What Is the Triad of Impairments?

The triad of impairments divides characteristics seen in people with autistic spectrum disorder into three categories. Emotional or social impairment, inflexibility in thought and imagination, and difficulty in communication or language make up the triad of impairments linked to this disorder. Behaviors defined in the triad of impairments usually show up during the first three years of life.

Social impairments might cause difficulty in making friends or acceptance by peers. The autistic child might not pick up social cues or non-verbal body language of inappropriate behavior. In severe cases, the child might be totally indifferent to others and reject being held or touched. An older child might exhibit odd behavior in social settings and become a loner after repeated rejection. If depression sets in, it might lead to further withdrawal from social interaction.

The communication component of the triad of impairments usually first appears as delayed speech in early childhood, except in children with Asperger syndrome. As these children mature, they may suffer trouble expressing feelings and communicate inappropriately. They commonly take words literally and fail to understand puns or figures of speech. Some children verbalize thoughts in an attempt to organize ideas and process information.

Socially inappropriate communication might involve approaching total strangers to talk about a topic of interest to the person with autism. During the monologue, he or she typically fails to read facial expressions of boredom or lack of interest. The inability to feel empathy might contribute to this type of behavior. Interrupting while others speak or making rude or offensive comments describe other impairments in communication. When someone reacts with hurt feelings, the concept might be totally foreign to a person with autism.

Lack of imagination and inflexibility in thought make up the final components in the triad of impairments. Children with autism show trouble pretending during play, such as playing house or cowboys and Indians. They commonly focus more on reality and concrete objects when playing. A toy gun makes a suitable plaything, but they typically cannot imagine a stick representing a toy gun.

These children might practice rituals or become obsessed with a single subject, sometimes showing exceptional abilities in that area. Variations in routine might cause distress, leading to an overreaction. Along with ritualistic behavior, the autistic child might rock, repeatedly tap his or her fingers, or arrange objects in a precise order.