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12-23-05, 11:47 AM
The Gifted Student with ADD: Between Two Worlds
Carol Watkins, MD
Baltimore, Maryland

The gifted child or adolescent with AD/HD may not fit classical definitions of educationally handicapped or gifted. On one hand, he may be able to use his skills to cover up the AD/HD and thus never receive help or guidance. On the other hand, he may be doubly handicapped, the minority within a minority who cannot fit into either accelerated classes or special education settings.

Giftedness has been defined in a variety of ways. In the past, giftedness was defined by a global score on an IQ test. More recently, professionals have been interested in looking at different types of talents instead of a global number. The term gifted is often used to refer to students with academic gifts in language or mathematics. Individuals with specific gifts in the areas of art, music or athletic performance are sometimes called talented. In this paper, I will be focusing on AD/HD students with great strengths in verbal or mathematical skills.

Gifted children and children with AD/HD can share many characteristics. Both groups may tend to question authority. A gifted child without AD/HD may become restless or even disruptive if the curriculum is not challenging. Some teachers may not appreciate a gifted child’s creative solutions to problems. Some studies have suggested that gifted children may be more active and sleep less than normal children. In the past, many educators felt that the gifted showed “across the board achievement.” More recent studies show that unevenness in abilities is greater in the gifted than in people with average intellectual ability. Unlike AD/HD children, gifted children usually pay attention quite well when placed in accelerated classes. An exception is the small group of profoundly gifted children whose abilities are so divergent that regular programs for the gifted cannot serve them. In this small group, there may be an increased incidence of educational and emotional problems whether or not AD/HD is present.

A gifted student with AD/HD may have particular challenges. A bright individual, often more self-aware, is more likely to perceive himself as inadequate. If the task is repetitive or below the student’s achievement level, he will tune out all the faster. Consequently, he will miss out on vital information presented later in the lesson. The same student, engaged, can perform brilliantly. Teachers may interpret poor performance as laziness or conflicts with particular teachers. In some cases, AD/HD students may spend time in resource room, unequipped to meet his or her unique needs.

When a student is gifted and also has AD/HD, while tests may indicate that he is gifted while he is performing at only an average level in classes. His homework and class work may be poor but his actual test and exam grades may be excellent. A student may be placed in a slower curriculum because the school may place many types of special needs students together. The student, bored and frustrated, may act out more, making administrators less likely to place him in a more challenging curriculum. This last situation may lead to a paradox for the student and his parents. While, they may feel that an unchallenging curriculum is exacerbating the child’s inattention or impulsivity, the school, on the other hand, may resist placing the student into an accelerated class until he can show improved performance.

Proper evaluation and diagnosis is essential. The comprehensive assessment should include a careful psychiatric evaluation to diagnose the AD/HD. The psychiatrist should also look closely for signs of depression, anxiety and other conditions that can co-exist with AD/HD. Psychological and educational testing are important parts the evaluation as well. Psychiatrists and psychologists often use continuous performance tests to help assess AD/HD. The manual for the (Tests of Variables of Attention) TOVA suggests that a score within the average range may actually be abnormal in an individual with an IQ in the gifted range. Gaps between intellectual ability and actual performance may indicate areas of learning disability. If the student is particularly creative, the parents may want to bring a portfolio of his work to the assessment.

Proper evaluation is beneficial even if the student doing fairly good work in school. Many bright adults are not diagnosed until they are much older. As children, they used their superior intellectual and creative abilities to develop their own learning strategies. Sometimes, this produces a creative, individualistic adult. Often, though, they experience the chronic strain of trying to compensate, and the shame of low achievement.

The gifted student may be eager to know more about his diagnosis. He may want a more technical explanation of the biological and psychological basis of AD/HD. In some cases, the clinician and family watch in amazement as the student takes the information and “runs with it.” A better understanding makes it easier to develop coping strategies. For those too inattentive to read books, there are books on tape about AD/HD.

Treatment is often multi-modal. Many treatments are similar to those recommended for individuals of average intelligence. These can include medication, behavioral programming and therapy. For some students, this may decrease or even eliminate the need for educational accommodation. Such a student may be excited and relieved when truly able to experience his great talents. If a learning disability (LD) is present, or if the AD/HD does not respond to medication, one may need to modify the school situation.

Gifted AD/HD students may be enrolled in either public or private schools. In the public schools, parents and staff can arrange educational modifications through 504 plans or an IEP (Individual Education Plan). In other cases, modifications are arranged on an informal basis. A student with an IQ of 135 who maintains passing grades only through hours of arduous supervised nightly homework, is still educationally handicapped. In Pennsylvania, giftedness is specifically recognized as a special education condition. In some other states, it may be more difficult to get special education services for highly gifted students who are performing at grade level. Informal agreements such as preferential seating, extra homework reminders, and a lower homework volume can help. Some gifted AD/HD students can benefit from being moved into more accelerated classes with special accommodations.

Certain private schools work well with bright AD/HD and LD students. The curriculum, along with small classes, tutoring on site and involved parent organizations, can serve such students well, especially since social skills development are built in. However, private schools are expensive, and may have waiting lists.

In the past decade, admission to traditional private schools has become much more competitive. This has made it more difficult for bright students with even mild AD/HD to secure admission to some schools. Parents should seek some guidance about which school might be best for their child. Many students with minimal LD and well-controlled AD/HD can do quite well in these schools. It is best if the school can provide small classes, some degree of structure without rigidity. The curriculum should still allow the student to express his areas of brilliance.

Parents can do many things at home to help stimulate a gifted AD/HD student. The parents themselves are often bright, energetic, and creative. They can provide appropriate learning situations for their child or adolescent at home. They might obtain accelerated material that is presented in a manner that captures his attention. This could include the truly educational computer programs, or special science and writing camps. Day trips and other excursions can provide the opportunity for informal teaching and learning. For instance, a parent might take his middle school offspring to yard sales to teach the microeconomic concept of supply and demand. From there, one can move to a discussion of barter economies in various parts of the world. A parent can encourage a child or adolescent who is artistically talented or writes well, a parent can encourage him to keep a portfolio of his work.

Both gifted and AD/HD individuals may have to deal with the feeling of being different from others. Sometimes, bright individuals who experience chronic frustration can develop narcissism as a defense against low self-esteem. Be empathic, and nurture his special gifts. At the same time, help him realize that he must live with other people in the world.