My eldest DDs OT considered her very spikey profile a problem regardless of her IQ, but predicted that she would be gifted or close to it and that if he was correct then her OT assessment was even more of a problem in his eyes. In his view sensory performance needs to be inline with intellectual performance for comfortable functioning in the world. His opinion that was an a child with an even average IQ and even average sensory performance would outperform a child with a profile like hers (both sensory and IQ scores were all top and bottom with very little middle ground).
Same OT saw our second child and immediately suggested she needed an IQ assessment for giftedness (noting that he only saw kids like her when they were the younger sibling of existing patients who now had paranoid parents). So my experience was that yes our OT thought giftedness mattered and he was good identify a need to have an IQ test.
