Keynote Address: HELP 2014 Conference, Holistic Enhancement of Learning Potential, 10th Annual Conference, Taj Club House, Chennai, India. Sponsored by the Alpha to Omega Learning Center, Lalitha Ramanujan, Founder/Director.

1. Differentiating Intellectual
Disability, Autism Spectrum
Disorder, and Specific Learning
Disability
Michael E. Gerner, Ph.D., P.C.
President, Consulting Psychologists
Flagstaff, Arizona, USA
<mgernerpsy@aol.com>
Special Thanks: Alpha to Omega Learning Centre, DSM-5 and ICD-11, and Drs.
Richard Woodcock, Dawn F. Flanagan, Kevin McGrew, Nancy Mather, and the
American Association on Intellectual & Developmental Disabilities (AAIDD)

16. What We Will Discuss
Learning Disability
Autism Spectrum
Disorder
Intellectual Disability

18. NORMALLY DEVELOPING CHILDREN:
SHOW INTEREST IN THE HUMAN
FACE
HAVE THE CAPACITY TO IMITATE
SEEK PHYSICAL COMFORT
DEVELOP IMAGINATIVE PLAY
ATTACH TO CARETAKERS
DEMONSTRATE PREFERENCE FOR
SPEECH SOUNDS

19. Most Fundamentally an Autism
Spectrum Disorder is:
Qualitative Impairment in
Social Interaction,
Communication, and
Restrictive/Repetitive/Stereotyp
ed Patterns of Behavior,
Interests & Activities.

21. People with ASD may have problems with
social, emotional, and communication skills.
They might repeat certain behaviors and
might not want change in their daily
activities. Many people with ASD also have
different ways of learning, paying attention,
or reacting to things. ASD begin during early
childhood and last throughout a person’s
lifetime.
What are some of the signs of ASD?

22. Not so rare. A new landmark study indicates
that Autism may be surprisingly widespread
--American Journal of Psychiatry (2011)
Discovering the true prevalence of Autism
requires a large scale study of a population – not
just who shows up at a doctor’s office or clinic.
Every child 7-12 screened in a region of South
Korea; yielded a total sample of 56,266.
Results: the rate of ASD was 2.64% or 1 in 38,
not 1 in 110, which was former U.S. estimate.

28. NORMALLY DEVELOPING CHILDREN:
BEGIN TO LEARN TO READ AT 4-5
ENJOY PRINTING & WRITING
DEVELOP A POSITIVE IDENTITY
AS A LEARNER
ENJOY GOING TO SCHOOL
SHOW READING/MATH SKILLS
SIMILAR TO VERBAL ABILITY

29. Most Fundamentally a Learning
Disability is:
Unexpected Underachievement
NOT DUE… to Lack of Instruction/Poor Teaching
A Sensory (Low Vision/Hearing) or Health Problem
Intellectual Disability (Mental Retardation)
Cultural/Linguistic, or Economic Difference Factors

31. Prevalence of specific learning disabilities among
primary school children in a South Indian city
Indian J Pediatr. 2012 Mar;79(3):342-7. doi: 10.1007/s12098-
011-0553-3. Epub 2011 Sep 2. Mogasale, et al.
RESULTS:
The prevalence of specific learning
disabilities was 15.17% in sampled
children, whereas 12.5%, 11.2% and 10.5%
had dysgraphia, dyslexia and dyscalculia
respectively.
WHO:
Children 8-11 from third and
fourth standard.

32. Ms. K.’s learning profile indicates that she is
“twice exceptional,” that is, she is an adult who
is both verbally gifted and who has a reading
disability.
1st Exceptionality: Verbal intelligence in the
Upper Extreme or Gifted/Talented range and
that surpasses 98% of adults nationally.
2nd Exceptionality: Her Dyslexia is manifested
by slower reading speed that exceeds only 9%
of a national sample when she reads longer
passages of connected text.
ADULT SLD/2e MEDICAL SCHOOL STUDENT

33. •Received “As” on all “Clinicals” in Medical School.
It’s not just about test results:
Collateral evidence for students w/SLD
•Ms. K was granted time extensions on medical school tests
and she earned “A” and “B” grades (time extensions
have not been allowed on the Licensing Exam ).
•Observations in medical school of consistently quick and
insightful verbal/visual decision making.
•Reported by friends, student colleagues, and instructors to
have superior social and interpersonal skills.
•Significantly weak spelling and slow acquisition of reading
skills in elementary school.
•By high school & college reading accuracy was established,
reading speed continued to an issue.
•Parent Observation throughout childhood, adolescence, and
early adulthood.

34. 3rd grade paper sent by Ms. K’s parents after approval for time extensions on the Medical Licensing Exam

35. Like These Stairs in India, Intelligence is Complex

36. John Horn (1985) on the concept of “g”
“…despite the prevalence of belief in
general intelligence, despite the emotional
intensity with which this belief is held, and
despite the fact that this belief is
proclaimed as true by some of the high
priests of our science, the belief should be
cast out—or at least put far away from
research and clinical practice” (p. 273).

38. CHC Ability Reading Achievement Math Achievement Writing Achievement
Gf Inductive (I) and general sequential reasoning
(RG) abilities play a moderate role in reading
comprehension.
Inductive (I) and general sequential (RG)
reasoning abilities are consistently very
important at all ages.
Inductive (I) and general sequential reasoning
abilities is related to basic writing skills primarily
during the elementary school years (e.g., 6 to 13)
and consistently related to written expression at all
ages.
Gc Language development (LD), lexical knowledge
(VL), and listening ability (LS) are important
at all ages. These abilities become increasingly
more important with age.
Language development (LD), lexical knowledge
(VL), and listening abilities (LS) are important
at all ages. These abilities become increasingly
more important with age.
Language development (LD), lexical knowledge
(VL), and general information (K0) are
important primarily after age 7. These abilities
become increasingly more important with age.
Gsm Memory span (MS) is important especially when
evaluated within the context of working
memory.
Memory span (MS) is important especially when
evaluated within the context of working
memory.
Memory span (MS) is important to writing,
especially spelling skills whereas working
memory has shown relations with advanced
writing skills (e.g., written expression).
Gv Orthographic Processing May be important primarily for higher level or
advanced mathematics (e.g., geometry, calculus).
Ga Phonetic coding (PC) or “phonological
awareness/processing” is very important
during the elementary school years.
Phonetic coding (PC) or “phonological
awareness/processing” is very important
during the elementary school years for both
basic writing skills and written expression
(primarily before age 11).
Glr Naming facility (NA) or “rapid automatic
naming” is very important during the
elementary school years. Associative memory
(MA) may be somewhat important at select ages
(e.g., age 6).
Naming Facility (NA); Associative Memory (MA) Naming facility (NA) or “rapid automatic naming”
has demonstrated relations with written
expression, primarily the fluency aspect of
writing.
Gs Perceptual speed (P) abilities are important
during all school years, particularly the
elementary school years.
Perceptual speed (P) abilities are important
during all school years, particularly the
elementary school years.
Perceptual speed (P) abilities are important
during all school years for basic writing and
related to all ages for written expression.
Summary of Relations between CHC Abilities and Specific Areas of
Academic Achievement (Flanagan, Ortiz, Alfonso, & Mascolo, 2006)
See McGrew and Wendling (2010) for an extension of this work

39. Cognitive Abilities Most Likely to be
Suppressed with Students Who Have a
Specific Learning Disability
Cognitive
Efficiency
(CE)
Processing
Speed
(Gs)
Short-Term
Memory
(Gsm)

40. Cognitive Abilities
Most Likely to be
Suppressed for
Culturally/
Linguistically-
Different
Migrant
Economically
Disadvantaged
Children and
Students
Verbal/
Crystallized
(Gc)
Auditory
Processing
(Ga)
Reading and
Writing
(Grw)
Quantitative
Knowledge
(Gc)

41. Ability
The power to perform some specified mental act or task
Cognitive Academic
Requires suitable,
unimpaired processing of
mental information for
successful performance
General abilities that result
more from informal, non-
school related experiences
Specialized abilities that result
more from formal, school
related experiences
Gt Gs Gsm Glr Gv Gf Ga Gc Grw Gq
Ability Continuum
Copyright 2002 Allyn & Bacon. In Flanagan et al. The Achievement Test Desk
Reference: Comprehensive Assessment and Learning Disabilities.

42. Responsive Accommodations
1. Oral testing in lieu of traditional paper/pencil
reading and/or writing intensive tests.
2. Supplemental oral testing for missed or unfinished
items.
3. Extended time on tests (time+one-half; double time).
4. Reduced assignments/workload, but not the range (i.e.,
every other item; selection from begin/start/end).
5. Allowing all or portion of written work done orally.
6. Books on tape to take advantage of verbal
fluency/listening comprehension as opposed to slow
reading speed and weak reading comprehension.

44. NORMALLY DEVELOPING CHILDREN:
COME TO SCHOOL READY TO
LEARN
SOCIALIZE WITH PEERS EASILY
MASTER PRACTICAL SKILLS
ASSUME MORE DUTIES AT
HOME
SCHOOL SKILLS = PEERS
DEVELOP GREATER INDEPENDENCE

45. Most Fundamentally an Intellectual
Disability (ICD-11 Intellectual
Developmental Disorders) is:
Significant Limitations in
Intellectual Functioning and
Adaptive Behavior
 Defined as 2SD below the Mean taking into
account the standard error of measurement.
 At least one Area/Domain of Adaptive Behavior
is approximately 2SD below the Mean.

46. The Definition of Intellectual Disability

48. Five Assumptions Regarding
the Definition

49. “…the kids are
tougher than ours,
they had to be
(o chavorro na
biandola
dandencar, the
saying
goes—the child is
not born with
teeth.”)

50. Five Assumptions Regarding
the Definition

51. Conceptual Framework of Human
Functioning
I. Intellectual
Abilities
II. Adaptive
Behavior
III. Health
IV. Participation
V. Context

53. Ethical “Musts” for the Assessment of
Intellectual Disability (Mental Retardation)
1. Always consider how poverty, socio-
economic, and/or cultural factors may suppress
cognitive ability test scores.
2. Always assess adaptive behavior. If the
child/student/adult is not low functioning in the
community, the individual does not have an
intellectual disability.
3. Never let access for educational services
(program in place) be the factor that decides if a
student has an intellectual disability.

55. COMMON THEMES IN SLD, ID, ASD EVALUATIONS
1-REQUIRES EXTENSIVE DATAAND THE
BEST INSTRUMENTATION WITH CLINICAL
JUDGEMENT. NOT A “CUT-POINT”
EXERCISE IN PSYCHOMETRY.
2-CULTURALAND LINGUISTIC DIVERSITY
MUST BE RIGOROUSLY TAKEN INTO
ACCOUNT.
3-USE A “STRENGTHS-BASED” APPROACH;
WHAT A PERSON CAN DO IS CRITICAL FOR
INTERVENTION.

56. COMMON THEMES IN SLD, ID, ASD
EVALUATIONS, CONTINUED
4-ALWAYS INVESTIGATE SOCIAL-
EMOTIONAL FUNCTIONING. SLD, ID, &
ASD ARE DISABILITIES THAT IMPACT
ADJUSTMENT AND SELF-CONCEPT.
5-ACCESS TO AND AVAILABILITY OF
“SUPPORTS” IN THE ENVIRONMENT
DETERMINE EXTENT OF DISABILITY.

57. AND LET US ALL REMEMBER…