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One possibility is William's Syndrome. It is not always allied with severity in cognitive delay, but it cannot be ruled out simply for that reason. The two friends I have with the condition are considerably more positive and optimistic than many of my friends with Asperger's.

They are therefore far more likely to repeatedly engage in approaches that might lead to real friendship and more typical social participation, but on the whole seem about as likely to succeed as people with Asperger's (i.e. as an exception to the rule that they can make and maintain friendly relationships they succeed from time to time and that this is often as dependent on the other person being accepting of difference and identifying their own differences as it is upon the skills of the person reaching out).

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Q: What may cause a child to have both severe cognitive delay and always happy demeanor but not Angelman syndrome?
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