The triad of impairment in autism revisited

J Child Adolesc Psychiatr Nurs. 2009 Nov;22(4):189-93. doi: 10.1111/j.1744-6171.2009.00198.x.


Topic: The triad of impairment referred to at present in the autism-related literature is a behavioral triad. This paper extends this thinking of the triad of impairment to the triad that underlies the behavioral manifestation. The real triad of impairment.

Purpose: This paper considers the thinking and information processing style of autism and takes the next transitional step in understanding the triad of impairment.

Sources used: Contemporary literature on autism and information processing.

Conclusions: Exceptional pioneering work in the late 1970s gave rise to the concept of the triad of impairments as the central plank of the construct of autism: impaired communication; impaired social skills; and a restricted and repetitive way of being-in-the-world. This clear articulation of the structures of the phenomena allowed a new way for professionals and families to see and understand autism, and to relate to those with autism. Like the evolution of many concepts, this was a transitional idea. The original triad of impairments described the behavioral manifestation; the actual triad of impairments is at the level of cognitive processing. The actual triad of impairment is static and ubiquitous unlike the variable and fluctuating behavioral manifestation. The actual triad of impairment in autism is visual as opposed to linguistic processing, impaired abstraction, and lack of theory of mind. The actual triad is central to all diagnosis that together makes up the autism spectrum.

MeSH terms

  • Autistic Disorder / psychology*
  • Child
  • Cognition*
  • Communication
  • Humans
  • Social Behavior*
  • Thinking