Follow Up Article Summary

Classic Article:
Creak, M. (1961). Schizophrenic syndrome in childhood. Lancet, 278, 818-819.
https://doi.org/10.1016/S0140-6736(61)91104-7

Follow-up Article:
Edelson, G. M. (2006). Are the majority of children with autism mentally retarded? A
systematic evaluation of the data. Focus on Autism and other Developmental
Disabilities. 21,66-83.

Relationship between classic article and follow-up article:

Both articles look at children with Autism and the process used to label them as
mentally retarded. The Classic article by Dr. Mildred Creak written in 1961 attempts to
create a list of recognizable traits in order to make a diagnosis of “schizophrenia
syndrome in childhood” (autism). The Follow up article on the other hand, written by
Meredyth Goldberg Edelson in 2006, looks at the historical roots of the evidence that
allows researchers to make such claims.

Purpose of the follow-up article

The Creak (1961) article created its list of recognizable traits in children based on the
observations of other Child Psychiatrists. Although, the article does mention the use of
evidence, it does not include that data in the article for examination by its readers. Also,
the article uses the term “retardation” at one point but does not explain how it came to
that conclusion and is an example of the kind of articles that Edelson is referring to.

The over all purpose of Edelson’s (2006) article is to review the widely used claim that a
“high prevalence of Mental Retardation” exists within children with Autism. She reviews
numerous articles in order to determine the roots a of such claims, as cognitive skills
are not normally a defining element in the process of diagnosing autism in children. As
an Example: she refers to the Diagnostic and Statistical Manual of Mental Disorders’
2001 (DSM) in which they cited the figure of 70% to 75% of children with autism are
mentally retarded. She questions these dubious methods and practises by which
researchers continue to re-use this unsubstantiated and hurtful claim without proper
supporting evidence.

Description of the study

She conducts an extensive systematic review of empirical and non-empirical research

that promoted the claim that a majority of Children with autism are mentally retarded.
Her research was guided by three basic inquiry questions: a.) Do prevalence rates
reported in the literature derive from empirical sources? b.) Can non-empirical sources
of these statistics be traced historically to valid empirical studies? and c.) When
empirical studies have been conducted, are the methods by which intelligence is
assessed appropriate?

Furthermore, she looked for statements in any English publication between 1943 and
2003, which dealt with “rates of mental retardation” and “children with Autism.” She
establishes a set of criteria of acceptable studies with which to start her review and she
selected 223 articles that meet that threshold. She further divides the selected articles
into empirical (58) and non-empirical (165) studies, with 8 articles in both columns.

Summary of results and conclusions

1.) Did the prevalence rates reported derive from Empirical sources?

After the Creak (1961) article, we see a rise in claims by researchers both empirical and
non-empirical, that a majority of children with autism are mentally retarded. Its
interesting to see the rates steadily increase since 1961 to higher levels of 70% to 80%
by 2001 without any data to support such claims.

From the 58 empirical sources, 74% (43) of claims came from non-empirical
researchers while 26 % (15) of claims came from empirical studies. The rates were
clearly inflated and as a result of the high numbers, researchers re-used these figures
time and time again with out checking the source data. From the 165 non empirical
sources, 36% did not provide citations to support claims, while 8% provided references
but with no evidence attracted, and 21% reported higher numbers than their citations
had stated. The result is that the figures were inflated by researchers.

2.) Could non-empirical sources of the Prevalence rates of MR in children with Autism
be traced historically to valid Empirical studies?

Out of the 165 non empirical studies, 53% didn’t bother to trace the source of the data,
while others (47%) did include the data but didn’t include the citations needed to support
the claims. They did not trace the source of their data. Her point here is that many
researchers using the claim that a high rate of children with autism are mentally
retarded are totally false and that they have not done their jobs properly.

3.) Were methods by which intelligence was assessed in the empirical studies valid
given the interference of autism on the process of intellectual assessment?

According to Edelson, the methods used to assess intelligence in many of the empirical
studies were completely inappropriate. In some cases, they borrowed the results from
epidemiological studies completed by other researchers and didn’t bother to check the
data for accuracy. Some researchers used developmental and adaptive tests to
measure intelligence, which we know they were not designed for that purpose. Also,
some examiners were untrained in administering IQ tests and were often unaware of
what autism was. The result being that they didn’t recognize that other medical
conditions may have affected the outcomes of the tests and that modifications may
have been necessary.

The data used to support the claim that there are high rates of MR in children with
Autism was over inflated and inaccurate at the best of times. The author cites an article
from 1937 which reported a prevalence rate of 30% and by 1970 that rate has ballooned
to 86%. The empirical data is often old and out of date and there is no way to re-
examine the original data that was used in order to check the accuracy of those claims.

Importance of the article

Edelson’s (2006) article is an attempt to dispel the myth that “a high rate of prevalence
of MR exists in children with Autism” and on the surface she does a grand job of it. She
examines the historical roots of several articles that continue to promote this false claim.
She has shown that many of these researchers have not done their due diligence and
simply repeated the old myth like a parrot in a zoo. She shows through her work that the
passing on of this hurtful idea and inaccurate concept continues, that Children with
Autism are Mentally Retarded, to the next generations of researchers. She even
produces evidence that articles as recent as 2003, that the claim of high rate of MR
continues to be bandied around amongst researchers trying to make a name for
themselves.

She suggests that researcher should use extreme caution when making these claims
against people with autism because of the damage they do to children with autism.
Researchers need to have experience with people with autism and should be aware of
the nature of the condition in order to make better recommendations. And that they
should use the correct assessment tools, so that their research can be accepted as
valid.