Gifted Issues Discussion homepage Forums Twice Exceptional Aspergers?, ADHD? and gifted?

We are still in the early stages of all of this, as my son is only 4...so seeking some insight from those with older kids who have been in our shoes possibly...the more I learn about giftedness and also aspergers, the more I feel my son may be twice exceptional. I could go on an on about the quirks/behavior difficulties we are dealing with. His memory is incredible and he thinks differently than your average 4 year old...The behavior issues are incredibly stressful for our entire family. He seems highly intelligent, but also has some extreme sensory needs and is very defensive/angry a lot. When he is in his realm though, he exceeds all of his peers in problem solving, logic and reasoning skills. A new doctor who specializes in kids on the spectrum did feel that after observing him that he does have some definite aspergers traits...looping conversations around to always be things he is interested in..perseverating on particular topics etc. He is incredibly hyperactive also, VERY impulsive...defensive...stubborn. The doctor also saw some traits of ADHD as well...Just incredibly trying for us as parents. The doctor is sending us for a psych consult in the next couple of months to hopefully get a diagnosis so we can better understand him. I want them to do IQ and giftedness testing also but not sure if they will do that right away or have to send him somewhere else after...

I guess my questions are for those with children with aspergers, and/or ADHD and giftedness , how did they present as 4 year olds? Any tips or things that helped manage the meltdowns, emotional highs and lows, impulsive behavior/sensory seeking behavior? How were you able to bring out the gifted side that you know is there? I feel that aspergers (if he indeed has it) is getting in the way of his giftedness...he gets stuck. How are these children doing later on into elementary school and beyond? He has social difficulties already...do they do ok academically? Can they function in life? It's so hard to imagine him being a rational well behaved child one day...just hoping we get there. Obviously some of this behavior may be typical 4 year old behavior but I feel he takes everything to the extreme.

I would give it a few years to see what happens.

Age 4 seems a bit young to get a good read on these issues.

Some people with these issues do just fine. Some don't. It depends on the person.

I think you need to see more than that to have Aspergers. DS is 7 and he's just now getting to the point where he understands that he is boring other people and refrains from going on and on about his idiosyncratic interests. Just last spring his speech therapist said she would turn his back on him while DS was babbling on (once going so far as to "hide" under the table from him) and DS would't even notice. Now just 6 months later his current IEP team (new people) is shocked that he was like that. They said it's actually an advanced skill for a 7 year old to realize whether they are boring their audience and what is appropriate to talk about with certain people (for instance other 7 year olds aren't interested in talking about Pearl Harbor).
DS walks on his toes sometimes and used to flap his hands and even with that the neuropsych who tested him said it's not enough. You need to fill out ASD inventories/checklists, look at things like "theory of mind" (there is a test for this), etc. The neuropsych who saw DS said a lot of clinicians diagnose based on superficial characteristics, so make sure you get a good eval. There are a lot of things that can cause extreme behavior. DD has ADHD for instance and has a lot of ups and downs and off the wall behavior. If your DS isn't that interested in other kids (4 year olds still don't necessarily play WITH each other that well, it's more parallel play), doesn't understand or enjoy social games, is obsessive about things (like needing to flip lights on and off), doesn't show signs of empathy, is very rigid about needing things to be a certain way--those would be red flags. I remember around age 1 1/2 or 2 DS was so quirky that I thought he might as well have ASD written on his forehead, but he would do things like give his sippy cup to another child who was crying and I knew he was probably developing normally. A lot of the quirks have decreased dramatically over time.

Yes I realize he is young and it will probably take years to figure out what exactly we are dealing with....It's tough, being our first born he seems older to me than just 4 because of the types of conversations we have. I feel he should be capable of more than he is, which I know I shouldn't have those expectations...it's hard with an intelligent kid who also does things you feel they should be able to control. It's also tough because we have been having these struggles and I have been wondering what is going on since before he turned 2...so it already seems like forever. I was just hoping at age 4 we could finally get a better grasp of what we are dealing with. The doctor seems to think now is the time to begin figuring it all out so that we can better help him (and us).

Glad to hear that some quirks have decreased over time...he just differs from his peers and trying to figure out why exactly that is...He never did really do the hand flapping. He has had some facial tics that he still does occasionally like opening his mouth wide, talking out of the side of his mouth...and likes to yell at the top of his lungs/blurt out loud phrases at deafening levels out of the blue just for fun. I worry of tourettes but not sure because he can control it at times so it seems... His eye contact is good and always has been. He can be very rigid/obsessive about things. He is a total perfectionist and can be OCD about things. If something doesn't go as anticipated or he can't do something the moment that it enters his mind, a full blown meltdown ensues. He does seem to have trouble with empathy...I constantly have to remind him that other people have feelings, that we can't just hit/shove etc. but I feel it falls on deaf ears. We have to repeat these concepts constantly all day long but he still does the behaviors. He will repeat what you say to appease you, but then do it again. Mostly he is just playing rough but he doesn't seem to be able to dial it down a few notches so that nobody gets hurt. It's just incredibly tough especially when he plays so rough with his younger sister and really doesn't seem to realize that he is hurting her. Stuff like that has me scratching my head...socially he likes to be around older kids but has difficulty with children his age or younger than him. Older kids keep his behavior in check better and I feel intellectually he has more in common with them so he gravitates towards them...He does like to be around other kids though and likes to have someone to play with...sometimes he can play appropriately with others and he seems like a normal kid. He has an imagination and likes to pretend things with others....Other times he does things that annoy other children and they don't want to play with him and his feelings get hurt...if his feelings get hurt or someone does something that doesn't go his way, he can get aggressive or angry. He isn't a joiner as far as some social activities, he can be shy...but I feel he has come out of his shell more recently and does enjoy active play like jump castles and playgrounds playing in groups of other children. Occasionally he can get rough with other kids in these situations but most of the time he does ok.

I know we won't really have any answers until the evaluation but just curious...yes I realize it has to be a really thorough evaluation and I trust this doctor and who he is sending us to. He said she does an extremely comprehensive detailed evaluation and he trusts her for all of the kids he sees. He is the best in our area as far as kids that are not neurotypical so I am thinking we are going to the best psych here. Although I may see if he can send us to someone else who specializes in testing for giftedness as well so we can also make sure we are picking up on anything else that may be going on if he is indeed gifted. It's just so hard to piece this all together and so tough at these younger ages. As a mom I know something is different with him and always has been.

Well - I've had a lot to say on this sort of topic recently. I'll consolidate it to this: We started down the assessment path when a well-meaning preschool teacher insisted DS (now 7) was Asperger's. We did ASD, SPD, ADHD, and anxiety assessments and others. My two cents is this: if you take a PG kid to a specialist in any of these areas, they will probably say, "Well - it's not a clear cut case, but there are several indications that he could be [X diagnosis]."

This is not because the assessor is bad or ineffective. It's because a PG kid has brain-wiring manifestations that present LIKE symptoms of all those other things. They may ALSO have those other things, but it's hard to tell when the PG kid is in the throes of asynchronous development.

And I don't use the word "throes" lightly. Early childhood is really, really tough for a PG kid and the kid's parents. You don't know (can't know) what is really going on but your kid feels broken and you feel an overwhelming need to help.

I have heard over and over from other HG/PG parents that (1) it becomes clearer as they grow, and (2) it becomes easier and the kids will be more functional and stable, emotionally and socially, as they grow.

I will tell you that this has been the case for my DS. If you read my other posts, you'll see that we are hardly out of the woods. My heart still seizes when I see the school caller ID on my phone! But - things are getting better and better. His "issues" are indeed both diminishing AND coming into clearer focus now, and it's easier for us to know how to support him.

You are smack in the middle of the time that was very hardest for us. When DS was between 4-6, he just had a very tough time. And so did his Dad and I. We survived by remembering that the problem is not always that "he won't." In fact, it's almost always that "he can't." Once you convince yourself to at least consider that point - it will help guide you to the best supports. And always know that he really is trying so hard to be good. So give him lots of unconditional love. Especially when he is having a bad day.

Lots of hugs to you,
Sue

What everyone else has said. Word for word. Four is worst. By six, things will get so much better. And especially what suevv said about HG kids and clear cut answers - you probably won't get them at this point.
What we did - a sort of functional approach, all trial and error:

Cut down social stimulation. One activity a day, period.
Ramp up intellectual stimulation.
Ramp up sensory diet (google that). And time outside, in nature!
A couple rounds of OT.
Fish oil, zinc, magnesium.
A low carb, high fat high protein diet, to regulate blood sugar.
Rewards for time periods without doing hurtful things to others (yanking my hair, maniacally),
Even after we had the "it's not ASD, but..." Diagnosis,I'd still read up on ASD strategies, figuring if it looks like ASD, ASD methods must help, and they did. If it looked more like sensory issues, we did sensory stuff. And so on.
And calm down, give it time. Eval periods are stressful, don't forget to enjoy the holidays. It won't be that bad.

Hi, my son is almost 5 and has an ASD diagnosis. I can agree with suevv in that the most helpful thing for me was to give up on the idea that he should be doing better and accept that he was doing his best. When I did this my stress went down. When my stress went down DS seemed to be happier and ended up doing a bit better.

I still am not confident that my son is on the spectrum. The experts who diagnosed him simply state that: ASD is the best diagnosis to explain his current difficulties. The diagnosis will get him the therapies he needs right now.

My son is terribly impulsive, rigid, oppositional, bossy, hyper, generally difficult. We started early intervention at 2 and he tested at 9 months for social development. At 2.5 we got an ASD diagnosis.

He is not like any of the other kids who have ASD in our community. He spoke early at 5 months and quickly ended up speaking in complex sentences. Testing at our ASD evaluation at 2.5 put his expressive language at over 4.5. Now at 4.5 he talks like an adult pretty much. He has a great imagination. He lags in play skills, but he can make up stories and come up with amazing ideas no problem. He does appear to have empathy, learned or natural I can't say, but he will run to help someone who needs help. He will also take out a baby who even looks like he might mess up something DS is working on.

My son gets PT and OT, 2 hours each per week. He has sensory issues and is clumsy in general. He has amazing fine motor skills though. He wants to play with the other kids. This is more recent. They don't always want to play with him though. He gets along a lot better with older kids and adults. I think this is because they are more predictable and follow rules better.

My son has been kicked out of 2 preschools and has a full time aide in his current preschool. 2.5 years of therapy, including behavioral therapy, was entirely ineffective. 4 months ago we found ourselves looking at getting kicked out of yet another school and very worried about the future.

We were desperate and our dev ped suggested Prozac. We were not yet ready to try medication. 2 months ago, we were. He had started biting again and was banging his head at school during meltdowns. My son has improved so much there are no words to describe it. Is he normal? No. But he can function now. The Prozac is to treat anxiety, he had lots of OCD symptoms and some tics on and off and was always so worked up about what awful thing might happen he never could enjoy himself. Now he is happy. Not all of the time and today was a rough day, but overall my son is happy. He no longer hits or pushes or bites or hurts himself.

Now I wonder if he really is ASD? Maybe it was anxiety? He's still super hyper. Maybe it's ADHD? Our dev ped says that anxiety and ADHD are often part of ASD and they still feel his diagnosis best captures where he is at right now. Just like any parent, I just want the best outcome for him as he grows up. It's difficult. There is nothing clear cut about any of this. DS is so amazingly advanced academically and so far behind socially I have no idea how he is ever going to manage to find his place in the world. We can only do our best to help them do their best.

I'm still in the same boat as you. Hopeful for some end to the difficulty. Waiting for my son to be old enough for IQ testing. Confused by everything. All of the other kids just run out onto a playground and start playing. Spontaneous and happy. That is what I want for my son. These days it even happens on occasion. He is just as likely to need to take a special path or to want to walk around to perimeter or to play on the bench the moms sit on rather than on the playground equipment or to use the wood chips to make math equations. If it's a playground we have been to before he is likely to go in order doing exactly what he did there the last time, which at one playground is counting all of the cutout circles in the metal platforms on the playground. How is that more fun than actually playing? It's frustrating for me. But I'm sure it is more frustrating for him.

What will we do with him when he starts school? He's not yet 5 and is academically at a 2nd grade level. And that is with minimal instruction. Basically we teach an idea and he runs with it. I taught him negative numbers and he immediately integrated it into his independent math play. He loves to read Magic Tree House and is obsessed with mazes. I now buy him adult maze books because he breezes through them so quickly. He makes mazes every time he touches a writing implement. He makes them out of everything. The other kids at preschool are learning their letters. I'm terrified of transition to K.

I guess there is no knowing where you will end up with kids like these. My son is so loving and wonderful at his good times that I just try not to think about the future any more than I have to. There are lots of books on autism and lots of books on giftedness. There isn't a lot on children who seem to combine the two. I don't know if my son is gifted yet, but I do know that his mind is amazing and entirely different from his peers. It's hard work raising children. It's really hard work raising special children. Just keep swimming.

"He will also take out a baby who even looks like he might mess up something DS is working on."

Hee hee. Same here. Or a girl with a screechy voice who looks like she might start singing "Let It Go."

Our DS (now 7) was pretty angry, impulsive, etc around that age. He spent a lot of time doing his own thing and resisting doing anything anyone else wanted, or following a schedule of any kind. He would be unable to keep himself from pushing buttons he was explicitly and nicely told not to. A very trying time. (We found The Difficult Child Workbook helpful, or at least it made us feel like we had a plan). For those years the best thing was focusing on anything positive he did, and trying to be understanding about all the rest. He mostly feels close to us and I didn't always think he would.

He has slowly improved over the last few years so that now much of the time no one would notice he's pretty different, more quirky. Teachers see him as anxious or perfectionist or having this or that minor behavioral thing, as exhausting maybe, but no one has come to us and said he needs evaluation for ASD. We have had comments on ADHD but that is usually adjustment and he figures out the routine and what to keep track of given a little extra time (ie at the beginning of the year most kids can organize their desk and know where things are after say the first 2 weeks, and DS takes 5 or 6 weeks of daily help from the teacher to get it down, but then he does).

Now we get more comments about the giftedness, teachers notice a child who remembers facts well and has things to add to the classroom discussion. Socially he's a mess but teachers don't care because he clearly tries hard and he's good at apologizing once his attention is drawn to a problem. Teachers also don't seem to listen too much to the actual content of the dialogue so if he seems to be chatting to other kids they assume he has no social issues with them.

For him being ill or tired or hungry are things that make him swing over the line that separates functional from not. It's just not much of a trip from one side of the line to the other. (He is tired right now -- yelling and throwing pencils away from his homework as I type, but it's Thursday night so to be expected for him).

So long term for us taking those 3 things very seriously has helped him maintain a "normal" child experience. Other kids maybe you can play catch up and feed them a cookie and have them ready to go out to some after school activity when they come home and shed a few tears about something that happened at school, but not DS. I just don't send him to school if he wakes up and seems like he's having an ASD/ADHD sort of morning, because I know that he's more prone to meltdowns on those days. I don't send him to school Monday am if he doesn't seem recovered yet from the previous week. We limit after school activities. We only have playdates on Sundays and Mondays when he's the best rested.

His schools have never complained about attendance, I think they can see what happens if I send him too tired, he has a meltdown and that's the last thing they want in class.

So it can be a struggle, but he likes school and goes all day and that makes us parents very relieved as we weren't sure that was a given when he was 4 or 5 or even 6.

He used to have to change all his worksheets mentally into whatever his interest was. He would pretend it was adding dinosaurs. It worked mostly. Now he finally just this year seems to have moved beyond that and can actually just do it without the rearrangement of it into his personal safety zone. That seemed to happen right around the time he turned 7.

I see school getting easier for him because: in a few years they will finally move to having their own desks and he struggles with the interpersonal issues created by rubbing elbows with random kids you didn't choose to sit next to at a claustrophobic tiny work table; there will be a little more academic content to focus on; there will be less emphasis on blurry group cut and paste projects, less get-to-know-you group activities, etc.

We did OT for over a year, I saw no difference. In fact the extra focus on fine motor skills seemed to make him hate writing even more. Maybe it just wasn't the right OT for him.

I have one of those and BTDT. DS12 has ASD with side helping of ADHD and is also PG.

Gifted kids with ASD are often misdiagnosed as not having ASD because their language skills can be exceptionally good. DS's verbal IQ is off the charts high-- which makes him not seem like typical Asperger's at all.


A lot like yours. When little girls came running up to me in the preschool to tell me (in an accusatory way) "what DS did today" I never knew whether it was going to be filling a whiteboard with math or biting someone. Or both.


Develop a zen-like calm. If you get riled, things will spiral more. Continue to teach him even in those moments that feel like a crisis.

Develop a sense of precisely what lessons and skills you want him to learn, and incentivize that like crazy. Break skills down into small steps as needed, and teach the steps.

Do not shy away from meltdown-inducing situations: teach him to tolerate the triggers.

Explicitly teach things that other kids seem to know ("no, we don't hit babies, here is how you touch a baby").


We did ABA therapy, which is tailored to the individual (and could therefore take advantage of the fact that gifted kids learn really, really fast).

As we got his reactivity and temper more under control (therapy and meds combined) it was obvious to everyone that the giftedness was a huge piece of the puzzle.


I think preschool through early elementary is the hardest period with a child like this.

This is DS12's best year at school ever and I expect things to continue to improve. He has really serious organizational issues, but every year his behavior has improved. He is getting along with people pretty well. He is loved by his teachers (he learns and is enthusiastic).

Our expectation is that he will continue to be a person who makes conspicuous mistakes, but at least he's learned to apologize really, really well. There are glimmers that he'll be a socially conscious, fair-minded adult with a full capacity for empathy and an excellent sense of humor. Work ethic remains to be seen, but he's 12!

Some of his perseverative interests are academic. That makes a difference, too.


I would recommend a neuropsychologist for this, preferably one at a children's hospital autism center or somewhere else where they've seen thousands of kids on the spectrum. That is where you will get the finest-grained reading on where he is.

IQ and achievement testing should be part of that workup. Note that kids with social skills issues often get wonky scores on these tests when they are young. If you remediate the ASD, the scores typically become more coherent and go up.


This is useful advice. Ours is very clearly ASD (loved spinning objects at age 6 mos.) What the dx got us was a genius case supervisor who made school really effective for DS so that the could learn throughout his day, every day. And who trained us to be the ninja parents DS needed. Couldn't have done this as well without him. A dx is just a tool.

DS is also happier since dx. Before he thought he was a badly behaved child, and he felt terrible about himself. After dx, he understood that "it's not his fault, but it's his challenge" to manage his behavior in accord with social norms. He likes who he is.

DeeDee