Epilogue: Conclusions and Future Directions

  • Hefziba Lifshitz


This final chapter discusses some conclusions drawn from the previous chapters as well as three novice topics that are currently at the core of continuing research efforts: (a) brain lateralization for language in adults with ID, (b) giftedness in ID, and (c) the implications of the CAT for persons with ID on the autism spectrum. The common denominator of the first two issues is a vision of persons with ID that extends beyond their disability and underscores compensation age theory. Contrary to previous studies, the emerging brain lateralization research indicates typical brain lateralization for linguistic perception among adults with ID. Giftedness research is also trying to map a novel perspective on ID – the cognitive profile of gifted persons with ID in diverse domains. Autism research aims to find out whether the developmental trajectories of individuals with comorbid ID and ASD demonstrate compensation with age into adulthood.


Brain lateralization for language in ID Giftedness in ID Cognitive trajectory Adults with comorbid ID and autism spectrum disorder 


  1. Alut. (2019). Alut: The Israeli Society for Children and Adults with Autism. Retrieved from
  2. American Psychiatric Association [APA]. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington, DC: Author.CrossRefGoogle Scholar
  3. Bishop, D. V. M. (1990). Handedness and developmental disorders. Oxford, UK: Blackwell Scientific.Google Scholar
  4. Bölte, S., Dziobek, I., & Poustka, F. (2009). Brief report: The level and nature of autistic intelligence revisited. Journal of Autism and Developmental Disorders, 39(4), 678–682. Scholar
  5. Bourne, V. J. (2006). The divided visual field paradigm: Methodological considerations. Laterality, 11(4), 373–393. Scholar
  6. Carpenter, P. A., Just, M. A., & Shell, P. (1990). What one intelligence test measures: A theoretical account of the processing in the Raven Progressive Matrices test. Psychological Review, 97(3), 404–431. Scholar
  7. Chen, I., Lifshitz, H., & Vakil, E. (2017). Crystallized and fluid intelligence of adolescents and adults with intellectual disability and with typical development: Impaired, stable or compensatory trajectories? The Grant Medical Journals Psychiatry, 2(5), 104–115. Retrieved from Scholar
  8. Cohen, B.-E. (2017). Laterlizatziyah mohit ve’shituf pe’ulah ben ha’hemisferot ba’hahlatah leksikalit, bekerev bogrim im mugbalut sicklit lelo eti’ologiah spezifit, ve’bogrim im tismonet da’un be’hashva’ah le’bogrim im hitpat’hut takinah [Brain lateralization and cooperation between the hemispheres within a lexical decision, among intellectually disabled without a specific etiology, and amongst those with Down’s syndrome, in comparison to adults with regular development] (Unpublished master’s theses). School of Education, Bar Ilan University, Ramat-Gan.Google Scholar
  9. Courchesne, E., Campbell, K., & Solso, S. (2011). Brain growth across the life span in autism: Age-specific changes in anatomical pathology. Brain Research, 1380, 138–145. Scholar
  10. Courchesne, E., Pierce, K., Schumann, C. M., Redcay, E., Buckwalter, J. A., Kennedy, D. P., & Morgan, J. (2007). Mapping early brain development in Autism. Neuron, 56(2), 399–413. Scholar
  11. Dawson, M., Soulieres, I., Gernsbacher, M. A., & Mottron, L. (2007). The level and nature of autistic intelligence. Psychological Science, 18(8), 657–662. Scholar
  12. Delis, D., Kaplan, E., & Kramer, J. (2001). Delis-Kaplan executive function system. New York, NY: The Psychological Corporation.Google Scholar
  13. Disabled Photographers’ Society. (n.d.). About us. Retrieved from
  14. Down, J. L. (1887). On some of the mental affections of childhood and youth: Being the Lettsomian lectures delivered before the Medical Society of London in 1887 together with other papers. London, UK: Churchill.Google Scholar
  15. Duncan, J. (2001). An adaptive coding model of neural function in prefrontal cortex. Nature Reviews. Neuroscience, 2(11), 820–829. Scholar
  16. Dunn, L. M., & Dunn, D. M. (1997). Peabody picture vocabulary test (3rd ed.). Circle Pines, MN: American Guidance Service.Google Scholar
  17. Durant, K. [KDTrey5] (2012, January 4). My favorite quote is “Hard work beats talent when talent fails to work hard”. Following that has helped me reach my goals #WinFromWithin [Tweet]. Retrieved from
  18. Elkoshi, R. (2015). Children’s invented notations and verbal responses to a piano work by Claude Debussy. Music Education Research, 17(2), 179–200. Scholar
  19. Elliott, D., Weeks, D. J., & Chua, R. (1994). Anomalous cerebral lateralization and Down syndrome. Brain and Cognition, 26(2), 191–195. Scholar
  20. Facon, B., & Facon-Bollengier, T. (1997). Chronological age and Peabody Picture Vocabulary Test performance of persons with mental retardation: New data. Psychological Reports, 81, 1232–1234. Scholar
  21. Facon, B., & Facon-Bollengier, T. (1999). Chronological age and crystallized intelligence of people with intellectual disability. Journal of Intellectual Disability Research, 43(6), 489–496. Scholar
  22. Feuerstein, R. (2003). Feuerstein’s theory of cognitive modifiability and mediated learning. In T. O. Seng, R. D. Parsons, S. L. Hinson, & D. S. Brown (Eds.), Educational psychology: A practitioner-researcher approach (pp. 59–60). Singapore, Singapore: Seng Lee.Google Scholar
  23. Feuerstein, R., & Rand, Y. (1974). Mediated learning experiences: An outline of the proximal etiology for differential development of cognitive functions. In L. Goldfien (Ed.), International understanding: Cultural differences in the development of cognitive processes (pp. 7–37). New York, NY: Guilford.Google Scholar
  24. Fisher, M. A., & Zeaman, D. (1970). Growth and decline of retarded intelligence. International Review of Research in Mental Retardation, 4, 151–191. Scholar
  25. Gagné, F. (1999). My convictions about the nature of human abilities, gifts and talents. Journal for the Education of the Gifted, 22(2), 109–136. Scholar
  26. Gagné, R. M. (1985). The conditions of learning and theory of instruction (4th ed.). New York, NY: Holt, Rinehart & Winston.Google Scholar
  27. Gardner, H. (1983). Frames of mind: The theory of multiple intelligences. New York, NY: Basic Books.Google Scholar
  28. Giencke, S., & Lewandowski, L. (1989). Anomalous dominance in Down syndrome young adults. Cortex, 25(1), 93–102. Scholar
  29. Gottfredson, L. S. (2003). Dissecting practical intelligence theory: Its claims and evidence. Intelligence, 31(4), 343–397. Scholar
  30. Green, V., & Auslander, G. (2004). Hakesher ben reshet hevratit formalit le’ven eyckut hahayim shel zkenim hamugbalim be’tifkud [The connection between the formal social network and the quality of life in the function-limited elderly]. Gerontologia [Gerontology], 31(1), 11–31.Google Scholar
  31. Greimel, E., Schulte-Rüther, M., Fink, G. R., Piefke, M., Herpertz-Dahlmann, B., & Konrad, K. (2010). Development of neural correlates of empathy from childhood to early adulthood: An fMRI study in boys and adult men. Journal of Neural Transmission, 117(6), 781–791. Scholar
  32. Grouios, G., Ypsilanti, A., & Koidou, I. (2013). Laterality explored: Atypical hemispheric dominance in Down syndrome. In K. D. Subrata (Ed.), Down syndrome (pp. 209–236). Rijeka, Croatia: InTech.Google Scholar
  33. Happé, F., & Charlton, R. A. (2012). Aging in autism spectrum disorders: A mini-review. Gerontology, 58(1), 70–78. Scholar
  34. Hayashi, M., Kato, M., Igarashi, K., & Kashima, H. (2008). Superior fluid intelligence in children with Asperger’s disorder. Brain and Cognition, 66(3), 306–310. Scholar
  35. Heath, M., & Elliott, D. (1999). Cerebral specialization for speech production in persons with Down syndrome. Brain and Language, 69(2), 193–211. Scholar
  36. Horn, J. L. (1991). Measurement of intellectual capabilities: A review of theory. In K. S. McGrew, J. K. Werder, & R. W. Woodcock (Eds.), Woodcock-Johnson technical manual: A reference on theory and current research (pp. 197–256). Allen, TX: DLM Teaching Resources.Google Scholar
  37. Horn, J. L., & Cattell, R. B. (1966). Refinement and test of the theory of fluid and crystallized general intelligences. Journal of Educational Psychology, 57(5), 253–270. Scholar
  38. Howe, M. (1989). Fragments of genius: The strange feats of idiots savants. London, UK: Routledge.Google Scholar
  39. Howe, M. J., Davidson, J. W., & Sloboda, J. A. (1998). Innate talents: Reality or myth. Brain and Behavioral Sciences, 21(3), 399–442. Scholar
  40. Hwang, Y. I., Foley, K. T., & Trollor, J. N. (2018). Aging well on the autism spectrum: An examination of the dominant model of successful aging. Journal of Autism and Developmental Disorders. Advance online publication.
  41. Ingram, J. C. L. (2007). Neurolinguistics: An introduction to spoken language processing and its disorders. Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
  42. James, I. A., Mukaetova-Ladinska, E., Reichelt, F. K., Briel, R., & Scully, A. (2006). Diagnosing Aspergers syndrome in the elderly: A series of case presentations. International Journal of Geriatric Psychiatry, 21(10), 951–960. Scholar
  43. Jończyk, R. (2015). Hemispheric asymmetry of emotion words in a non-native mind: A divided visual field study. Laterality, 20(3), 326–347. Scholar
  44. Kapur, N. (1996). Paradoxical functional facilitation in brain-behavior research: A critical review. Brain, 119(5), 1775–1790. Scholar
  45. Katzman, R. (1993). Education and the prevalence of dementia and Alzheimer’s disease. Neurology, 43(1), 13–20. Scholar
  46. Kavé, G., Kukulansky-Segal, D., Avraham, A., Herzberg, O., & Landa, J. (2010). Searching for the right word: Performance on four word-retrieval tasks across childhood. Child Neuropsychology, 16(6), 549–563. Scholar
  47. Klin, A., Volkmar, F. R., Sparrow, S. S., Cicchetti, D. V., & Rourke, B. P. (1995). Validity and neuropsychological characterization of Asperger syndrome: Convergence with nonverbal learning disabilities syndrome. Journal of Child Psychology and Psychiatry, 36(7), 1127–1140. Scholar
  48. Lezak, M. D. (1983). Neuropsychological assessment (2nd ed.). New York, NY: Oxford University Press.Google Scholar
  49. Lifshitz, H., Bustan, N., & Shnitzer-Meirovich, S. (2018). Endogenous and exogenous factors as predictors of crystallized and fluid intelligence among adolescents and adults with Down syndrome. Manuscript submitted for publication.Google Scholar
  50. Lifshitz, H., Riger, M., Schwartz, T., & Ankori, R. (2019). Global or domain-specific giftedness in adults with ID: Academic and occupational frontiers in plastic arts, sports, music, photography, and theater. Manuscript submitted for publication.Google Scholar
  51. Lifshitz, H., Tzemach, M., Zachor, D. A., & Vakil, E. (2019). Cognitive trajectories from adolescence to adulthood among adults with ASD. Manuscript submitted for publication.Google Scholar
  52. Lifshitz-Vahav, H. (2015). Compensation Age Theory (CAT): Effect of chrono-logical age on individuals with intellectual disability. Education and Training in Autism and Developmental Disabilities, 50(2), 142–154.Google Scholar
  53. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Jr., Leventhal, B. L., DiLavore, P. C., … Rutter, M. (2000). The Autism Diagnostic Observation Schedule—Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223. Scholar
  54. Mashal, N., Yankovitz, B., & Lifshitz, H. (2019). Lexical decision performance using the divided visual field technique following training in adults with intellectual disabilities with and without Down syndrome. Laterality: Asymmetries of Body, Brain and Cognition, 11, 1–21. Scholar
  55. Mayer, J. (n.d.). John Mayer quotes. Retrieved from
  56. Miller, L. K. (1999). The savant syndrome: Intellectual impairment and exceptional skill. Psychological Bulletin, 125(1), 31–46. Scholar
  57. Miller, L. K. (2005). What the savant syndrome can tell us about the nature and nurture of talent. Journal of Education of the Gifted, 28(3–4), 361–373. Scholar
  58. Minshew, N. J., Sweeney, J., & Luna, B. (2002). Autism as a selective disorder of complex information processing and underdevelopment of neocortical systems. Molecular Psychiatry, 7(Suppl. 2), S14–S15. Scholar
  59. Morsanyi, K., & Holyoak, K. J. (2010). Analogical reasoning ability in autistic and typically developing children. Developmental Science, 13(4), 578–587. Scholar
  60. MOSA Museum in Washington State. (2019). About us. Retrieved from
  61. Mottron, L., Dawson, M., & Soulières, I. (2009). Enhanced perception in savant syndrome: Patterns, structure and creativity. Philosophical transactions of the Royal Society of London: Series B. Biological sciences, 364(1522), 1385–1391. Scholar
  62. Mukaetova-Ladinska, E. B., Perry, E., Baron, M., & Povey, C. (2012). Ageing in people with autistic spectrum disorder. International Journal of Geriatric Psychiatry, 27(2), 109–118. Scholar
  63. National Association for Gifted Children [NAGC]. (2010). Redefining giftedness for a new century: Shifting the paradigm. Retrieved from
  64. Neisser, U. (1998). Introduction: Rising test scores and what they mean. In U. Neisser (Ed.), The rising curve: Long-term gains in IQ and related measures (pp. 3–22). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  65. Oberman, L. M., Enticott, P. G., Casanova, M. F., Rotenberg, A., Pascual-Leone, A., & McCracken, J. T. (2016). Transcranial magnetic stimulation in autism spectrum disorder: Challenges, promise, and roadmap for future research. Autism Research, 9(2), 184–203. Scholar
  66. Oberman, L. M., & Pascual-Leone, A. (2014). Hyperplasticity in Autism Spectrum Disorder confers protection from Alzheimer’s disease. Medical Hypotheses, 83(3), 337–342. Scholar
  67. Oliver, M. (1990). The politics of disablement. London, UK: Macmillan.CrossRefGoogle Scholar
  68. Oss, M. E. (2018, November 29). Adults with autism: A growing population and opportunity. Open minds – Executive briefing. Retrieved from
  69. Paivio, A. (1971). Imagery and verbal processes. New York, NY: Holt, Rinehart & Winston.Google Scholar
  70. Paivio, A. (1991). Dual coding theory: Retrospect and current status. Canadian Journal of Psychology, 45, 255–287. Scholar
  71. Paivio, A. (1995). Imagery and memory. In M. S. Gazzaniga (Ed.), The cognitive neurosciences (pp. 977–986). Cambridge, MA: MIT Press.Google Scholar
  72. Perrone-Bertolotti, M., Lemonnier, S., & Baciu, M. (2013). Behavioral evidence for inter-hemispheric cooperation during a lexical decision task: A divided visual field experiment. Frontiers in Human Neuroscience, 7, 316. Scholar
  73. Pipe, M.-E. (1988). A typical laterality and retardation. Psychological Bulletin, 104(3), 343–349. Scholar
  74. Piven, J., & Rabins, P. (2011). Autism spectrum disorders in older adults: Toward defining a research agenda. Journal of the American Geriatrics Society, 59(11), 2151–2155. Scholar
  75. Plerou, A., & BoBori, C. (2015). Memory disorders within the frame of algorithmic thinking: Brain imaging evidence. The 15th IEEE International Symposium on Signal Processing and Information Technology ISSPIT, 2015, 381–386. Scholar
  76. Powell, S. P., Klinger, L. G., & Klinger, M. R. (2017). Patterns of age-related cognitive differences in adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(10), 3204–3219. Scholar
  77. Raven, J. C. (1936). Guide to using the Colored Progressive Matrices, Set A, Ab, and B. London, UK: H. K. Lewis.Google Scholar
  78. Raven, J. C., Court, J. H., & Raven, J. (1986). Manual for Raven’s Progressive matrices and vocabulary scales. London, UK: H. K. Lewis.Google Scholar
  79. Redcay, E., & Courchesne, E. (2005). When is the brain enlarged in autism? A meta-analysis of all brain size reports. Biological Psychiatry, 58(1), 1–9. Scholar
  80. Reis, S. M., Schader, R., Shute, L., Don, A., Milne, H., Stephens, R., & Williams, G. (2000, Fall). Williams syndrome: A study of unique musical talents in persons with disabilities. National Research Center on the Gifted and Talented Newsletter. Retrieved from
  81. Reiss, S., & Havercamp, S. M. (1998). Toward a comprehensive assessment of fundamental motivation: Factor structure of the Reiss profiles. Psychological Assessment, 10(2), 97–106. Scholar
  82. Renzulli, J. S. (1978). What makes giftedness. Phi Delta Kappan, 60(3), 180–184.Google Scholar
  83. Renzulli, J. S. (2012). Reexamining the role of gifted education and talent development for the 21st century: A four-part theoretical approach. Gifted Child Quarterly, 56(3), 150–159. Scholar
  84. Rey, A. (1964). L’Examen Clinique en psychologie [The clinical examination in psychology]. Paris, France: Presses Universitaires de France.Google Scholar
  85. Sanders, L. (2014, July 2). Autism may carry a benefit: A buffer against Alzheimer’s: Brain plasticity of people with the developmental disorder may protect them from dementia. ScienceNews. Retrieved from
  86. Satz, P. (1993). Brain reserve capacity on symptom onset after brain injury: A formulation and review of evidence for threshold theory. Neuropsychology, 7(3), 273–295. Scholar
  87. Scarmeas, N., & Stern, Y. (2003). Cognitive reserve and lifestyle. Journal of Clinical and Experimental Neuropsychology, 25(5), 625–633. Scholar
  88. Shafran, L., & Harel, G. (2017). Chelek 4: Anashim im otizem [Persons with autism]. In Y. Zaba (Ed.), Skirat ha’sherutim ha’chevratiyim [Review of social services] (pp. 447–460). Jerusalem, Israel: Ministry of Labor, Social Affairs and Social Services.Google Scholar
  89. Smith, L. E., Maenner, M. J., & Seltzer, M. M. (2012). Developmental trajectories in adolescents and adults with Autism: The case of daily living skills. Journal of the American Academy of Child & Adolescents Psychiatry, 51(6), 622–632. Scholar
  90. Soulières, I., Dawson, M., Gernsbacher, M. A., & Mottron, L. (2011). The level and nature of Autistic intelligence II: What about Asperger syndrome? PLoS One, 6(9).
  91. Soulières, I., Dawson, M., Samson, F., Barbeau, E. B., Sahyoun, C. P., Strangman, G. E., … Mottron, L. (2009). Enhanced visual processing contributes to matrix reasoning in autism. Human Brain Mapping, 30(12), 4082–4107. Scholar
  92. Sparrow, S. S., Cicchetti, D. V., & Saulnier, C. A. (2016). Vineland™-3: Vineland adaptive behavior scales (3rd ed.). London, UK: Pearson Clinical. Retrieved from Scholar
  93. Stern, Y., Habeck, C., Moeller, J., Scarmeas, N., Anderson, K. E., Hilton, J., … van Heertum, R. (2005). Brain networks associated with cognitive reserve in healthy young and old adults. Cerebral Cortex, 15(4), 394–402. Scholar
  94. Stern, Y., Zarahn, E., Hilton, H. J., Delapaz, R., Flynn, J., & Rakitin, B. (2003). Exploring the neural basis of cognitive reserve. Journal of Clinical and Experimental Neuropsychology, 25(5), 691–701. Scholar
  95. Sternberg, R. J. (1985). Beyond IQ: A triarchic theory of human intelligence. New York, NY: Cambridge University Press.Google Scholar
  96. Sternberg, R. J. (1997). A triarchic view of giftedness: Theory and practice. In N. Coleangelo & G. A. Davis (Eds.), Handbook of gifted education (pp. 43–53). Boston, MA: Allyn and Bacon.Google Scholar
  97. Tannenbaum, A. J. (1960). Adolescents’ attitudes toward academic brilliance (Unpublished doctoral dissertation). Columbia University, New York, NY.Google Scholar
  98. Terman, L. M. (1916). The measurement of intelligence. New York, NY: Arno.CrossRefGoogle Scholar
  99. Treffert, D. A. (2009). The savant syndrome: An extraordinary condition. A synopsis: Past, present, future. Philosophical Transactions of the Royal Society of London: Series B. Biological Sciences, 364(1522), 1351–1357. Scholar
  100. Treffert, D. A. (2014). Savant syndrome: Realities, myths and misconceptions. Journal of Autism and Developmental Disorders, 44(3), 564–571. Scholar
  101. United Nations. (2006). Convention on the rights of persons with disabilities. Retrieved from
  102. van Niekerk, M. E. H., Groen, W., Vissers, C. T., van Driel-de Jong, D., Kan, C. C., & Oude Voshaar, R. C. (2011). Diagnosing autism spectrum disorders in elderly people. International Psychogeriatrics, 23(5), 700–710. Scholar
  103. Visser, B. A., Ashton, M. C., & Vernon, P. A. (2006). Beyond “g”: Putting multiple intelligences theory to the test. Intelligence, 34(5), 487–502. Scholar
  104. Wechsler, D. (1991). Wechsler intelligence scale for children: WISC-III (3rd ed.). San Antonio, TX: Psychological Corporation.Google Scholar
  105. Wechsler, D. (1997). Manual for the Wechsler Adult Intelligence Scale – Third edition (WAIS-III). San Antonio, TX: Psychological Corporation.Google Scholar
  106. Wechsler, D. (2001). Mivchan inteligenzia le’mevugarim – Girsa ivrit [WAIS-IIIHEB: Manual of administration and scoring]. Jerusalem, Israel: PsychTech.Google Scholar
  107. Wilson, R. S., & Bennett, D. A. (2005). Assessment of cognitive decline in old age with brief tests amenable to telephone administration. Neuroepidemiology, 25(1), 19–25. Scholar
  108. Wolfensberger, W. (2002). Social role valorization and, or versus, ‘empowerment’. Mental Retardation, 40(3), 252–258.<0252:SRVAOV>2.0.CO;2CrossRefPubMedGoogle Scholar
  109. Woodcock, R. W., Mather, N., & McGrew, K. S. (2001). Woodcock-Johnson III tests of cognitive ability. Itasca, IL: Riverside.Google Scholar
  110. World Health Organization [WHO]. (2004). ICD-10: International statistical classification of diseases and related health problems: Tenth revision (2nd ed.). Geneva, Switzerland: Author.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Hefziba Lifshitz
    • 1
  1. 1.Head of MA Program in Intellectual Disability, School of EducationBar-Ilan UniversityRamat GanIsrael

Personalised recommendations