Misdiagnosis and dual diagnoses of gifted children & adu

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Has anyone else read it? It argues that too many people who receive diagnoses, including AS, are really just gifted people who are out of their element. The descriptions of people with AS as compared to gifted people include:

(for aspies)"learning is primarily in the form of memorizing facts but seldom being able to apply them"

"gifted children /.../will know how others see them; children with Asperger's do not."

"When a child's lack of empathy is seen in some situations but not in others the likelihood of AS is substantially reduced./.../A gifted child often shows remarkable empathy /..../ toward those who are less fortunate or who are hurting."

"in working with children who suffer from AS/.../one must break down every social behaviour into its smallest components. For example, it may be necessary to show exactly how close one typically stands when having a conversation..."

"Children without AS /.../ will generally respond eagerly to suggestions and strategies that will improve their acceptability to peers"


under features incompatible with AS (in children) are listed among others:

-lacks motor clumsiness
-is comfortable with abstract ideas
-speech patterns and humor are more like that of adults
-readily understands /.../ idioms like "don't jump the gun"

If this is true than I definitely don't have AS. But quite a lot of it seems to contradict other things I've read. What are your thoughts?

-is comfortable with abstract ideas
-speech patterns and humor are more like that of adults
-readily understands /.../ idioms like "don't jump the gun"

Those three apply for me, but I show most of the other symptoms (motor clumsiness, rather extreme sensory issues (most of the time wearing noise-cancelling headphones in public, trouble with touching certain surfaces, oversensitive to smells and taste, dangerously undersensitive to cold), propagnosia, lack of understanding of gestures and mimic, not able to recognize pictograms or other abstracted depictions, inappropriate social behavior (well, sometimes), OCD behavior, unusual fields of interest, special interests pursued excessively, bad at expressing emotions (have to consciously remember to move my face muscles accourding to social situation), problems with intonation of language, really really really bad at small talk, not able to talk to more than one person at once) so I'm not really questioning my diagnosis.

About this particular point, I think that the problem is the confuse meaning of the word "empathy" in the context of AS.

In regular language, "empathy" means something like "feel the feelings of others" (like being sad because John is sad). In the context of AS means something like "having an intiutive knowledge of what others feel" (like looking to John and understand that he is sad)

There are different things: I can have difficulty in knowing the feelings of other people, but, in the rare cases that I can "read" their feelings, feel empathy (1st meaning) by them.

And I can have a perfect knowledge about the feelings of other individuals, about who they react, etc. but not give a damn about that.

And know my point : "show[ing] remarkable empathy /..../ toward those who are less fortunate or who are hurting" has to do with the "empathy - 1st sense", not with "empathy - 2nd sense" (this wil be something like "having a quick understanding that other person is less fortunate or is suffering").

I agree - when I know someone is sad I feel sad for them and try to make them feel better, so I guess I'm showing empathy, but usually I don't notice someone is sad unless they tell me directly. I just don't get nonverbal signs.

If I don't know the person, which is nearly everyone, I won't feel anything, nor will I attempt to make them feel better. If it's an emergency, I'll render first-aid, but that's it.

If it's someone I know, which takes a long time to happen, I'll feel for them.

But perhaps there is a good case to not diagnose AS at "gifted" individuals, even if they indeed have the symptoms: diferentiate between "gifted+asperger" and "gifted without asperger" can be so difficult that we can have a situation very similar to the dual diagnosis of AS and schiziophrenia (it is so difficult see the diference between "asperger+schiziophrenic" and "pure schizophrenic" , then because that a diagnosis of schizophrenia rules out a diagnosis of AS).

I found the best way to cope with society and to function as normally as possible is to assume that unless they prove otherwise, everyone is a friend I just haven't met yet. It takes a lot of self-persuasion (and of course sometimes I'm completely off the mark) but it helps being more or less friendly (or at least polite) towards strangers, and usually they're also reacting in a friendly way when they get the impression they're liked or at least tolerated. And if they don't, they can kiss my... well, you know. Of course I feel a lot more for people I know than for strangers, but that's also true for NTs.

I have to admit that people who are completely indifferent to the suffering of others put me off. It's one thing not being able to read the signs, another to simply not give a crap.

I don't think I'm typically NT nor typically AS when it comes to this. On the one hand I'm not very good at reading the feelings even of my own family. I know if they're "up" or "down", but nothing specific unless they tell me. With facts at hand I can reason my way through their feelings and feel a lot of compassion.

On the other hand I sometimes "feel" other people's feelings without being able to determin what they are nor separate thos feelings from my own, making me very confused. In either case, I'm never indifferent, only bewildered.

None of these are 'incompatible' with AS.

Motor clumsiness is mentioned in the official criteria of DSM-IV-TR and ICD-10 but not a diagnostic feature (=not a criterion). There are a couple of very autistic people with advanced motor skills from a young age on and several more who are just not clumsy.

'Comfortable' can mean a lot abstract ideas can mean a lot. Literally comfortable, feeling good with them? I don't mind abstract ideas at all, they don't bother me. I have an 'exceptional' grasp (teacher and others said so) on a number of very abstract ideas too! I do however have significant issues with other abstract ideas. 50/50 for me I guess.

Those with AS have always been called 'little professors' due to the way they present themselves and can talk. 'Little professor' usually means that how a child presents in a certain situation is very unlike for his age and eerily similar to the display of an adult.

Misunderstanding idioms is typical amongst autistic people across the spectrum, though it is not a necessary traits (there are still other criteria one can fulfil to receive the diagnosis) for any form of autism.

Interesting though.

I find the phrase "comfortable with abstract ideas" too abstract. I must be AS. Fact is, I still don't know what they mean by "abstract ideas". The one that really cheese me off, though, is the suggestion that anyone can know what others think of them. Why does everyone keep acting as though it's a natural ability to read minds?

It's been quite a while since I read Misdiagnosis..., but I remember being annoyed and unimpressed by the chapter on Asperger's. It depended on the DSM criteria and pretty outdated assumptions about how Asperger's presents in different people. I would not use it as a guide for trying to differentiate between giftedness and Asperger's or deciding if both are involved.

Many aspies who write on the web ave talked about their being identified as gifted, based on IQ tests, or are clearly gifted, judging from their writing and thinking.

I'm gifted and AS. If I hadn't picked up the gifted label so early, I might have been diagnosed sooner.

Many of the Aspie traits in the OP don't describe me, but "gifted children /.../will know how others see them; children with Asperger's do not" definitely does. I have no idea what other people think of me, and I really don't care.

I recently found some old journal entries... apparently, when I was thirteen, I noticed my classmates didn't like me. I attributed it to the fact that I was smarter than them. (I'm still not entirely sure this is wrong.) When I was eleven, I wrote that it's impossible to know what other people are thinking and feeling. No ToM? But at the same time I had a concept of comparative psychology and cultural relativism.

So, I'm pretty sure I'm both.

I've read the book, and it has some very good points, but the relationship between giftedness and autism spectrum disorders is so intertwined and so complex, that it is very difficult to separate them. Since they have so much in common, and people who are gifted and/or ASD experience such similar things, it seems to me that putting them in tidy, separate boxes is mostly an attempt to have a "positive" label for those whose IQs are high enough to be considered gifted, without (gasp) recognizing the deficits that some of us have, and how much those deficits resemble the autism spectrum.

Z

That's misinformation right there. It is very difficult to make such blanket rules.

See this:
http://www.sciencenews.org/view/generic ... f_empathy_

"You can have so much empathy that it’s painful for you, so you have to disengage,” Pavlova says. “Sometimes autistic people are not insensitive; they’re too sensitive.”

This immediately comes to mind what the Wikipedia page says:

http://en.wikipedia.org/wiki/Asperger_syndrome

"The cognitive ability of children with AS often lets them articulate social norms in a laboratory context,[1] where they may be able to show a theoretical understanding of other people's emotions; they typically have difficulty acting on this knowledge in fluid, real-life situations, however."

Ok, Theoretical = Abstract to me!

But what are the real advantages of being diagnoses as "gifted + asperger" instead of simply as "gifted"?

At the first look, I have the idea that, for the individual (even if he is really "AS+GFT"), it is better being diagnosed only as "gifted":

- It is better fot the self-esteem

- He will not have "therapists" trying to "treat"/brainwash him

- Some people say that the advantage of a diagnosis is understand what is the cause of our problems; but a diagnosis of "gifted" only also gives these sensation of having understood the cause of the problems (even if is a wrong understanding!)

- Even if he is less sucessful in life than is intelligence should predict, it is better for him if he sees himself as a "misunderstood genius" (like a character of a XIX century novel...) then as a person with a disabilitie