By thinking
of giftedness as an “exceptional” condition, it follows that those labeled or
diagnosed as gifted are indeed exceptional individuals. They are the exception
from the norm – most frequently illustrated on the right-hand outer edges of a
traditional bell curve of intelligence measures.
There is
some concern that the exceptionality of giftedness is occasionally misdiagnosed
or mistaken for other exceptionalities, “because specific social
and emotional characteristics of gifted children are mistakenly assumed to be signs
of pathology,” according to James T. Webb, psychologist and
noted gifted education advocate, who wrote Misdiagnosis and Dual Diagnoses of Gifted Children and Adults.
Among the most common misdiagnoses – or also a common
dual diagnosis along with giftedness – is the condition of Attention
Deficit/Hyperactivity Disorder. According to M. Layne Kalbfleisch’s and
Meredith Banasiak’s ADHD chapter in “Critical Issues and Practices in GiftedEducation,” the two conditions “can share many similar traits including rapid
speech, impulsive actions, overindulgence, extra sensitivity to environmental
stimuli, intense curiosity, melodrama, tendency to mix truth with fiction, use
of image and metaphor, behavior extremes, somatic complaints, and difficulty
adjusting to new environments.”
Among the first to link giftedness to what he termed “overexcitabilities”
is Polish psychiatrist and psychologist Kazimierz Dabrowski. He identified five
areas of intensity:
- Psychomotor
- Sensual
- Intellectual
- Imaginational
- Emotional
According to Dabrowski, these overexcitabilities can
bring much joy – there are reasons to celebrate these excitabilities, while the
frustrations and negatives that excitabilities may bring about can “be
positively dealt with and used to help facilitate the child’s growth,”
according to a SENG (Social/Emotional Needs of Gifted Children) newsletter.
Dr. Webb describes it in the following manner: “Gifted
children-and gifted adults often are extremely intense, whether in their
emotional response, intellectual pursuits, sibling rivalry, or power struggles
with authority figures. Impatience is also frequently present, both with
oneself and with others. The intensity also often manifests itself in
heightened motor activity and physical restlessness.”
The misdiagnosis of ADHD in gifted children may be
attributed to the manner in which ADHD is often diagnosed by a collection of
behavior checklists, often filled out by parents and teachers. “The behaviors
of children with ADHD are generally thought to be caused by a neurological
abnormality in the prefrontal cortex of the brain and/or neurotransmitter
dysfunction. ADHD behaviors exhibited by gifted children likely have far
different explanations,” according to a Winter 2004 Roeper Review article
entitled “Gifted or ADHD.” Kalbfleisch and Banasiak have one such possible
different explanation: the failure “to
assess how intellectually engaging a (gifted) child’s environment is.” Dr. Webb
puts it bluntly by pointing out the boredom gifted children may experience in a
classroom – he estimates that gifted students “may spend a quarter to half
their day waiting for kids to catch up.” That amount of boredom may indeed
cause a gifted student to display ADHD-like behaviors.
So while there is the potential to misdiagnose ADHD
in gifted children, there certainly are also correct diagnoses of both giftedness
and ADHD. The Diagnostic and Statistical Manual of Mental Disorders(DSM), which outlines a list of behavioral criteria used to identify any of the
three ADHD subtypes, states that “individuals with ADHD may show intellectual
development in the above-average or gifted range.”
Studies of gifted children with ADHD and gifted
children without ADHD show that children with the combined condition “tend to
exhibit inconsistency in academic performance, difficulties with handwriting,
and prefer group or participatory activities to working alone,” according to
Kalbfleisch and Banasiak. Furthermore, gifted students with ADHD will have
difficulty acquiring new information at the same speed that gifted students
without ADHD are able to demonstrate. “Thus, there is a gap between rapid
knowledge acquisition and what a gifted student with ADHD may be able to
demonstrate.” Gifted students with ADHD should be given the opportunity to show
their knowledge in verbal presentations rather than written recall scenarios.
Interestingly, Kalbfleisch and Banasiak also point out
potential benefits of the combined condition of giftedness and ADHD such as high
degrees of creativity, propelled by complete immersion to a task that can
actually lead to a state of “flow” or “hyperfocus.”
There certainly is the potential to mis- or
over-diagnose ADHD, particularly with gifted children. With that thought in
mind, it is naturally critical that only a licensed/qualified clinician make
such a diagnosis. According to the American Psychiatric Association, “symptoms
of hyperactivity must be present for at least six months to a point that it is
disruptive and inappropriate for developmental level.”
