Triad of Impairments

The three main areas of difficulty which all people with autism share are sometimes known as the ‘Triad of Impairments’, as first described by Lorna Wing.  They are:

triad of impairmentDifficulty with Social Communication

Individuals with severe autism may never develop any speech whilst those with Asperger Syndrome may speak fluently, using full sentences. For all people on the spectrum it is the ability to use their communication skills that is impaired. Individuals may experience difficulties in any of the following:

  • Processing language and interpreting facial expressions, body language or tone of voice.
  • Understanding figures of speech or metaphors.  Their literal understanding means that they will think you mean exactly what you say.  Therefore, they would find metaphors such as “she bit my head off” confusing and even frightening. Sarcasm and humour are often beyond them.
  • Following long or complicated sentences, and they might only be able to follow one simple instruction at a time.  Therefore, communication in school or the workplace is often an area of difficulty for individuals with Asperger Syndrome even though they appear to have good verbal skills.
  • Explaining how they feel.

Some like to repeat the last word of your sentence when asked a question.  Others may say things more than once – echolalia.

Difficulty with Social Interaction

A person with classic autism may appear withdrawn, aloof or uninterested in the people they meet and have difficulties around social relationships. Their ability to develop friendships is generally very limited.  People with Asperger Syndrome also have these difficulties, but are often more aware that they have difficulties.  They may want to make friends and be a part of society but are awkward or clumsy in social situations.

Some of the things you might notice are:

  • Avoiding eye contact (because they cannot process the information overload of speech, facial expression and body language).
  • Standing too close when talking to someone – unaware of personal space.
  • Not realizing when the person they are talking to is cross or tired.
  • Laughing or speaking at inappropriate times.
  • Showing no interest in other people’s opinions or interests.

These behaviours are often taken as a sign of rudeness which further affects their ability to socialise.

Difficulty with Social Imagination

Social imagination allows us to understand and predict other people’s behaviour, make sense of abstract ideas, and to imagine situations outside our immediate daily routine. Difficulties with social imagination mean that people with autism find it hard to:

  • Imagine the world from someone else’s perspective and understand that other people may have different thoughts and feelings from their own.
  • Interpret other people’s thoughts, feelings and actions.
  • Predict what will happen next, or what could happen next.
  • Understand the concept of danger, for example that running on to a busy road poses a threat to them.
  • Engage in interpersonal or imaginative play, unless it is something they have copied, in which case they often pursue this rigidly and repetitively.
  • Prepare for change and plan for the future.
  • Cope in new or unfamiliar situations.