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We often receive interesting follow-ups to past columns, and I've included one here. First, I'll share an abbreviated form of the original question and answer, and then the exciting update from the mother of a child who was described by her doctor as “flirting with Asperger Syndrome.”
Our family is facing a dilemma. Our daughter, 6, was identified as gifted when her kindergarten teacher referred us for an assessment for AD/HD. Although transitions, lack of written output, and difficulty expressing anger disrupt her at school, no AD/HD was found. This year, when the school referred us for an autism assessment to check for a double exceptionality, she scored borderline Asperger's. I'll also note that she's gifted in gymnastics, cycling, running, and swimming, which isn't typical with an Asperger's diagnosis.
I remain on the fence. Based on her borderline score and the behavioral evidence, the doctor is willing to diagnose her so that we can access services for her challenges; but I'm torn. Should we pursue the diagnosis and all the self-esteem risks associated with a label if, as the doctor said, she's just "flirting with Asperger's”? I must add that the psychologist on her educational committee stated that she wouldn't send a child with a behavioral disability to a gifted program. This sounds absurd to me, but the psychologist is the one who ultimately gets to make the decision.
Here's a summary of my original answer.
Gifted children are as similar and different from each other as are other children. While it appears from your daughter's evaluations, she shares enough traits with some who have Asperger's, she also has many characteristics of a gifted child. It's tempting to accept the disorder label because it will provide your daughter with special services. Because the school receives funding to pay for those services, they'll be willing to accept the diagnosis even if it's a borderline one. Funds are either non-existent or much smaller for gifted children than for children with disabilities. When a child clearly meets both criteria, school should provide for both; but they rarely do. You may end up battling the school to have your daughter in the gifted program with an Asperger's label.
It might be better to resist the diagnosis in the hopes of finding good academic and athletic opportunities and getting some additional mental health help outside the school for now. Private psychologists can help your daughter learn anger management, better communication, and social skills. Involvement in gifted academic and athletic sports programs can also improve her social skills. If these aren't sufficiently helpful and her problems become worse with maturity, you can then have your daughter re-evaluated for services.
Because I haven't actually evaluated your daughter, please regard this letter as only providing some thoughts to consider. You'll have to get guidance from the psychologists who are evaluating her in and outside of school. Below is the mother's update.
"I want to thank you for your great advice last year when we were struggling with the decision of whether to accept an Asperger's diagnosis for our gifted child based on a borderline score. Turns out that was the right advice for the school we were in at the time. Fortunately, we obtained a new school placement that is providing support for the whole child. She's loving it! Her disruptive behavior has completely evaporated. Depression and anger around school have lifted. The improvement in her eye contact within weeks of leaving the previous school astounded a doctor.
It appears that the disruptive behavior at school was mainly about improper educational setting. We've become very aware now of how rare the proper setting is for twice-exceptional kids. We're personally still on the fence about the Asperger label; but since the services are now available in an equitable and inclusive way, it's looking like a win-win situation. We feel very lucky for this outcome. Thanks so much for your help."
Dr. Sylvia Rimm is a child psychologist and clinical professor at Case University School of Medicine, author, newspaper and magazine columnist, and radio/TV personality. For free newsletters about gifted children, AD/HD, and/or learning disabilities, send a self-addressed, stamped envelope for each newsletter to P.O. Box 32, Watertown, WI, 53094. All questions are answered.