Differentiating characteristics of deafblindness and autism in people with congenital deafblindness and profound intellectual disability.
In deafblind clients with profound ID, social reciprocity and signal use separate autism from deafblindness, while stereotypy and play do not.
01Research in Context
What this study did
The team looked at adults who have three diagnoses at once: deafblindness, autism, and profound intellectual disability.
They asked, 'Which behaviors point to autism and which come only from deafblindness?'
Each adult was watched during everyday activities and short play tasks.
What they found
Clear signs of autism were poor back-and-forth exchange, few social starts, and weak use of signals.
Repetitive body movements and simple play looked the same in both groups, so these do not help separate the diagnoses.
How this fits with other research
de Vaan et al. (2018) built on this idea and made the OASID test. OASID gives you cut-off scores for four autism severity levels in clients with sensory loss plus ID.
Boswell et al. (2023) seem to disagree at first. They say stereotypy at 12 months predicts later self-injury in infant siblings. The key difference is age and risk group: tiny, high-risk babies versus deafblind adults. In babies, stereotypy is still a red flag; in deafblind adults it is not.
Bizzell et al. (2020) also treat sensory quirks as autism markers, but their clients could see and hear. A et al. warn that when both vision and hearing are gone, you must weigh social reciprocity more than sensory oddities.
Why it matters
If you assess a client who is deafblind and has profound ID, skip the stereotypy checklist. Focus on whether the person shows shared attention, takes social turns, or tries to start contact. Use tools like OASID for extra clarity. This keeps you from giving the wrong label and guides you to the right social-communication goals.
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02At a glance
03Original abstract
BACKGROUND: In persons with deafblindness, it is hard to distinguish autism spectrum disorders from several deafblind specific behaviours caused by the dual sensory impairments, especially when these persons are also intellectually disabled. As a result, there is an over-diagnosis of autism in persons who are deafblind leading to unsuitable interventions. METHODS: Autism as specified by the DSM-IV was studied in 10 persons with congenital deafblindness with profound intellectual disabilities. Behaviours of people with deafblindness and autism (n = 5) and of people with deafblindness without autism (n = 5) were observed in a semi-standardised assessment. RESULTS: All people with deafblindness showed impairments in social interaction, communication and language. In contrast to persons without autism, people with deafblindness and autism showed significantly more impairments in reciprocity of social interaction, quality of initiatives to contact and the use of adequate communicative signals and functions. No differences between the groups were found for quantity and persistence of stereotyped behaviour, quality of play and exploration and adequate problem-solving strategies. CONCLUSIONS: This study indicates that there are some possibilities to differentiate autism from behaviours specific for deafblindness. It also confirms the large overlap in overt behaviours between people with deafblindness and persons with autism.
Journal of intellectual disability research : JIDR, 2009 · doi:10.1111/j.1365-2788.2009.01175.x