Gifted Issues Discussion homepage Forums Twice Exceptional When is it more than just being gifted?

I am starting to become extremely concerned with my daughter who will be 4 at the end of this month. We took at her to a psychologist at the age of 3 because of her behaviors. She had already been diagnosed with SPD but she also had problems with temper tantrums that would last for hours, the inability to snap back to "normal" after her fits, short temper, auditory stimulation by using a monotone hum when doing anything that requires concentration, and very rigid and routine behaviors like having to count her steps every night from the exact same spot before she could go to bed. She also had an intense obsession with the color yellow and if anyone touched something yellow, she became very upset because that was her color and they might ruin it. Those are just a few examples. The psychologist, to our surprise, gave her an IQ test and sure enough, her scores put her well into the gifted category. He explained that many of her behavior could be attributed to her giftedness and that at that time, he did not see ASD but wasn't ruling it out either. Just a little sidenote, my son (2.5) was diagnosed with Autism and Hyperlexia by the same psychologist.

Fast forward to now, almost a year later. Some of her former behaviors, like counting her steps and obsessing over yellow have gone away. She still has the monotone hum and some sensory issues, especially with what I'm thinking may be hyperacusis. Her fits are still horrible and actually worse as they are starting to become more violent and verbal. She is unable to pull herself together and will shut down for hours. Sometimes we cannot even talk about the problem that set her off until the next day. Generally the things that set her off are minor but she has everything sequenced out in her brain if the sequence is broken, she loses it. It can be something as little as putting the left shoe on before the right. She has control issues as well and gets upset about things like people not walking orderly on the left or right sides of hallways or the sun not coming up at the exact time she wanted it too. No matter how hard I try, I cannot convince her that it's going to be ok and we cannot control everything in our world. There are days it's just too hard to leave the house because I fear the world will be too chaotic for her that day and not only do I have to deal with her meltdown, but I've also got my Autistic son to deal with which is stressful in itself.

When her IQ testing was preformed, there was some concern in her scores indicating there might be an issue with listening comprehension. I would have just chalked it up to age but she really does have issues with understanding what is being said to her. I took her in for an eval with an SLP who said she did have some auditory perception issues. She is currently in therapy for that.

Every therapist we have seen has said she is too young for an Asperger's dx but that it cannot be ruled out. What has me and everyone else thrown off though is how overly social she is. When I say overly social, I mean the kind of kid who smothers you and won't shut up for two seconds. She is so social, that it's actually awkward. If you have ever seen the movie Autism: The Musical, she is much like Wyatt in how talkative she is. She sustains eye contact, at least from what I can tell.

At what point does it go from just being issues stemming from giftedness to something more? Any clue what is going on here? Or is this typical behavior for a gifted a preschooler? Having a young gifted child is isolating but having one who is gifted with extreme behavior issues feels like living in a dark cave. I am so desperate for help.

It sounds like much more is going on than being gifted - do you think the evaluator you took your dd to previously understands that children can be intellectualy gifted plus have a disability all wrapped up in the same child? I am not sure that you're dd is too young for an Asperger's diagnosis, I have a friend who's child was diagnosed much younger than your dd. Have you thought about yet another eval or opinion? Do you need a diagnosis at this point in time - for yourself? For school?

I also have some skepticism about IQ tests on very young children - each of my two oldest kids had IQ tests when they were young. My older dd had her first IQ test at 4 when she was suffering from extreme anxiety. Her test came out quite high - a later test when she was in 2nd grade showed the same patterns in her subtest scores but the actual scores came in lower overall. Our ds, otoh, has had extremely consistent results each time he's had his IQ tested... but he has a disability tied to his processing speed, and when he had his first IQ test at 5 (for admission to a gifted program), that discrepancy showed up clearly and the evaluator shrugged it off as "he's just a slowpoke by nature" and it wasn't until two years later when ds was about to completely melt down from anxiety that a different professional, looking at the same pattern, saw that it was a red flag for a possible disability.

polarbear

The guy we took her too is supposedly the go to guy for Autism and IQ in this region of the state. He thought the scores actually came out to low (even though they are not low as far as IQ goes) and her SLP also believes they are too low based on other scores from non- IQ tests (like PPVT) as well as her abilities. Truthfully, that kind of scares me!

Even my son's therapists who have gotten to know my daughter say they wouldn't rule out Asperger's but they aren't sure that's what it is either. I see her at her worst and wonder if they did too that they would then think that yes, she is somewhere on the spectrum.

Can ASD kids be overly social? She loves to cuddle and will talk to everyone and says everyone is her friend but like I said earlier, it's awkward because it is so over the top.

She is so much like her brother yet she isn't. I can't quite put my finger on it and apparently neither can any professional! I guess I need the diagnosis for myself simply to figure out how to help her. We are out of ideas as nothing seems to really work to help her with some of her more troubling issues.

It sounds like there is more going on to me, I wonder whether the extent of it might be due to her being a girl and gifted? Either of those things can make other issues like ADHD or ASD harder to diagnose, both together and you really want to be consulting with someone who is very experienced with 2E kids.

Isn't there some hypersocial spectrum-esque diagnosis out there somewhere?

I remember seeing that on one of the Discovery Health shows I used to watch before it became the 24-hour Oprah channel.

We cross posted. My understanding is that yes you can get extroversion and Aspergers - the result being awkward interactions because they child still can't figure out the social cues any more than if they were introverted.

For what it is worth we are waiting for an ASD assessment for our 9yr old daughter. She's extroverted and makes eye contact and has great empathy, but she only shows that empathy in situations of overt need as she doesn't notice it's needed until there is screaming, crying, blood, etc. A sad face would be unlikely to result in a hug.

I am searching right now for anything related to being hypersocial and autism but am coming up empty handed. I just keep finding articles about ADHD (I guess that could be a possibility) and Williams Syndrome which I'm 99.9% sure she doesn't have.

It could have been Williams Syndrome they were talking about. I honestly can't recall. It would seem to be pretty easy to see if someone has that problem, if Wikipedia is accurate.

Aren't there a number of autism related sensory processing disorders, too?

Was there any mention made of anxiety with her evaluations? I ask because my friend's daughter has severe anxiety and it manifests in intense control issues and tantrums/fits that escalate beyond what I would adequately describe in a post. They are literally held hostage by her behaviour. The littlest of things can set her off and then it is like watching a train about to derail... you can see it coming but you can't do a thing to stop it.

I wish I had more to add or offer. ((hugs))

I am so very out of my realm of experience, but as I read your posts my first thought was that some of her behaviors remind me of a relative who has OCD. The behavior includes being very talkative/monopolizing a conversation, as well as being very social.

I wish this was easier for you, and every parent who is trying to figure out what's going on with a child, based on their behavior. My heart goes out to you, as your situation sounds really challenging. I hope you have people nearby to lean on. And I hope you find some help here on the board, as well.

It does sound OCD-ish.

That should be relatively easy for a good psychologist/psychiatrist to rule out.

Hi, Utkallie,

Yes, this sounds like some form of 2E. The severity of your DD's reactions to things is not typical (and if you think about it, very disabling for her)-- I'd want to follow up, especially with the family history.

This sort of thing is very difficult to sort out: for instance, autism can come with shades of OCD/anxiety and shades of ADHD mixed in, so it's hard for a lay person to make a good armchair diagnosis. A thorough neuropsych exam would help you figure it out. Girls with autism are missed more often than boys, they often present very differently, so they need to be looked at closely before ruling anything out. Can you find a practitioner who's seen lots of girls with autism? Our children's hospital does a pretty good job.

As you probably know, it is a disadvantage to postpone a diagnosis if one is to be made-- the delay prevents you from establishing services right away. I can see how the psych may not have wanted to diagnose when she was 3 if he wasn't sure, but given the severity of the behaviors, it seems highly likely to me that there is something real there that should be addressed sooner rather than later.

My DS9 is a pretty extroverted, gifted kid with Asperger's/ autism. He has trouble with maintaining personal space (gets too close or stays too far away, touches people when they're not expecting it, doesn't notice they're not interested in his interests). He loves having friends but has trouble maintaining the reciprocity that comes with friendship. It's pretty hard for him, but therapy has helped enormously.

BTW, the Asperger's diagnosis is going to go away in the next DSM-- it will be lumped in with the other kinds of autism. The idea that Asperger's "shouldn't" or "can't" be diagnosed early is just based on the fact that it usually *isn't* caught early (because of the normal to high IQ feature). That doesn't mean it's not diagnosable at a young age-- the signs are all there-- just that we have a ways to go in getting people to understand what those signs look like in a bright kid, especially a bright girl.

I also recommend the OASIS website and parent forum-- there are wise and helpful people over there. http://www.aspergersyndrome.org/Home.aspx

Best wishes,
DeeDee

MumOfThree,

Your daughter could certainly be gifted with Asperger's. The description is very similar to my DS7, who was hyperlexic (read at 21 months), had impossible tantrums similar to what you describer, and has always been intensely outgoing, affectionate, and inclined to assume that everyone wanted to be his friend. Through some wonderful interventions and amazing therapeutic programs, he is doing extremely well now, though it is still challenging, and his pain can cut me to the quick sometimes. He is learning about friendships, but as other people here have described, it is a skillset that he must be taught painstakingly. I was saying to him just the other night, that he needs to remember that it isn't unfair that he gets to do 3rd grade math and 4th grade enrichment while he's in 1st grade, because the other kids who find math extremely difficult to learn (he just stares at me in horror) have mostly had a very easy time learning how to make friends and calm themselves down, which he has always needed help with. And just as the other kids WILL learn math and reading and writing in script, so he is gradually learning these skills. And as with math, the skill will get stronger through teaching and practice.

He knows about his ADHD (easier to explain, and I have it myself, so it gives him a point of identification with Dad), but we haven't told him he has Asperger's per se (he's an oversharer, so we don't need him hanging that label out for all to see right now). But he understands these issues and that he has them, so when the time comes to go into the specifics, I don't think it will be much of a bomb to drop. Truth to tell, by the time we have that conversation, his diagnostician may not be able to formally say he present Asperger's symptoms anymore. In the past year, several people who have experience with Asperger's in adults or older kids have questioned us when we mentioned it.

And yes, he really does have it--but that's the thing. Particularly with PG kids like this, the labels don't always apply in the standard ways. 2e kids are very different both from other gifted kids, and from other kids with issues.

Best of luck. I'm confident both your kids are going to do beautifully.

Sounds an awful lot like my D at that age (she is 16 now). Loonnggg tantrums, and many rules that we had to follow exactly (made me feel like a trained seal). She had trouble with personal boundaries -- she would get into people's personal space and make them uncomfortable without realizing it, which sounds like your D.

Ultimately she was diagnosed with a non-verbal learning disorder. ADHD tests have been "inconclusive". We have been told by testers that she would probably test as having Asperger's, while others assure us she wouldn't; we say she "flirts with Aspergers" because she is on the border. But we have no formal diagnosis.

She is also very bright, and has done well at programs like Davidson's THINK. She is super disorganized (that non-verbal learning disorder seems to be the culprit), which keeps her from knocking the socks off every class in school. But she does pretty well, especially with some organizational support. She has come a long ways socially. Still awkward sometimes. Still...she went to a robotics training course today, and told me at the end with a laugh that she had the best social skills in the room -- meaning that the others were REALLY poor at social interaction. But in comparison, she felt pretty good.

Hang in there, you are at the age that was hardest for us. It does get better!

I don't know about aspbergers. I don't know if the things in this link are true. I don't even know if I got the link from here. If I did it was not from this thread. Here's someone's chart about Aspbergers vs. Gifted vs. 2e Aspie~GT.
http://www.hoagiesgifted.org/eric/fact/asperger.pdf

Are her behaviors consistent or do they ebb and flow? Is it worse when she has been sick? Did they appear out of no where? Are there times when she does not exhibit the concerning behaviors? There is even a symptom called the exorcist syndrome when a child loses it like you have described. Does she act remorseful and ask for a hug whn she is "done"? I only ask because anytime OCD is present I suggest looking into PANDAS syndrome. My ds has it and we are soooooooooooooooo much better since we got have figured it out and gotten treatment. Doctors will resist testing someone that age for strep I would also include mycoplasma but I would run a blood test and check ASOcand Anti- DNASE titers. If they are high you might be on to something that is treatable!!!
! If you have any questions let me know.

Her behavior is pretty consistently intense and she is never remorseful. She has several tantrums throughout the day and has been doing so pretty much since birth. She was the hardest baby!

So sorry! We dealt with that in bursts due to the PANDAS and. It was a rough few years u til we figured it out! I hope you find out something soon!!!