The misunderstanding of autism and learning disability perhaps, in part, reflects a history of these two diagnoses often being grouped together and a lack of understanding and awareness of autism. It is true that these two diagnoses can co-exist but they can also be mutually exclusive.

Both diagnoses are lifelong conditions. Difficulties associated with both are present from childhood and neither has a ‘cure’. Both will likely have a significant impact on a person’s life and the way they view and interpret the world and others. We would hope that our understanding of autism has developed somewhat over recent years. However, autism can still be associated with the savant-like character played by Dustin Hoffman in Rain Man: socially isolated, seemingly separate from the world and highly gifted in specific areas and interests. Rain Man portrays a man with autism with high intellect but significant difficulties in other areas of functioning such as social communication. Whether you feel Rain Man presents a positive image of an individual with autism or not, it certainly highlights how autism does not always go hand in hand with intellectual disability.

Intellectual disability, also known as learning disability, is currently defined as a significantly reduced ability to understand new or complex information, to learn new skills and a reduced ability to cope independently. Typically, this is measured by intellectual functioning (commonly referred to as IQ) and adaptive functioning  (day-to-day independent skills), both of which are significantly below that which would be typically expected with difficulties in most, if not all, areas of intellectual functioning and daily living skills. As a result, individuals with a learning disability will likely require some level of support throughout their lives. How much support will vary from person to person depending on their strengths and needs. Many live independently in the community with minimal support from family or services. Others may require more of a care home environment or supported living services. Learning disability can often get confused with specific learning difficulties such as dyslexia. The key difference here is specific difficulties versus global difficulties in learning.

Autism is considered a spectrum disorder, meaning that whilst all individuals with autism share the same type of difficulties, these will be present and affect them in different ways. Currently, diagnostic assessment looks for significant and persistent difficulties with social communication and social interaction and restricted and repetitive patterns of behaviour, activities or interests. Autism can be diagnosed in individuals both with and without a learning disability. It is not uncommon for individuals with a learning disability to have difficulties in the areas typically associated with autism, making diagnosis in the learning disability population more complex. Individuals with autism, as with those with a learning disability, may or may not require additional support from family and/or services depending on their level of needs. For some, autism can have a significant impact on day-to-day functioning that at initial impression, can be misunderstood as resulting from a learning disability.

For clinicians, this highlights why appropriate assessment and formulation are so important, to go deeper than the surface. A list of symptoms may give us a summary of someone’s concerns or difficulties but it tells us very little about why they feel how they feel, think what they think or view the world the way they view the world. As with any diagnosis or presenting issue we may be supporting our clients with, understanding informs intervention. Without this we run the risk of setting clients up to fail by trying to fit people into inappropriate services, later wondering why it went wrong. So not only is there a difference between learning disability and autism but it’s also one worth noting.