Autism, Giftedness, and Human Diversity
By Marianne Kuzujanakis M.D. M.P.H.
For some, we will become expert actors on the stage of life, but it will always be a part, one we just learn to perform more skillfully as the years go by. For others, true emotional relatedness is a seed buried deeply under sensory issues and unmet physical needs…”
~Temple Grandin (The Unwritten Rules of Social Relationships)
Temple Grandin exemplifies the role of eloquent spokesperson for those on the autism spectrum. The feeling of not quite fitting in, of needing to pretend in uncomfortable social situations, and of having specific strengths yet intense sensory issues hindering the ease of what should be a natural emotional relatedness to the world. Hearing her words, it is clear that those with autism (including the related Asperger Syndrome), do not feel less, but may feel far more. The profound effects of autism, a condition diagnosed 4-5 times more frequently in boys, encompasses every aspect of the lives of families.
I’ve often watched Touch (a television drama about a nonverbal child with apparent autistic traits including a strong predilection towards numbers and patterns). While Hollywood always puts its own twist upon subjects, I find myself deeply drawn into this program. Though the autism community does not universally approve of the show, perhaps I am a sucker for unanticipated superheroes, hopeful possibilities, deep parental love, and the positive acceptance of non-neurotypical individuals. Perhaps my interest also is because the drama mentions giftedness and misdiagnosis.
Some twice-exceptional gifted individuals indeed have autism spectrum disorders, yet misdiagnoses routinely occur: both over-diagnosis and under-diagnosis. There are times when the distinction between giftedness and autism is unclear, and symptoms can overlap, especially in the asynchronous gifted. Difficulties with social interactions and friendships may occur with both autistic individuals and gifted individuals, as can tantrums, focused (and unusual) interests, sensory intensities, and even a lack of motor coordination. Excessive talkativeness can also be seen in both. The American Academy of Pediatrics has useful diagnostic and management articles on the topic, but a full evaluation by someone with expertise in giftedness and multi-exceptionality is crucial.
The proposed 2013 DSM-5 changes might further complicate the current diagnostic criteria of autism by no longer listing Asperger Syndrome, folding it within autism spectrum disorder, and narrowing the inclusion criteria. Both sides of the debate are outspoken, with the many who support those who are higher functioning concerned that they may be left without a defined medical diagnosis, resulting in a possible end to their already established support.
Other people look with promise to the proposed DSM-5 changes, as autism diagnoses have risen by 78% in the past decade. 1 in 88 people are said to have an autism spectrum disorder. The rise, while it may be associated with better awareness, may in part be a result of misunderstandings about autism and/or giftedness, and a possible excess of diagnoses (and self-diagnoses) of high functioning autism and Asperger Syndrome. It is believed that a majority of individuals currently diagnosed with an autism spectrum disorder fits this profile.
I am deeply uneasy about individuals in need who may be at risk of losing life-changing services, but particularly I also am concerned with what happens to children who learn they have autism or Asperger Syndrome, and then have that diagnosis taken away. How could the changes affect a child’s self-identity?
Yet watching the media present endearing portrayals of characters like Jake from Touch, I feel hope that one of the most important things we can do as a society is to tirelessly strive to achieve unquestionable accuracy in diagnosis and management, to lessen the knee-jerk urge to identify and compartmentalize people by labels, and to fully and without question heartily embrace the entire vibrant and powerful spectrum…the spectrum that is our human diversity.
Make sure to check out all the posts in this series:
- Part 1: “ADHD, Autism, and Giftedness: An Invitation To A Conversation“
- Part 3: “Giftedness, ADHD, and the Complexities of Society“
- Part 4: “Giftedness, Misdiagnosis & National Children’s Mental Health Week“
- Uniquely Gifted
- Davidson School
- Hoagies Gifted
- Council for Exceptional Children
- 2e Newsletter
- Wrights Law
- A Parent’s Guide to Asperger Syndrome and High-Functioning Autism by Sally Ozonoff and Geraldine Dawson
- Different Minds by Deirdre V. Lovecky
- Misdiagnosis and Dual Diagnoses of Gifted Children and Adults by James T. Webb, Edward R. Amend, Nadia E. Webb, Jean Goerss, Paul Beljan, and F. Richard Olenchak
- The Mislabeled Child by Brock & Fernette Eide
- The Unwritten Rules of Social Relationships by Temple Grandin
- Uniquely Gifted: Identifying and Meeting the Needs of the Twice-Exceptional Student by Kay Kiesa
Marianne Kuzujanakis M.D. M.P.H. is a pediatrician and former director on the board of SENG (Supporting Emotional Needs of the Gifted).