Autism has been in the spotlight for many years. In movies, television, and novels, autistic characters are portrayed to have social difficulties, repetitive movements or tics, and often nearly superhuman mental capacity. The truth is, many people who are on the autism spectrum do not have such easily noticeable symptoms and often go undiagnosed, specifically those who are high functioning. A common misconception is that if a child has autism it will be fairly obvious at a very young age and even more so during daycare or school, in a setting where socialization with peers is expected. Although some parents are able to obtain a preliminary diagnosis for infants and toddlers, this is not always the case since autism is an extremely broad spectrum with each child developing differently. It is also possible that doctors will miss symptoms altogether or attribute them to other causes. The lack of full understanding of autism across medical disciplines makes identification of symptoms and a clear diagnosis difficult.

The populations that are most often misdiagnosed or undiagnosed are academically gifted children. Those who are gifted can fly under the radar because they may easily learn appropriate behaviors that can mask symptoms of autism. It is also possible that they are simply seen as quirky and unique. People who are highly gifted in art, math, technology, or memorization are usually very focused on their specific skill to the detriment of personal friendships. People see this as a proof of their giftedness and not as a sign of disability. A child who shows passion in academics or a great talent in arts is often praised and rewarded instead of taken for an evaluation. When the behaviors are disruptive to the life of the child, family, or classroom it could be a sign that the child needs to be assessed.

Asperger’s Syndrome is a type of autism spectrum disorder where there might be a higher level of functioning and a special constellation of symptoms that are different from typical autism. There are many similarities between children who are gifted and those who have Asperger’s, hence to diagnose the disorder you need a specialist who is knowledgeable in treating ASD clients and also has experience working with gifted children. It should be clear that giftedness and Asperger's are not mutually exclusive. During gifted testing we typically watch for the traits of Asperger’s yet it is not always possible to provide a definite answer. If such traits are noticed we might recommend further assessment to confirm or rule out the diagnosis of Asperger's syndrome.

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Both gifted children and children with Asperger's may have difficulty creating and maintaining friendships due to a lack of interest in age-typical activities or because they are not attuned to the desires of their peers. In other words, they do not share the interests of peers and will make that obvious in their interactions. Other signs of Asperger’s that might not coincide with those who are academically gifted include difficulties in tasks that require attention to multiple threads at once; being naïve or unquestioningly trusting of strangers; difficulty holding a conversation about things other than their interest; and struggles with environmental changes or changes in schedule. A child with Asperger’s may walk or run abnormally or have difficulty with either fine or gross motor control. Once they reach an age where they dress themselves, they might not fully grasp how to choose clothing based on weather or activity. They may also overlook hygiene, leading to bad breath, body odor, and unkempt hair.

The trouble with picking out these differences is that a child that has learned that an outward expression of displeasure will be met with consequences may learn early on to internalize it and act in expected ways. In girls with Asperger’s, for example, it is common to see that they are able to figure out how to fit in by copying the behavior of others and mimicking social norms, although they might not fully understand them. This can often mask the symptoms of Asperger’s and lead to a misdiagnosis of attention deficit hyperactivity disorder, obsessive-compulsive disorder, or other identification. Once a child is suspected of having one of these disorders, which are usually much easier to diagnose, it is possible that there will be no further assessments leading to misunderstanding and ineffective treatment. Although frustrating, a misdiagnosis with unsuccessful treatment should be a sign that further assessment is necessary. Unless the teachers or other faculty are specifically trained in recognizing children with high functioning autism, it will likely be up to the parent to initiate this process and seek out a specialist.

Finding a specialist can be fairly simple but there may not be one in your area. Searching your national autism awareness website or contacting licensing organizations for psychologists and developmental pediatricians is a good first step. It is also possible to find trusted specialists by seeking out local organizations that provide care and treatment for those with a diagnosis of autism. Be sure to look at medical resources from hospitals or universities and research in well known, peer reviewed, scientific journals. Autism is a disorder that occurs during development and thus far there is no evidence showing that specific foods, medicines, or vaccinations can cause or cure it.

Image Credit: Dimitris Papazimouris @ https://www.flickr.com/photos/papazimouris/635409920