Mild autism with special skills and non-autistic gifted children with low social skills: differential diagnosis

*Correspondence: [e-mail].

Abstract

Background: Considering the increased demand for mild autism diagnosis it is very important to understand the subtle clinical conditions, where the borders are not well delimited. In this context, establishing the differential diagnosis between autism spectrum disorder (ASD) and children with high cognitive abilities (special gifted) with impairment in social skills is crucial. These conditions have significant overlap since it is estimated that 10% of children in the autism spectrum have some type of special skill or savant characteristic (Rimland, 1988) and, in general, children with high cognitive abilities are also more likely to present social difficulties (Hoogeveen, 2008). Therefore, it is urgent that we understand how to distinguish autistic high functioning children from neurotypicals with high IQ, in order to promote better development and adequate stimulation.

Objective: To discuss the differential diagnosis between children with mild autism and special skills from non-autistic gifted children (with high IQ) with low social skills.

Methods: A search was performed in March 2023 on PubMed with the keyword combinations: Autism AND high abilities; Autism AND gifted; Autism AND prodigy; Autism AND savant.

Results: Data synthesis: 223 articles were found, and, after reading, only 7 of those were focused on the differential diagnosis between ASD and gifted children. From the review articles, data were found that points to different causes behind social difficulties in both groups: while children with autism present difficulties in understanding facial expressions and reading social situations, gifted children that don’t have autism tend to look for symmetrical social relationships, with people that have similar cognitive ability and interests, which is not frequently found among pairs of the same age. Another relevant aspect for the differential diagnosis between the groups is the linguistic ability, especially pragmatics, which is revealed to be compromised in the autism group, but not in the high abilities group.

Conclusion: It is essential to evaluate the ability to read social situations and the competence in social use of language (pragmatics) in order to achieve a more precise differential diagnosis between children with mild autism and non-autistic gifted children with low social skills. Although both groups may present social difficulties, the causes are very distinct, as well as the interventions to be made.

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Artikel online veröffentlicht:
12. Mai 2025