4.3. Outline what is meant by the ‘triad of impairments’.

We briefly introduced the ‘triad of impairments‘ when we explored Wing and Gould’s theoretical model of autism.

The term “triad of impairments” refers to three core areas of difficulty that individuals with Autism Spectrum Disorder (ASD) often experience. These were originally defined by Lorna Wing and Judith Gould in the 1970s as:

1. Social Interaction: This includes difficulties in recognizing and understanding other people’s feelings and managing their own emotions. It might be challenging for them to initiate or maintain a conversation or friendship.
2. Social Communication: This pertains to problems using and understanding verbal and non-verbal language, like gestures, facial expressions, and tone of voice. For example, they might interpret language literally and have difficulty understanding jokes, metaphors, or sarcasm.
3. Social Imagination and Flexible Thinking: This includes difficulties in understanding and predicting other people’s intentions and behaviour, imagining situations outside of their own routine, and coping with new or unfamiliar situations. This might also extend to having a limited range of imaginative activities, which might be pursued repetitively and rigidly.

It’s important to note that the concept of the “triad of impairments” has been revised with the release of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). In the DSM-5, the triad has been redefined as two areas of difficulties: social communication/interaction and restricted, repetitive patterns of behavior, interests, or activities. The change recognizes that social communication and social interaction are deeply intertwined and that the previous category of “imagination” is better described as a part of restricted, repetitive patterns of behavior and interests.

In the next section, we will explore the positive and negative points of the triad of impairments.