Gifted Issues Discussion homepage Forums Twice Exceptional Fine line?

This is exactly what I am dealing with on an on-going basis. I have a daughter in 7th grade. I am sure she meets some of the criteria of Aspergers and this has come up since she was very young - most recently 2 weeks ago with a new psychiatrist. The problem I have is that the criteria is so broad, and for every characteristic I can check "yes" to I can think of an example where the exact opposite was true. It is also frustrating not to know how her intelligence and introversion plays into her nature, particularly with her impatience and intolerance with others, especially other middle-schoolers. She already has a dx of ADHD. Reading James Webb's 'Misdiagnosis' a bit I see dd in the pages - like ADHD with intellectual, imaginational, and sensorial OEs. At this point, I am working to accept the grey area. DH is adamant that no label will be applied to her. I think it is unfortunate that this label would likely be used to define everything about a person rather than a way to understand her and give her the tools she needs to navigate the social world comfortably. For example, she is highly intelligent solely as a by-product of Aspergers, not vice-versa, or gifted with Aspergers. This is something that was implied by the psychiatrist.

Hils, I guess that this isn't an definitive answer to your question. Unfortunately, that is why it is so "grey." I think that professionals come with their own bias and will apply that bias. Of course, right now the tool they use is the DSM, and therefore what is defined in the DSM is what they see. There is no DSM diagnosis of giftedness that would take in to account the theories in James Webb's book, so they can't apply criteria to "choose" between giftedness and "other." Since DSM criteria is broad and interpretation of behaviors is based upon each professionals subjective experience and limited interactions with each patient, the giving of a dx seems to be discretionary and that makes it hard to accept. If you are looking for your own dc, the best you can do is learn what you can, get to know your child, find a professional that can connect with your child, and do the best with the information you have.

Discussion along the lines of this topic - with people much more knowledgeable than I am - is in the thread "Gifted Should Not Be Considered a Disorder."

Sorry to say this, but time to find a new psychiatrist. Most people with Asperger's are of average intelligence, not gifted. The intelligence of most people with autism is hard to measure because of their moderate-to-severe language and social communication-impairments.

It is simply NOT TRUE that Asperger's can "cause" people to be gifted.

The gifted ones are a tiny minority; they also compensate better, so they tend to look like borderline cases, even while their struggles are real.

I'd want to get someone who really knows about autism, and has seen the autism+gifted combo, to help you sort this out. The person you're seeing... I'm suspicious that they don't know enough.

Hang in there,

DeeDee

We're dealing with the fine line as well. Two boys, DS4.5 PDD-NOS and DS3 High functioning Autism. I am more and more convinced that DS4.5 is NOT on the spectrum. At this point his only issues are sensory processing related (I had to deal with that all my childhood and still do), being overly sensitive at times and fighting boredom. A lot of things he used to do (rituals, etc.) went away as he learned to cope better. But we now have this diagnosis that the school is going by (unfortunately that is what we originally wanted :() and the school (special ed preschool class) is dead set on trying to correct something that in my mind does not need correcting. He's extremely verbal and always asking questions and always explaining something or talking to himself because he doesn't have anyone else to talk to and always wanting to answer all the teacher's questions. And the school sees it as an issues and possibly might be recommending him to be held back from K in the fall and attend pre-school again. The teacher is very nice but she's so busy trying to teach the other 9 kids to count to 10 that she doesn't see how under challenged DS4.5 is. She never in those 4 months he's been there realized how much of what she says he is taking in (pretty much all of it). And there are things she's said the he now understands are the law because he's teacher said that and we're working hard at home to reverse that. We had a parent teacher conference last week where I mentioned some of the issues that arose from this and the OT (who seems to get him!) suggested to the teacher to have a normal "adult" conversation with him because that's how you need to speak with him and explain again the things we're having issues with. The preschool has been great in terms of getting him be with age peers but that's about it. Everything else has been a fail. His teacher has absolutely no idea what he actually knows academically, which means there is no way she could ever even try to accommodate him in the slightest possible way. Apparently his biggest problem at school is that it takes him 15 minutes to take off his coat in the morning because he's too busy thinking out loud and because of that misses the first part of their table time! lol ... NOT an issue at home. I explained to him a little while ago that if he stops talking, he can get things done a lot faster. So when he gets home, it's coat and shoes off first and THEN he can tell me all about his day . But back to the "fine line" ... as soon as I mention getting more challenge for him (in my emails to the teacher or at the conference), it always comes down to them wanting to work on his "areas of weakness" and not one suggestion that would solve the boredom issue. His IEP is for speech with OT consult. Meaning he gets ST at school once a week and the OT just sits there with him and some other kids and just oversees their behavior. He has NOT needed any speech therapy in well over a year. If anything, he needs OT for fine motor skills. But his diagnoses called for ST and that's what he's getting. Because of this and because of health issues (allergies and being sick all the time), we'll be most likely homeschooling K and possibly 1st grade. In the meanwhile I am planning on getting him tested to see where he's at. We are pretty sure he is gifted just not sure where exactly on the scale. But as for the PDD-NOS diagnosis, I am 99% sure he does NOT have it.

DS3 is very different from his older brother. Most likely more gifted than his brother (doing most things 1.5-2 years ahead of his advanced brother) but he is also the one with more issues and for him the High Functioning Autism diagnosis will probably last, though for reasons other than what the evaluators initially saw in him. But we won't know for sure until he's fully verbal. At this point he acts autistic one day and "almost normal" the next day. I am saying "almost normal" because he doesn't do very many age-appropriate things so it's hard to call his behavior normal. But because of these switches in behavior, it really is a fine line as well. And once again, EVERYONE concentrates on his diagnosis and NOBODY pays any attention to the needs that his brain has even though a lot of the autistic behavior seems to be coming from his brain working so hard wanting to learn more.

Sigh. Nothing about this surprises me.

In fact, I've had somewhat similar conversations with doctors about my DD's atypical asthma. (The concern is that the dx will "follow" her, with potential repercussions.)

What is the concern about an asthma diagnosis "following" the child?

Our school has been reasonably responsive when we have needed to change the diagnostic information in our IEP. And school records, while sensitive and affecting things while one is in school, do not typically "follow" a person into the world. Once a person ages out of the school system, it's not likely that anyone would see those records or use that information for anything.

Maybe I'm missing some crucial piece of the picture. But I just don't see it.

DeeDee

It's an insurance concern, or so I was told (maybe they're worried about it being a pre-existing condition?) DD really is atypical, so there's adequate reason to say that she may not have asthma. The concern is also that she will be overtreated with meds she may not need.

Asthma is a disqualifying condition for an enlistment or commission in the US armed forces.

Thanks, Dude--that's helpful to know, and I didn't know it. (My son also has asthma; he really does have it, I think, but I don't believe it is "officially" on his file either. They like to put "reactive airway disease" on kids' files insetad.)

No problem. Since the question was asked about how an asthma diagnosis could hurt someone, that came immediately to mind.

It turns out that asthma is one of those conditions that can be outgrown, because of airway expansion, and possible changes to allergy responses. At the time I enlisted, if you hadn't had an attack since age 13, you were golden. This was during peacetime, when they could be a little selective. The rules have a funny way of changing when they're coming up short on recruiting targets... at least for enlistees.

I kind of view a lot of the diagnostic game as kind of as a joke, at least in the world of mental health.

I say this after having read a ton of psychological and medical reports.

If you liked the DSM-IV-TR, you're going to love the DSM-V.