Research in Autism Spectrum Disorders 6 (2012) 58–64

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Research in Autism Spectrum Disorders

Journal homepage: http://ees.elsevier.com/RASD/default.asp

Cognitive profiles of adults with Asperger’s disorder, high-functioning

autism, and pervasive developmental disorder not otherwise specified
based on the WAIS-III
Chieko Kanai a,*, Masayuki Tani a, Ryuichiro Hashimoto a, Takashi Yamada a, Haruhisa Ota a,
Hiromi Watanabe a, Akira Iwanami b, Nobumasa Kato a
a
Department of Psychiatry, Showa University, Karasuyama Hospital, 6-11-11 Kitakarasuyama, Setagayaku, Tokyo 157-8577, Japan
b
Department of Psychiatry, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawaku, Tokyo 142-8655, Japan

A R T I C L E I N F O A B S T R A C T

Article history: Little is known about the cognitive profiles of high-functioning Pervasive Developmental
Received 6 September 2011 Disorders (PDD) in adults based on the Wechsler Intelligence Scale III (WAIS-III). We
Accepted 6 September 2011 examined cognitive profiles of adults with no intellectual disability (IQ > 70), and in adults
Available online 1 October 2011 with Asperger’s disorder (AS; n = 47), high-functioning autism (HFA; n = 24), and pervasive
developmental disorder not otherwise specified (PDDNOS; n = 51) using the WAIS-III.
Keywords: Verbal Intelligence (VIQ)–Performance Intelligence (PIQ) differences were detected
Asperger’s disorder (AS) between the three groups. Full Intelligence (FIQ) and VIQ scores were significantly higher
High-functioning autism (HFA)
in AS than in HFA and PDDNOS. Vocabulary, Information, and Comprehension subtest
Pervasive developmental disorder not oth-
scores in the Verbal Comprehension index were significantly higher in AS than in the other
erwise specified (PDDNOS)
Wechsler Intelligence Scale III (WAIS-III)
subgroups, while Digit-Symbol Coding and Symbol Search subtest scores in the Processing
Speed index were significantly lower in HFA. The findings demonstrated cognitive profiles
characteristic of adults with high-functioning PDD.
ß 2011 Elsevier Ltd. All rights reserved.

1. Introduction

Based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2000)
and the International Classification of Diseases (ICD-10; World Health Organization, 1993), Pervasive Developmental
Disorders (PDD) are characterized by markedly abnormal or impaired development in social interaction, a restricted and
stereotyped repertoire of activities and interests, and a history of cognitive or language delay. The most common subtypes
are Asperger’s disorder (Asperger syndrome [AS]), Autism, and pervasive developmental disorder not otherwise specified
(PDDNOS). AS is different from the other types of PDD in that communication ability is not impaired. PDD was once thought
to be an extremely rare disorder, affecting 2–4 persons in a population of 10,000 (Pickles et al., 1995), but high-functioning
(IQ  70) PDD has recently attracted great attention. Chakrabarti and Fombonne (2001) estimated that the prevalence of
high-functioning PDD is 0.45%. According to a published epidemiologic study, the population prevalence of AS is 0.36% and
suspected AS cases comprise 0.7% (Ehlers & Gillberg, 1993).
Diagnosing high-functioning PDD is difficult, however, especially in adults (Ritvo et al., 2008). Because some primary
caregivers often remember only a portion of a patient’s developmental history during early childhood, it is difficult to collect
accurate information for a differential diagnosis of PDD in adults. High-functioning PDD in adults is also associated with

* Corresponding author. Tel.: +81 3 3300 5231; fax: +81 3 3308 1710.
E-mail address: chikanai1003320@gmail.com (C. Kanai).

1750-9467/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.rasd.2011.09.004
 C. Kanai et al. / Research in Autism Spectrum Disorders 6 (2012) 58–64 59

other psychiatric disorders, such as depression, anxiety disorder, and schizotypal personality disorder (Cederlund, Hagberg,
& Gillberg, 2010; Kanai, Iwanami, Hashimoto, et al., 2011; Kanai, Iwanami, Ota, et al., 2011; Mattila et al., 2010), making it
difficult to distinguish between high-functioning PDD and other psychiatric disorders in adults. Therefore, efficient
indicators for a precise diagnosis of high-functioning PDD are important in the clinical setting.
The Wechsler Intelligence test is one of the most widely used behavioral tests to examine cognitive profiles of children
and adults and it has been translated into many languages, including Japanese. The Japanese version of the Wechsler Adult
Intelligence Scale-Third Edition (WAIS-III) is a new version of the Wechsler Intelligence test for adults. Determining the
cognitive profiles based on the Wechsler Intelligence test, comparing full intelligence (FIQ), verbal intelligence (VIQ), and
performance intelligence (PIQ), and even index and subtest score profiles among high-functioning PDD groups will be
helpful for diagnosing adults with high-functioning PDD.
VIQ–PIQ differences are considered to be an efficient indicator of PDD (Spek, Scholte, & van Berckelaer-Onnes, 2008).
Cederlund and Gillberg (2010) reported that VIQ is higher than PIQ in adolescents with AS. Ghaziuddin and Mountain-
Kimchi (2004), studying IQ profiles of 34 participants with high-functioning PDD (AS and HFA), found that both AS (82%) and
HFA (50%) had a higher VIQ than PIQ. In the one study reported to date of WAIS-III profiles of adults with high-functioning
PDD, no VIQ and PIQ differences were detected (Spek et al., 2008). Each of these previous studies, however, was performed
with a relatively small number of samples. Therefore, it is important to clarify the VIQ–PIQ differences in a larger sample of
adults with high-functioning PDD.
At the index level, Spek et al. (2008) found Processing Speed problems in adults with high-functioning PDD. Nydén et al.
(2010) also found higher Verbal Comprehension and lower Perceptual Organization scores in adults with high-functioning
PDD than in those with attention deficit hyperactivity disorder (ADHD) and PDD with ADHD traits groups based on the
Wechsler Adult Intelligence Scale-Revised (WAIS-R), which is the previous version of the WAIS-III.
At the subscale level, Spek et al. (2008) reported high Comprehension and Block Design scores, and low Digit Span scores
in adults with AS. In adults with HFA, Digit-Symbol Coding, Matrix Reasoning, and Symbol Search scores were relatively low,
and the Information score was relatively high. Some studies of the WAIS or WAIS-R in adults with high-functioning PDD
reported low Comprehension and high Block Design scores (Goldstein, Beers, Siegel, & Minshew, 2001; Rumsey &
Hamburger, 1988).
Although some studies have identified the cognitive profiles of children with high-functioning PDD (Bölte, Dziobek, &
Poustka, 2009; Ehlers et al., 1997; Koyama, Tachimori, Osada, & Kurita, 2006; Mayes & Calhoun, 2008; Scheirs & Timmers,
2009), little is known about the characteristics of adults with high-functioning PDD. In addition, the cognitive characteristics
of adults with AS, high-functioning autism, and PDDNOS have not yet been clarified. While PDD includes subtypes based on
the DSM-IV-TR, the clinical features of high-functioning PDD vary widely (Wing, Gould, & Gillberg, 2011). Elucidation of the
cognitive patterns on the WAIS-III of the three types of high-functioning PDD is important for supporting a precise diagnosis
in adults with high-functioning PDD.
In the present study, we clarified the different cognitive profiles on the WAIS-III among adults with no intellectual
disability (IQ  70), and adults with AS, high-functioning autism, and PDDNOS, with large number of samples.

2. Methods

2.1. Participants and procedure

All participating patients provided written consent prior to completing the questionnaires and testing in the study, which
was approved by the ethics committee of the Faculty of Medicine of Showa University.
The clinical group of this study comprised 122 outpatients at Showa University Hospital (Mean age, 29.4 years [range, 18–
60]; 86 men and 36 women) attending a diagnostic outpatient clinic for adults 18 years of age and older with suspected PDD.
All patients were referred by physicians from other clinics. Inclusion criteria were WAIS-III FIQ  70; age of 18–60 years; no
current use of anti-psychotics; and formal diagnosis of PDD, including autistic disorder, AS, and PDDNOS based on the DSM-
IV-TR. In addition, because PDDNOS is defined as a residual category of PDD and has no operational criteria, we used the ICD-
10 for atypical autism, which requires that children either show abnormal or impaired development after 3 years of age or
that they do not exhibit all three characteristics required for a diagnosis of autistic disorder (i.e., impairment in reciprocal
social interaction, impairment in communication, and restricted/stereotyped behavior/interests). The former case [i.e.,
impaired development after 3 years of age] seems to be quite uncommon in our clinical experience. Exclusion criteria were
comorbid psychiatric disorders based on the DSM-IV axes I and II. All patients were asked to complete an interview sheet
before clinical examination at the initial visit. The interview sheet comprised five main questions regarding: (1) the major
complaint; (2) history of visits to medical and educational organizations/consultation services; (3) problems during the fetal
and newborn period; (4) developmental delays (walking and language); and (5) education and occupation of the patient and
their parents. The patients were also required to bring school records covering elementary school through high school and a
maternal and child health handbook. The maternal and child health handbook includes records of pregnancy, childbirth, and
the neonatal and infant periods, and are provided by the local government office in Japan.
To assess the presence of autistic traits, the Japanese version of the Autism-Spectrum Quotient (AQ) (Wakabayashi,
Baron-Cohen, Wheelwright, & Tojo, 2006), developed originally by Baron-Cohen, Wheelwright, Skinner, Martin, and Clubley
(2001), was administered to all patients before clinical examination. In the present study, a total AQ of 25 was the cut-off
60 C. Kanai et al. / Research in Autism Spectrum Disorders 6 (2012) 58–64

score for PDD. Total AQ score did not differ significantly among the three types of PDD [AS, Mean = 36.3, SD = 6.9; HFA,
Mean = 33.0, SD = 6.6; PDDNOS, Mean = 35.8, SD = 6.1, F(2,118) = 2.88, p = 0.060], and was higher than the clinical cut-off
score of 26.0 for high-functioning PDD (Woodbury-Smith, Robinson, Wheelwright, & Baron-Cohen, 2005).
Further diagnostic assessment of all patients was subsequently performed, irrespective of the AQ score. A team of three
experienced psychiatrists and a clinical psychologist performed the assessments. The assessment comprised two detailed
interviews of the patients about development and behavior from infancy to adolescence ((1) developmental history; (2)
present illness; and (3) past history), and family history, performed independently by a psychiatrist and a clinical
psychologist on the team. The patients were also asked to bring suitable informants who knew the patient in early childhood.
At the end of the clinical interview, the patients were diagnosed by the psychiatrist according to the DSM-IV-TR diagnostic
criteria for PDD based on a consensus between the psychiatrist and clinical psychologist. Approximately 3 h were required
for the diagnostic process. After the clinical examination, the WAIS-III was administered to patients diagnosed with PDD by
clinical psychologists. The three groups did not differ significantly in sex ratio (AS: M = 32, F = 15; HFA: M = 20, F = 4;
PDDNOS: M = 34, F = 17; X2 = 2.30, p = 0.32) or age (AS: M = 30.5, (SD 9.7); HFA: M = 29.0 (SD 7.9); PDDNOS: M = 28.5 (SD 6.1);
F(2,118) = 0.81 p = 0.45).

2.2. Instrument

2.2.1. Japanese version of the WAIS-III

The Japanese version of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) (Wechsler, 1997) was used in the
study. The Japanese version of the WAIS-III was standardized among 1381 Japanese adults, and was found to have good
reliability and validity (Japanese WAIS-III Publication Committee, 2006). The WAIS-III has three composite scores (Full IQ
[FIQ], Verbal IQ [VIQ], and Performance IQ [PIQ]) and comprises 14 subtests. The VIQ consists of 7 subtests (Vocabulary,
Similarities, Arithmetic, Digit Span, Information, Comprehension, and Letter-Number Sequencing). The PIQ comprises 7
subtests (Picture Completion, Digit-Symbol Coding, Block Design, Matrix Reasoning, Picture Arrangement, Symbol Search,
and Object Assembly). The FIQ also comprises four index scores; Verbal Comprehension (Vocabulary, Similarities, and
Information), Perceptual Organization (Picture Completion, Block Design, Matrix Reasoning), Freedom from Distractibility
(Arithmetic, Digit Span, and Letter-Number Sequencing), and Processing Speed (Digit-Symbol Coding and Symbol Search)
(see Table 1).

2.3. Statistical analysis

We compared age and AQ among the AS, HFA, and PDDNOS groups using the one way analysis of variance (ANOVA). Two-
way analyses of variance with one among-participants and one within-participants factor were performed to test for
differences among the three groups, for differences among IQ scores (verbal vs. performance IQ, the index, and subtest
scores), and their interaction. In case of main effects, a follow-up analysis of one-way ANOVA was performed for each IQ,
index, and subtest score. To adjust for the multiple statistical tests performed at each IQ score, the Benjamini and Hochberg
(BH) method was applied, with the false discovery rate controlled at 5% (Benjamini & Hochberg, 1995). In case of significant
effects, post hoc comparison was performed using a Bonferroni test. Differences between VIQ and PIQ among the three
groups were estimated by means of paired t-tests. We examined the relationships among sexes using X2 tests (Pearson). We
analyzed the data using SPSS version 18.0 (SPSS, Tokyo, Japan).

3. Results

3.1. Differences between VIQ and PIQ in the WAIS-III

VIQ was significantly higher than PIQ in all three groups. Of the three groups, AS exhibited the highest scores (Table 1). A
total of 95 (78%) patients from all three groups (AS 37 [79%], HFA 18 [75%], PDDNOS 40 [78%]) had a higher VIQ than PIQ,
whereas 27 (22%) of all patients (AS 10 [21%], HFA 6 [25%], PDDNOS 11 [22%]) showed the converse discrepancy. In 11 (9.8%)
of the 122 patients (AS 4 [8.5%], HFA 2 [8.4%], PDDNOS 5 [9%]), VIQ was 15 to 19 points greater than PIQ. In 50 (40.6%) of the
patients (AS 22 [46.7%], HFA 19 [37.7%], PDDNOS 19 [37.5%]), VIQ was 20 or more than points greater than PIQ. In 6 (4.9%) of

Table 1
VIQ and PIQ differences in the AS, HFA, and PDDNOS groups.

WAIS-III Full scale Verbal Performance VIQ–PIQ t P

Mean SD Mean SD Mean SD

AS (n = 47) 107.0 15.3 113.7 14.0 97.0 19.3 16.5 6.38 <0.001
HFA (n = 24) 94.5 16.3 100.9 17.5 87.7 15.9 13.2 4.00 0.001
PDDNOS (n = 51) 98.4 16.7 104.3 17.0 91.6 16.9 12.7 5.88 <0.001

Means of paired t-tests was used for comparing three groups. AS, Asperger’s disorder; HFA, high-functioning autism; PDDNOS, pervasive developmental
disorder not otherwise specified.
 C. Kanai et al. / Research in Autism Spectrum Disorders 6 (2012) 58–64 61

Table 2
Comparion between AS, HFA, and PDDNOS groups.

WAIS-III AS (n = 47) HFA (n = 24) PDDNOS (n = 51) F(2,118)

Mean SD Mean SD Mean SD

IQ
Full Scale** 107.0a,b 15.3 94.5a 16.3 98.4b 16.7 5.90
Verbal** 113.7a,b 14.0 100.9a 17.5 104.3b 17.0 6.55
Performance 97.0 19.3 87.7 15.9 91.6 16.9 2.44
Index
Verbal Comprehension** 114.9a,b 12.2 102.8a 15.5 105.2b 15.9 7.77
Perceptual Organization 95.7 20.5 94.5 25.3 92.4 15.1 0.35
Freedom from Distractibility 104.7 15.8 96.0 18.1 95.3 22.0 3.34
Processing Speed** 95.3a,b 18.9 78.9a 16.2 85.5b 17.4 7.61
Verbal Subtests
Vocabulary*** 14.2a,b 3.8 10.3a 3.8 11.9b 3.4 10.15
Similarities 12.2 2.7 11.0 3.0 11.0 3.4 2.33
Arithmetic 11.0 3.0 9.4 3.9 9.3 3.5 3.42
Digit Span 11.1 3.8 10.2 3.7 10.6 3.8 0.52
Information* 11.9a 2.8 10.1 3.1 10.0a 3.1 5.61
Comprehension*** 13.5a,b 3.3 9.9a 4.4 10.6b 3.4 11.35
Letter-Number Sequencing 10.2 3.4 8.9 3.1 8.8 3.8 2.26
Performance Subtests
Picture Completion 8.3 3.2 7.5 3.1 7.9 2.9 0.59
Digit-Symbol Coding** 9.0a,b 4.0 6.1a 3.1 6.8b 3.3 6.85
Block Design 9.7 4.6 8.1 3.3 8.5 3.4 1.76
Matrix Reasoning 10.1 3.6 10.0 2.7 9.8 3.7 0.12
Picture Arrangement 9.8 4.1 9.5 4.2 10.1 4.1 0.23
Symbol Search** 9.4a 3.7 6.4a 3.3 8.1 3.4 5.94
Object Assembly 8.1 3.9 6.8 2.7 7.9 3.4 0.97

One way analysis of variance was used for comparing the three groups. A significant difference was present between the groups denoted by the same
alphabet (a and b). AS, Asperger’s disorder; HFA, high-functioning autism; PDDNOS, pervasive developmental disorder not otherwise specified.
a
A significant survives after Benjamini and Hochberg adjustment for multiple tests, applied to analyses of the multiple IQ scores (IQ, Index, and subtests) of
WAIS.
*
P < 0.05.
**
P < 0.01.
***
P < 0.0001.

the patients (AS 2 [4.2%], HFA 2 [8.4%], PDDNOS 2 [4%]), VIQ was 11–14 points greater than PIQ. In 4 (3.2%) of the patients (AS
2 [4.2%], HFA 1 [4.2%], PDDNOS 1 [2%]), PIQ was 15 to 19 points greater than VIQ.

3.2. IQ and four index scores

We found a significant main effect of group in the FIQ and VIQ scores after adjusting for multiple comparisons [FIQ:
F(2,118) = 5.90, p = 0.006, VIQ: F(2,118) = 6.55, p = 0.006; Table 2, Fig. 1]. Post hoc tests showed that FIQ and VIQ were
significantly higher in AS than in HFA [FIQ: F(2,118) = 5.90, p = 0.007, VIQ: F(2,118) = 6.55, p = 0.003] and PDDNOS [FIQ:
F(2,118) = 5.90, p = 0.030, VIQ: F(2,118) = 6.55, p = 0.004].

Fig. 1. Mean WAIS-III IQ and index scores for the three diagnostic groups. Values are after Benjamini and Hochberg adjustment. $, Significant difference
between AS and HFA; ^, significant difference between AS and PDDNOS. p < 0.05.
62 C. Kanai et al. / Research in Autism Spectrum Disorders 6 (2012) 58–64

Fig. 2. Mean WAIS-III subtest scores for the three diagnostic groups. Values are after Benjamini and Hochberg adjustment. $, Significant difference between
AS and HFA; ^, significant difference between AS and PDDNOS. p < 0.05.

Analysis of variance showed a main effect of group in the Verbal Comprehension and Processing Speed scores after
adjusting for multiple comparisons [Verbal Comprehension: F(2,118) = 7.77, p = 0.004, Processing Speed: F(2,118) = 7.61,
p = 0.002; Table 2, Fig. 1]. Post hoc tests showed that Verbal Comprehension and Processing Speed were significantly higher
in AS than in HFA [Verbal Comprehension: F(2,118) = 7.77, p = 0.003, Processing Speed: F(2,118) = 7.61, p = 0.001] and
PDDNOS [Verbal comprehension: F(2,118) = 7.77, p = 0.004, Processing Speed: F(2,118)= 7.61, p = 0.020].

3.3. Subtests in the WAIS-III

Analysis of variance showed a main effect of group in the Vocabulary, Information, Comprehension, Digit-Symbol Coding,
and Symbol Search scores after adjusting for multiple comparisons [Vocabulary: F(2,118) = 10.15, p < 0.001; Information:
F(2,118) = 5.61, p = 0.014; Comprehension: F(2,118) = 11.35, p < 0.001; Digit-Symbol Coding: F(2,118) = 6.85, p = 0.009;
Symbol Search: F(2,118) = 5.94, p = 0.010; Table 2, Fig. 2]. Post hoc tests showed that Vocabulary, Comprehension, and Digit-
Symbol Coding scores were significantly higher in AS than in HFA [Vocabulary: F(2,118) = 10.15, p < 0.001; Comprehension:
F(2,118) = 11.35, p < 0.001; Digit-Symbol Coding: F(2,118) = 6.85, p = 0.006] and PDDNOS [Vocabulary: F(2,118) = 10.1,
p = 0.007; Comprehension: F(2,118) = 11.35, p < 0.001; Digit-Symbol Coding: F(2,118) = 6.85, p = 0.008]. Information and
Symbol Search scores were significantly higher in AS than in PDDNOS [Information: F(2,118) = 5.61, p = 0.006; Symbol
Search: F(2,118) = 5.94, p = 0.008].

4. Discussion

To our knowledge, this is the first study to clarify the cognitive profiles of adults with AS, HFA, and PDDNOS based on the
WAIS-III. The results will be meaningful for assessing adults with high-functioning PDD to provide a precise diagnosis,
leading to appropriate treatments and support, such as educational support/job assistance based on specific cognitive
characteristics of these patients. The patients themselves could also gain more insight into their strengths and weaknesses
(Scheirs & Timmers, 2009).
In the present study, VIQ was significantly higher than PIQ, and the AS group exhibited higher scores than the other
groups. Approximately 80% of all groups (AS 79%, HFA 75%, PDDNOS 78%) had higher VIQ than PIQ, whereas approximately
20% (AS 21%, HFA 25%, PDDNOS 22%) had the converse discrepancy. Although some patients with high-functioning PDD
showed VIQ < PIQ in the present study, the three groups showed a similar pattern between VIQ and PIQ (VIQ > PIQ), which
might be characteristic of high-functioning PDD.
The findings of a discrepancy between VIQ and PIQ were consistent with those of previous studies (Noterdaeme, Wriedt,
& Höhne, 2010; Siegel, Minshew, & Goldstein, 1996; Williams, Goldstein, Kojkowski, & Minshew, 2008). Adults with high-
functioning PDD selected by Kosaka et al. (2010) had a higher VIQ than PIQ with a discrepancy of approximately 15 points.
Other studies reported that autism with intellectual disability was characterized by PIQ > VIQ, while AS showed the opposite
pattern (Lincoln, Courchesne, Allen, Hanson, & Ene, 1998). The superiority of verbal skills over visuospatial functions and
nonverbal problem-solving in AS is supported by finding of higher VIQ compared with PIQ (Woodbury-Smith & Volkmar,
2009). On the other hand, our finding was not consistent with a recent study that reported no VIQ–PIQ discrepancy in 43
adults with high-functioning PDD (Spek et al., 2008). These conflicting results might be due to differences in the definition of
high-functioning and the diagnostic system used. Therefore, further studies are required to determine whether a VIQ–PIQ
discrepancy is a true trait of adults with high-functioning PDD.
 C. Kanai et al. / Research in Autism Spectrum Disorders 6 (2012) 58–64 63

The AS group had the highest IQ scores of the three groups, consistent with the findings of the only other reported study
examining cognitive characteristics among AS, HFA, and PDDNOS (de Bruin, Verheij, & Ferdinand, 2006). Comparing the
score tendency in the present study with that reported by de Bruin’s study, the IQ level pattern (AS > PDDNOS > HFA) is
similar between groups with high-functioning PDD. Based on the results of both the previous and present studies, the IQ
pattern in high-functioning PDD in the present study seems consistent.
With regard to the four index scores and subtest scores, AS had the highest score among the three groups. This study
aimed to clarify the cognitive patterns on the WAIS-III among AS, HFA, and PDDNOS. To validate our results regarding the
four index scores and subtest scores of the WAIS-III, we compared our results with those of Spek who compared AS and HFA
(Spek et al., 2008). The score tendency of the four index scores and most subtest scores of the WAIS-III in the present study
was higher in AS than in HFA, consistent with findings by Spek et al. (2008). Spek et al. (2008) reported that the subtest score
Digit Span, relating to working memory capabilities, however, was slightly higher in HFA than in AS. People with HFA and AS
tend to store information as details instead of using strategies, which often leads to problems in retaining information
(Minshoew, Goldstein, Muenz, & Payton, 1992; Spek et al., 2008). Adults with HFA might had more problems retaining
information in the present study, although the cognitive characteristics of AS and HFA were similar.
AS also performed significantly better in Vocabulary, Information, and Comprehension subtests of the Verbal
Comprehension index, while Digit-Symbol Coding and Symbol Search scores in the Processing Speed index were
significantly lower in HFA, consistent with recent studies of adults with PDD using the WAIS (Spek, Schatorjé, Scholte, & van
Berckelaer-Onnes, 2009; Spek et al., 2008; Siegel et al., 1996). As reported in previous studies (Ghaziuddin & Gerstein, 1996;
Howlin, 2003), adolescents and adults with AS show superior language comprehension and expression, and pedantic speech.
Gaus (2007) also reported that adults with AS have advanced verbal skills. The results of the present study indicated that
adults with AS might also have superior verbal skills.
Low scores on the Digit-Symbol Coding and Symbol Search subtest associated with the Processing Speed index indicate
problems in the speed of processing visual information (Wechsler, 1997). Spek et al. (2008) reported that people with HFA
need more time than others to process and integrate visual information and to act on this information. Low Processing Speed
scores might also be associated with motor clumsiness in high-functioning PDD. Some patients with high-functioning PDD
show poor visual-motor coordination (Gaus, 2007). Previous studies reported that patients with high-functioning PDD,
especially those with HFA, exhibited coordination problems (Manjiviona & Prior, 2000; Noterdaeme et al., 2010). The results
of the present study indicated that among PDD groups those with HFA might have the most difficulty doing more than two
things at the same time.
In the present study, some profiles on the WAIS-III differed significantly among the three groups. Therefore, we compared
studies of adults with high-functioning PDD to those of children with high-functioning PDD based on the WAIS-III profiles in
those with AS and HFA. Both Bruin’s study and our study showed similar IQ level patterns (AS > PDDNOS > HFA), and
VIQ > PIQ in AS and HFA, consistent with a previous study comparing children with AS to HFA (Ehlers et al., 1997). The VIQ–
PIQ pattern, however, was different in PDDNOS ([VIQ–PIQ] PDDNOS 1.3 vs. 12.7 [de Bruin’s study vs. our study]) (de Bruin
et al., 2006). With regard to the WISC-R and WAIS-III subtest scores, both studies showed that among the three groups AS had
the highest scores on the Vocabulary, Information, and Comprehension subtests, and HFA had the lowest scores on Coding.
The results are consistent with the findings of Siegel et al. (1996) in a study of WISC-R traits in children with HFA. These
findings indicate that the cognitive profiles, superior verbal ability in AS and inferior visual-motor coordination in HFA,
might be specific to both adults and children with high-functioning PDD. In addition, most of the adults with high-
functioning PDD reached the mean level in Comprehension, whereas Comprehension scores were lower than average in
children with high-functioning PDD, suggesting that adults with high-functioning PDD acquire common knowledge socially
during the course of development. Children with PDDNOS, on the other hand, did not show a VIQ–PIQ discrepancy. These
incongruities might be due to differences between participants (children or adults), but further studies are required to
elucidate whether both children and adults with PDDNOS show a VIQ–PIQ discrepancy in other large samples. Further,
longitudinal studies of high-functioning PDD in children through adulthood are needed to clarify the cognitive profiles of
high-functioning PDD.
The findings of the present study indicate that all three diagnostic groups share similar cognitive characteristics. The
results are consistent with the concept that the three groups belong to the same category, i.e., ‘Autism spectrum disorders’,
regarding a behavioral level continuum of AS, HFA, and PDDNOS. Based on this concept, the present results are reasonable.
Additional studies based on a larger number of participants in a general population are necessary to further elucidate the
cognitive profiles of adults with high-functioning PDD because the outcomes might depend on patients with high-
functioning PDD at the hospital, which may reflect a selection bias. Nevertheless, the present findings support the clinically
significant notion that the results of the WAIS-III could provide a useful basis for comparing the cognitive profiles among
adults with AS, HFA, and PDDNOS.

References

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