Although considered controversial in the scientific and clinical communities alike, Rourke and Mykleburst coined this term to describe a subset of individuals that they were seeing in their clinical work who seemed incredibly bright but unable to “see the big picture”. In some cases, the individuals with this profile were thought to be gifted in the primary grades given their strong reading decoding skills, vocabulary, and rote memory and did not come to the attention of school personnel, families, or clinicians until middle elementary school or later. However, careful observation revealed many to struggle with the subtle emotional and behavioural cues emitted from others that are necessary for social success. Similarly, their tendency to get lost in detail rather than thinking about information in a more holistic manner contributed to difficulties with more abstract aspects of reading and language comprehension. Further, research revealed weaknesses with visual-spatial processing affecting math (aligning numbers, reading graphs) and subtle motor difficulties (drawing, implementing multi-step commands in body movement/coordination). The combination of challenges was found to impact social skills and communication (e.g., reading social cues, recognizing facial expressions and emotion, body language).
In our own clinical experience over the years, we have come across a similar subset of individuals often with known medical or neurological conditions that contribute to the above-mentioned clinical patterns. Often the only issues noted in early childhood or primary school are problems with fine motor skills. However, by grade 4-5, or beyond, teachers and parents become frustrated as the individuals begin to have difficulties coping with minor stressors, completing homework, seeming unprepared for classes, seeming unable to follow directions, having increasing difficulties with math, organizing essays/written assignments, being anxious in social or performance-based environments, and increasingly experiences social isolation or challenges fitting in.
A neuropsychological evaluation comprehensively evaluates the visual-perceptual, motor, executive, language, social cognitive skills, and other components that underlie this profile.
- Please note that the clinic does not provide diagnostic assessments for Autism or Pervasive Developmental Disorders. A list of excellent diagnosticians and allied health professionals who specialize in this area can be provided upon request. We do see older children, adolescents, and adults with high functioning Asperger’s/Autism, who have already been diagnosed, for in-depth neuropsychological assessment for academic and vocational planning only.