Anemone's Research Emporium

Autism versus giftedness

Anemone Cerridwen
April 14, 2009

Autism sometimes gets confused with having a schizoid personality. It is sometimes confused with late talking in children. The other thing it is often confused with, at least at a distance, is gifted levels of intelligence. We see this especially in all those lists of famous historical figures who must have had autism because they were weird, they weren't socially normal, they didn't fit in, they had obsessive interests, etc. etc.

Hate to tell you, but those guys were gifted, and that's pretty normal for gifted. There are some very unusual gifted people out there. When you've got a supercharged brain, it tends to act in unusual ways. How could it not? The energy just spills out all over the place.

As Webb et al. (2005) describe in Misdiagnosis and dual diagnoses of gifted children and adults (see also Webb, 2000), it's normal for exceptionally gifted kids to be intensely focussed on unusual interests and be socially isolated as kids. In general, gifted people become less isolated as they grow older and gravitate towards environments shared by people they actually have something in common with. Typically by the time gifted people enter the world of work, they have found a niche where they're really no weirder than anyone else in that environment. And the isolation ends. (Although unfortunately not for everyone - I'm still struggling to find my niche, as it happens. And maybe I'd still be isolated even if I did.)

Webb et al.'s description of what it's like to be gifted is great. As far as I know, the way they differentiate between giftedness and commonly misdiagnosed conditions like ADHD, OCD, and bipolar disorder is also great. And they do describe how gifted people are at higher than average risk of both existential depression and anorexia. Great, wonderful, magnificent.

Then they talk about Asperger's Syndrome (see also Amend, 2003), which they call Asperger's Disorder, and they blow it. Their description of AS sounds more like schizoid personality disorder than autism, per se. Aaaaaaah!

Amend (2003) says:

For example, a lack of social or emotional reciprocity is characteristic of Asperger's Disorder while gifted children most often show a tremendous concern for others. They may not always know how to express it appropriately, but the concern is there.

Webb (and Amend) et al.'s book is even worse. If you read Amend carefully, he might be saying is that gifted kids show concern more readily, rather than feel it more readily, but Webb et al. (2005) are more explicit. They say we lack empathy.

First, they include Asperger's Disorder in the chapter on ideational and anxiety disorders, along with Obsessive-Compulsive Disorder, Obsessive-Compulsive Personality Disorder, Schizoid Personality Disorder, Schizotypal Personality Disorder and Avoidant Personality Disorder. Ideational disorders are disorders where people live intellectually within their minds, and the authors state that for Asperger's Disorder:

. . . there is often a great amount of generally unemotional intellectualized thinking and pondering, though there may be significant discomfort and even anxiety in specific social circumstances or in unexpected situations. [page 85]

While some autistic people might be happy with such a description, many of us would hit the roof. It seems to me that our core problem is more likely to be related to information processing rather than personality. The authors are aware that some might disagree with their lumping the above disorders all in the same chapter, but that is a lesser issue in comparison to how they actually describe Asperger's.

The more detailed description of Asperger's Disorder has its hits and misses. I like it that the authors point out that you need to be more than just "socially awkward, eccentric, or uncomfortable in social settings" [page 94] to qualify for a diagnosis. They also think that many of the so-called famous autistic historical figures were unlikely to have been on the spectrum at all, or if they were, they were likely to be only mildly impaired. Hear me cheer! And they point out, quite rightly, that someone who doesn't know much about Asperger's may mistakenly assume that an introverted gifted person who's keen on math or computers is autistic. The long list of famous historical figures who weren't socially impaired and yet still get retroactively diagnosed with autism is evidence enough for that. I can imagine it would be even more aggravating if you're looking for appropriate support and people keep missing the point and mislabelling you.

But when they get into the detailed description, hear my teeth gnash. Actually, a lot of it is fine, but they clearly state that people with Asperger's "lack empathy" [page 94] and that we "connect with the concrete rather than with the abstract" [also page 94]. Isn't the latter one what they say about primitive tribes? Let me quote that one more fully:

Persons with Asperger's Disorder connect with the concrete rather than the abstract, which makes it hard or them to generalize from one situation to another. Learning is primarily in the form of memorizing facts but seldom being able to apply them in a meaningful and creative manner without specific direction or assistance. [pages 94-95]

Huh?

And here's another huh?:

Children who suffer from Asperger's Disorder tend to talk about their interests in a pedantic, monotonous voice. [page 100]

Well, I suppose this is true of some of us. But it's hardly diagnostic, as far as I know.

Back to empathy again:

A child's ability and capacity for empathy and consideration of others are key areas for evaluation to establish the Asperger's diagnosis, as opposed to a child who simply has poor social relationship skills. [page 96]

True Asperger's Disorder children lack empathy . . . [page 100]

When a child's lack of empathy is seen in some situations but not in others, the likelihood of Asperger's Disorder is substantially reduced. If the problem is primarily a lack of tolerance rather than a lack of empathy, the likelihood of Asperger's Disorder is also markedly lessened. A gifted child often shows remarkable empathy and understanding of others, particularly toward those who are less fortunate or who are hurting. [page 102]

In other words, they take the lack of empathy seriously as a diagnostic criterion, even though no one has ever proven we actually lack empathy, and in fact, since then researchers have come out and demonstrated otherwise (Rogers et al., 2007).

As I'm sure you know by now (and perhaps Webb et al., do by now, too), autistic people often feel concern for others but don't know how to show it. I think the difference between the two groups is that autistic people have a harder time figuring out what is going on in the first place (following conversations, reading people, etc.), but then when we finally do, our internal reactions run the full range from low empathy to high empathy, same as everybody else (although we may then have a harder time figuring out how to express ourselves, too). And I expect that gifted kids run the full range from low empathy to high empathy too, same as autistics. There may actually be average differences between the two groups (perhaps gifted are above average on average, who knows?), but I doubt it's enough to be diagnostic in any way.

I think what is happening here is that these people are genuinely expert at understanding giftedness, and do a very good job of describing all the ramifications of it. On the other hand, they don't seem to know as much about the disorders they compare giftedness to, or at least they don't for Asperger's, and so they make a hash of it. Please, please, please, do not take this book's description of Asperger's seriously. Go to other books by authors who specialize in Asperger's, or better yet, go to blogs written by autistic people (since autism experts sometimes mess up spectacularly, too), to get the full picture.

But definitely, definitely, definitely, Webb et al. (2005) is a must-read if you want to understand how giftedness can play itself out in a person's personality. Go read it, and don't bug me about Einstein until you're done.

References

Edward R. Amend, 2003. Misdiagnosis of Asperger's Disorder in gifted youth: An addendum to Mis-Diagnoses and dual diagnosis of gifted children by James Webb, Ph.D. Retrieved on April 13, 2009 from http://www.sengifted.org/articles_counseling/Amend_MisdiagnosisOfAspergersDisorder.pdf

Kimberley Rogers, Isabel Dziobek, Jason Hassenstab, Oliver T. Wolf, and Antonio Convit, 2007. Who Cares? Revisiting Empathy in Asperger Syndrome. Journal of Autism and Developmental Disorders 37:709-715.

James T. Webb, 2000. Misdiagnosis and dual diagnoses of gifted children. Retrieved on April 13, 2009 from http://www.sengifted.org/articles_counseling/Webb_MisdiagnosisAndDualDiagnosisOfGiftedChildren.pdf

James T. Webb, Edward R. Amend, Nadia E. Webb, Jean Goerss, Paul Beljan, and F. Richard Olenchak, 2005. Misdiagnosis and dual diagnoses of gifted children and adults: ADHD, bipolar, OCD, Asperger's, depression, and other disorders. Great Potential Press, Inc. Scottsdale Arizona