Trastorno del espectro autista en menores con superdotación intelectual: descripción de un diagnóstico complejo

Abstract

Introduction

We intend to analyze the clinical characteristics of intellectually gifted minors with autism spectrum disorder (ASD), stating that early identification of giftedness is not linked to an early ASD diagnosis.

Material and method

Descriptive analysis in a sample of n = 8 patients ages 7 to 16, with identified giftedness refered to a medical consultation specialized in infantile autism for a diagnostic evaluation.

Results

6 of the latter referred patients received an ASD clinical diagnosis. Only 3 of the patients were above the cut-off point for autism spectrum on the ADOS-2 evaluation. The average age of detection was 5’88 for Giftedness and 9’83 for ASD, with an average time of 4’83 years elapsed in between. All of them had been previously evaluated in Mental Health Services and 7 had received at least one previous psychiatric diagnosis, as well as psycho-pharmacological treatment.

Discussion

It is possible that the superimposition between the clinical characteristics of Giftedness and ASD symptoms may delay the latter’s diagnosis when the previous have been detected, be it due to a masking phenomenon, an attribution bias, or that the Giftedness category is better accepted. This patients significant clinical deterioration seems to worsen during adolescence. The uncompleted conceptualization of neuro-divergence may be hampering the clinicians ability to identify and classify minors with an atypical neurodevelopment.

Conclusions

Giftedness identification may delay ASD diagnosis. We must improve investigation about neuro-development and neuro-diversity, as well as intelligence and its connection to ASD. Child and Adolescent psychiatrists’ specific training in neuro-development is therefore essential.