interpersonal relationships, sensory input or motor skills. In fact, he says, "Nonverbal intelligence is the single biggest factor influencing outcome."
How do you measure nonverbal intelligence? Dr. Coplan recommends the comprehensive Test of Non-Verbal Intelligence (TONI), saying that children who do poorly on typical intelligence tests may do very well on the TONI. The test looks more directly at what children know than other tests —- not at how well children can use language to communicate what they know. What's more, the test is administered nonverbally. Overall, the test measures four areas of intelligence:
- Object permanence (understanding that an object still exists, even when it is out of sight)
- Tool use
- Cause and effect
- Problem solving
- Adaptive skills
At 12 to 14 months, says Dr. Coplan, a child should be able to use objects as tools, solve simple problems and show an interest in cause and effect. Autistic children, however, may do all of these things idiosyncratically. For example, Coplan describes one parent as saying, "My child uses my hands as if they were surgical instruments." By age 2, children should be combining different things together to see what they do. Stacking and dumping are signs of this type of development. "Typical children will use language," says Dr. Coplan, "but adaptive skills (fasteners, clothes on and off, etc.) are all nonverbal problem-solving skills you find at 36 months."
Other tests for intelligence measure fewer aspects of intelligence but may also be useful. The Raven Matrices is a matching test, which measures a child's ability to grasp spatial representation. The Bender Gestalt tests involve copying pictures (and require physical output). Depending upon the child, these and other additional tests may be helpful in determining the best treatment plan.
Intervew with Dr. James Coplan, May, 2008. Koegel L., Koegel R., et al. Variables Related to Differences in Standardized Test Outcomes for Children with Autism. Journal of Autism and Developmental Disorders Volume 27, Number 3 / June, 1997 pages 233-243. Seigel, D., Minshew N., et al. Wechsler IQ profiles in diagnosis of high-functioning autism. Journal of Autism and Developmental Disorders Volume 26, Number 4 / August, 1996 pages 389-406.
Intervew with Dr. James Coplan, May, 2008.
Koegel L., Koegel R., et al. Variables Related to Differences in Standardized Test Outcomes for Children with Autism. Journal of Autism and Developmental Disorders Volume 27, Number 3 / June, 1997 pages 233-243.
Seigel, D., Minshew N., et al. Wechsler IQ profiles in diagnosis of high-functioning autism. Journal of Autism and Developmental Disorders Volume 26, Number 4 / August, 1996 pages 389-406.