There’s a fine line between giftedness and Aspergers. This thought-provoking and carefully considered article, explains to a certain extent how closely related the two can be (or more precisely, can seem to be). There are people – including professionals – who hold to the position that to be gifted is to have Aspergers; but they tend not to believe the inverse, that having Aspergers is the same as being gifted.
Clearly the claim that Aspergers and giftedness are the same in some regard, can be a confused and distorting view. If one insists on a relationship between them, surely it makes sense to think of them as potentially “co-morbid:” That sometimes people who have Aspergers are gifted, and sometimes they’re not. Similarly, sometimes people who are gifted have Aspergers, and sometimes they don’t. How tightly related the two “conditions” are, might reflect confused and imprecise diagnostic practices, rather than a “true” relationship between them.
The difference matters. We need to know whether a child is struggling to relate to others and make their way in the world, due to functioning at a much higher level than their peers, or due to a neurological condition which makes these tasks fundamentally more difficult and challenging. One of the reasons this matters so much, is because of how you then address the problems: Do you respond to their difficulties by actively extending their education and increasing interactions with those of much higher intellect than their peers; or do you respond to their challenges by giving them remedial assistance and addressing their anxieties and behaviours with therapies and maybe even drugs. (Or, indeed, do all of the above, since the child is gifted and has Aspergers.)
Will the changes to Aspergers placement in the DSM-5 (due to come into effect in May 2013), make the distinction between giftedness and Aspergers, better or worse?
Having looked over the differences, my opinion is it will make the distinction much clearer. Indeed, those who are gifted and as a consequence of their giftedness were diagnosed as having Aspergers, would appear to be likely to drop off the autism spectrum under the DSM-5. And those who have problems that are not caused by giftedness, appear likely to slip quite easily into the new Autism Spectrum Disorder category. Allow me to explain how I’ve reached that view.
Here is the current (DSM-IV) criteria for Aspergers. If you read the article I linked to at the start of my post, you’ll see how it would be quite easy for a gifted child to fall into Aspergers so-defined. In particular, the observed social impairments under “A” could be a consequence of being gifted. And the behaviour under “B” – particularly the intense focused interests under (1) – would be easily met by many (most?) gifted children too. Ticking the rest of the boxes in the list is easily done, especially since being gifted can – and often does – isolate a child socially. Voila, you have Aspergers.
So how does this change for DSM-5?
DSM-5 removes Aspergers from the DSM altogether, but specifically folds Aspergers into the newly defined Autism Spectrum Disorder (Aspergers was already considered as being on the autism spectrum, the change just makes that even more explicit). It will be harder for a gifted child to be mistaken for a child with Aspergers, considering they now need to exhibit persistent deficits in social interaction and social communication across all three areas under “A”. But of particular note, it’s no longer enough to have intense interests (like under B (1) that I mentioned above, now represented by B (3)). Rather, the child must meet two of the criteria under B, ie, something more than just intense interest in an area. It’s arguable too that the requirement under D that the symptoms limit and impair everyday functioning, will be harder to show for a gifted child than the previous DSM-IV requirement that it significantly impairs social “or other important areas” of functioning.
So it seems to me, that the proposed changes to the DSM will help separate the “merely” gifted, from those with a neurological impairment. Hopefully leading to a clarification of relevant treatments and responses in general to the child. (I have focused on the child rather than the adult through-out this post, since there are consequences for a child’s education and the way their self-image is formed, in a way that is usually going to be much more impactful and severe than for an adult.) These changes do not mean someone could not have Autism Spectrum Disorder (for example, they were previously diagnosed as having Aspergers) and be gifted at the same time. It still seems most correct to think of these two conditions as sometimes occurring together: There is nothing inherent in autism that means you aren’t highly intelligent, or inherent in giftedness that means you can’t have autism.
In summary then, there is clearly some modern confusion about where to draw the line between Aspergers and giftedness. The drawing of that line does have serious consequences, particularly for treatments / therapies and education. The proposed changes to the DSM – that abolish Aspergers and fold it into a new criteria for Autism Spectrum Disorder – would seem to clarify that distinction between giftedness and Aspergers. In turn, I would be hopeful that the resultant clarity will also mean more accurate and helpful responses to the challenges faced by these remarkable children.