Triad of Impairments in Autism [Summarized and Revised]

Autism is often diagnosed based on the Triad of Impairments. The components of the triad include deficits in 1. Social Relationships and Interaction, 2. Communication and 3. Imagination. Let’s get a summary and a deep understanding of the autism triad of impairment.

What is Autism Spectrum Disorder?

ASD stands for Autism Spectrum Disorder which encapsulates a diverse set of conditions. Children and adults with Autism Spectrum Disorder struggle with communication and social contact to a certain extent.

Atypical patterns of behaviour and activity, such as difficulties switching from one activity to another, attention to detail, and unique responses to sensations, are other traits.

However, people with autism can show extraordinary set of skills which others fail to possess. It is usually difficult for autistic children to adjust with requirements that they are sought for.

Some may learn to adjust with the changes over time and learn to live independently. Others struggle with daily routines and require ongoing assistance to cope up with their life. This encircles educational possibilities as well as employment prospects.

Additionally, there may be a lot of obligations placed on families that provide care and assistance. The level of support offered by local and national authorities, as well as societal views, are significant determinants of the quality of life for people with autism.

Autism may show early signs of development, but the disorder is frequently not recognized until much later. Epilepsy, depression, anxiety, and attention deficit hyperactivity disorder are common co-occurring disorders in people with autism, along with challenging behaviours such as trouble falling asleep and self-harm.

People with autism have a wide range of intellectual functioning abilities, from severe impairment to exceptional levels.

Here are some of the features summarized altogether:

  • Global impairment of social and communication
  • Stereotyped and repetitive behaviour
  • Impairment of social relationships
  • Compulsive behaviour
  • Collecting things (e.g., a boy has >2000 toy cars)
  • Most children have decreased IQ- the “Savant syndrome” is rare
  • Autism patients usually present when there is a change in their lives e.g., moving to a new school, the death of someone they love

What is the Triad of Impairments in Autism Spectrum Disorder?

Three levels of the Triad of Impairments are frequently used to describe the core deficits in Autism Spectrum Disorder (ASD). These are as follows:

  1. Relationships and Interactions
  2. Communication
  3. Imagination

These have been briefly summarized below:

1. Relationships and Interactions


Summarized concerns with social relationships and interactions, the first part of a triad of impairments, include:

  • inability to form an understanding of what other people are thinking or feeling
  • avoiding interaction
  • inability to make eye contact
  • unable to understand the tone of voice
  • difficult cooperative play with children


Issues with social relationships appear to be a key concern for caretakers of autistic individuals. This can involve a complete lack of concern for other people. Or this can revolve around a strong desire to acquire friends but being unable to do so because of a lack of understanding of social cues, other people’s behaviours, and their feelings.

Researchers clue towards lack the mentalizing ability, often known as the “theory of mind,” which is the capacity to comprehend what the thoughts and feelings of others are. Social settings can be difficult, and this makes some desire to completely avoid interacting with others.

An autistic person lacks the skills necessary for eye contact, emotion interpretation, speech tone comprehension, and facial expression reading, all of which have an impact on how social connections normally develop. As a result, playing together with other kids is frequently challenging for autistic youngsters.

They would much rather carry on with their own monotonous pastimes without the involvement of others. These children’s developmentally delayed learning of many core abilities is hampered by impairments in social and environmental exploration. They might also be uncomfortable making eye contact, show no interest in physical contact, and show no emotional awareness of how other kids react to them.

2. Communication


Communication skills are another core feature of the triad of impairments in autism. Let’s have a look at the summary of the second part:

  • impaired tone, pitch, or even absent speech
  • difficulty with intonation
  • repetitive speech focused on individual ideas
  • delayed language milestones


Communication issues in this area affect both verbal and nonverbal interactions. In certain circumstances, speech may be completely absent, or it may be present but have problems with tone and pitch modulation.

Due to these issues, many struggle with intonation and are unaware of how others utilize it. Even when speech does happen, it could be boring and focused on the speaker’s own obsessive thoughts rather than anything that is important to the conversation.

This results directly from the incapacity to understand the true significance of what is being said or done. A further symptom of this impairment is the inability to start and participate in conversations.

Non-verbal communication skills like facial expressions, body language, and social cues are not intrinsic for anyone, including those who are usually developing or have autism, but rather are acquired over time from one’s social environment.

Because of this, individuals with autism may exhibit a limited understanding of and capacity for expressing emotions, gestures, body language, and other signs. Their ability to communicate socially is negatively impacted by these.

3. Imagination


Imagination is the last component of the autism triad of impairments. Features include:

  • defective imagination and conceptual skills
  • rigid way of thinking
  • rigid patterns and routines
  • difficulties in incidental learning


The inability to transfer newly acquired skills and think abstractly can sometimes be attributed to deficiencies in imaginative and mental abilities. Restricted interests, recurrent behaviours, and rigid ways of thinking and acting are the results of these. Changes in routines can cause worry and suffering in children with autism.

Variations in eating habits, exercise routines, and other everyday activities could all be part of these shifts. They may be trying to make sense of the world around them, which is why they favour rigid patterns and rituals in their activities.

Along with this rigidity, there could also be issues with incidental learning, a lack of creativity and playfulness, and a lack of imagination. Since it has a significant impact on how these children are handled at home and at school, it has the most profound effect on the day-to-day lives of these kids and their families.

Is Triad of Impairments always present in Autism Spectrum Disorder?

A kid can only be given an autism diagnosis under the DSM-IV when he is 3 years old. If a person displays at least six symptoms from each of the three categories in the triad of impairments, autism can be diagnosed. The prerequisites comprise:

  1. At least two social interaction impairments
  2. One social communication impairment
  3. One from imagination deficits

The abbreviation “PPD”, or pervasive developmental disorders, is also used in the DSM-IV to refer to a variety of illnesses, such as autism and Asperger’s syndrome.

The classic example of a condition where the affected person has an IQ higher than average is Asperger Syndrome. Another name for it is high-functioning autism. However, social interaction problems and behavioural disorders remain a difficulty for those with Asperger Syndrome.


Autistic individuals tend to show this triad of impairments very often. Often, such individuals can nourish and can lead a normal life like others if handled with “maintained” care.

They may not be able to develop social cues naturally and often end up memorizing rules that govern social behaviour for them to live independently and thrive professionally.

They are capable of carrying out daily tasks with ease, yet they could struggle in social situations. They frequently have a small range of interests, and others can find their routines odd. They could also have motor delays and be quite clumsy.

The likelihood that a boy will have Asperger’s Syndrome is about three to four times greater than that of a girl. Children with this syndrome frequently achieve academically on par with or better than average and do not have decreased IQ.

It should be noted that not every child with autism or Asperger’s Syndrome displays all these limitations to the same degree; instead, each displays a subset of the symptoms with varied degrees of severity.

A multidisciplinary team of professionals and physicians uses specialised clinical interviews and observation procedures to diagnose and assess ASD.

At this time, there isn’t a single root reason for these deficits. According to some experts, there are numerous, mainly unrelated genetic, cognitive, and neurological reasons for ASD-related deficits.

We hope that this post has helped you better grasp the Triad of Impairments in Autism Spectrum Disorder. Please post any questions or remarks in the comments section.

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