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Old 10-01-05, 10:15 PM
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ADHD and Children Who Are Gifted

http://www.kidsource.com/kidsource/c...nd_gifted.html

ADHD and Children Who Are Gifted

by James T Webb and Diane Latimer
ERIC EC Digest #522 1993




Howard's teachers say he just isn't working up to his ability. He doesn't finish his assignments, or just puts down answers without showing his work; his handwriting and spelling are poor. He sits and fidgets in class, talks to others, and often disrupts class by interrupting others. He used to shout out the answers to the teachers' questions (they were usually right), but now he day-dreams a lot and seems distracted. Does Howard have Attention Deficit Hyperactivity Disorder (ADHD), is he gifted, or both?

Frequently, bright children have been referred to psychologists or pediatricians because they exhibited certain behaviors (e.g., restlessness, inattention, impulsivity, high activity level, day-dreaming) commonly associated with a diagnosis of ADHD. Formally, the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) (American Psychiatric Association) lists 14 characteristics that may be found in children diagnosed as having ADHD. At least 8 of these characteristics must be present, the onset must be before age 7, and they must be present for at least six months.

DSM-III-R Diagnostic Criteria For Attention-Deficit Hyperactivity Disorder*
  1. Often fidgets with hands or feet or squirms in seat (in adolescents may be limited to subjective feelings of restlessness).
  2. Has difficulty remaining seated when required to.
  3. Is easily distracted by extraneous stimuli.
  4. Has difficulty awaiting turns in games or group situations.
  5. Often blurts out answers to questions before they have been completed.
  6. Has difficulty following through on instructions from others (not due to oppositional behavior or failure of comprehension).
  7. Has difficulty sustaining attention in tasks or play activities.
  8. Often shifts from one uncompleted activity to another.
  9. Has difficulty playing quietly.
  10. Often talks excessively.
  11. Often interrupts or intrudes on others, e.g., butts into other people's games.
  12. Often does not seem to listen to what is being said to him or her.
  13. Often loses things necessary for tasks or activities at school or at home (e.g., toys, pencils, books).
  14. Often engages in physically dangerous activities without considering possible consequences (not for the purpose of thrill-seeking), e.g., runs into street without looking.
Almost all of these behaviors, however, might be found in bright, talented, creative, gifted children. Until now, little attention has been given to the similarities and differences between the two groups, thus raising the potential for misidentification in both areas-giftedness and ADHD.



Sometimes, professionals have diagnosed ADHD by simply listening to parent or teacher descriptions of the child's behaviors along with a brief observation of the child. Other times, brief screening questionnaires are used, although these questionnaires only quantify the parents' or teachers' descriptions of the behaviors (Parker, 1992). Children who are fortunate enough to have a thorough physical evaluation (which includes screening for allergies and other metabolic disorders) and extensive psychological evaluations, which include assessment of intelligence, achievement, and emotional status, have a better chance of being accurately identified. A child may be gifted and have ADHD. Without a thorough professional evaluation, it is difficult to tell.


How Can Parents or Teachers Distinguish Between ADHD and Giftedness?

Seeing the difference between behaviors that are sometimes associated with giftedness but also characteristic of ADHD is not easy, as the following parallel lists show.

BEHAVIORS ASSOCIATED WITH ADHD (BARKLEY, 1990)
  1. Poorly sustained attention in almost all situations
  2. Diminished persistence on tasks not having immediate consequences
  3. Impulsivity, poor delay of gratification
  4. Impaired adherence to commands to regulate or inhibit behavior in social contexts
  5. More active, restless than normal children
  6. Difficulty adhering to rules and regulations
BEHAVIORS ASSOCIATED WITH GIFTEDNESS (WEBB, 1993)
  1. Poor attention, boredom, daydreaming in specific situations
  2. Low tolerance for persistence on tasks that seem irrelevant
  3. Judgment lags behind development of intellect
  4. Intensity may lead to power struggles with authorities
  5. High activity level; may need less sleep
  6. Questions rules, customs and traditions

Consider the Situation and Setting

It is important to examine the situations in which a child's behaviors are problematic. Gifted children typically do not exhibit problems in all situations. For example, they may be seen as ADHD-like by one classroom teacher, but not by another; or they may be seen as ADHD at school, but not by the scout leader or music teacher. Close examination of the troublesome situation generally reveals other factors which are prompting the problem behaviors. By contrast, children with ADHD typically exhibit the problem behaviors in virtually all settings-including at home and at school-though the extent of their problem behaviors may fluctuate significantly from setting to setting (Barkley, 1990), depending largely on the structure of that situation. That is, the behaviors exist in all settings, but are more of a problem in some settings than in others.

In the classroom, a gifted child's perceived inability to stay on task is likely to be related to boredom, curriculum, mismatched learning style, or other environmental factors. Gifted children may spend from one-fourth to one-half of their regular classroom time waiting for others to catch up-even more if they are in a heterogeneously grouped class. Their specific level of academic achievement is often two to four grade levels above their actual grade placement. Such children often respond to non-challenging or slow-moving classroom situations by "off-task" behavior, disruptions, or other attempts at self-amusement. This use of extra time is often the cause of the referral for an ADHD evaluation.

Hyperactive is a word often used to describe gifted children as well as children with ADHD. As with attention span, children with ADHD have a high activity level, but this activity level is often found across situations (Barkley, 1990). A large proportion of gifted children are highly active too. As many as one-fourth may require less sleep; however, their activity is generally focused and directed (Clark, 1992; Webb, Meckstroth, & Tolan, 1982), in contrast to the behavior of children with ADHD. The intensity of gifted children's concentration often permits them to spend long periods of time and much energy focusing on whatever truly interests them. Their specific interests may not coincide, however, with the desires and expectations of teachers or parents.

While the child who is hyperactive has a very brief attention span in virtually every situation (usually except for television or computer games), children who are gifted can concentrate comfortably for long periods on tasks that interest them, and do not require immediate completion of those tasks or immediate consequences. The activities of children with ADHD tend to be both continual and random; the gifted child's activity usually is episodic and directed to specific goals.

While difficulties and adherence to rules and regulations has only begun to be accepted as a sign of ADHD (Barkley, 1990), gifted children may actively question rules, customs and traditions, sometimes creating complex rules which they expect others to respect or obey. Some engage in power struggles. These behaviors can cause discomfort for parents, teachers, and peers.



One characteristic of ADHD that does not have a counterpart in children who are gifted is variability of task performance. In almost every setting, children with ADHD tend to be highly inconsistent in the quality of their performance (i.e., grades, chores) and the amount of time used to accomplish tasks (Barkley, 1990). Children who are gifted routinely maintain consistent efforts and high grades in classes when they like the teacher and are intellectually challenged, although they may resist some aspects of the work, particularly repetition of tasks perceived as dull. Some gifted children may become intensely focused and determined (an aspect of their intensity) to produce a product that meets their self-imposed standards.


What Teachers and Parents Can Do

Determining whether a child has ADHD can be particularly difficult when that child is also gifted. The use of many instruments, including intelligence tests administered by qualified professionals, achievement and personality tests, as well as parent and teacher rating scales, can help the professional determine the subtle differences between ADHD and giftedness. Individual evaluation allows the professional to establish maximum rapport with the child to get the best effort on the tests. Since the test situation is constant, it is possible to make better comparisons among children. Portions of the intellectual and achievement tests will reveal attention problems or learning disabilities, whereas personality tests are designed to show whether emotional problems (e.g., depression or anxiety) could be causing the problem behaviors. Evaluation should be followed by appropriate curricular and instructional modifications that account for advanced knowledge, diverse learning styles, and various types of intelligence.

Careful consideration and appropriate professional evaluation are necessary before concluding that bright, creative, intense youngsters like Howard have ADHD. Consider the characteristics of the gifted/talented child and the child's situation. Do not hesitate to raise the possibility of giftedness with any professional who is evaluating the child for ADHD; however, do not be surprised if the professional has had little training in recognizing the characteristics of gifted/talented children (Webb, 1993). It is important to make the correct diagnosis, and parents and teachers may need to provide information to others since giftedness is often neglected in professional development programs.



*Note. DSM-III-R Diagnostic Criteria For Attention-Deficit Hyperactivity Disorder reprinted with permission from the "Diagnostic and Statistical Manual of Mental Disorders," Third Edition, Revised, Washington, DC, American Psychiatric Association, 1987.


References

American Psychiatric Association (1987). "Diagnostic and statistical manual of mental disorders," Third edition, revised. Washington, DC: Author.

Barkley, R. A. (1990). "Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment." Guilford Press: New York.

Clark, B. (1992). "Growing up gifted." Macmillan: New York.

Parker, H. C. (1992). "The ADD hyperactivity handbook for schools." Plantation, FL: Impact Publications.

Webb, J. T. (1993). "Nurturing social-emotional development of gifted children." In K. A. Heller, F. J. Monks, and A. H. Passow (Eds.), "International Handbook for Research on Giftedness and Talent," pp. 525-538. Oxford: Pergamon Press.

Webb, J. T., Meckstroth, E. A., and Tolan, S. S. (1982). "Guiding the gifted child: A practical source for parents and teachers." Dayton: Ohio Psychology Press.



Credits

This ERIC Digest was developed in 1993 by James T. Webb, Ph.D., Professor and Associate Dean, and Diane Latimer, M.A., School of Professional Psychology, Wright State University, Dayton, Ohio.

The Council for Exceptional Children,
ERIC Clearinghouse on Handicapped and Gifted Children,
Reston, Va.

This publication was prepared with funding from the Office of Educational Research and Improvement, U.S. Department of Education, under contract no. RR93002005. The opinions expressed in this report do not necessarily reflect the positions or policies of OERI or the Department of Education.




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Old 10-01-05, 10:23 PM
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I have found that there is very little about what ADD/ADHD and giftedness combined look like. Most of the information is about how gifted students are often misdiagnosed. Here are a few links describing what ADD and giftedness together look like:

http://www.addresources.org/article_gifted_lovecky.php
http://www.addvance.com/help/parents/gifted_child.html
http://www.ncpamd.com/Gifted_ADD.htm
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Last edited by HighFunctioning; 10-01-05 at 10:43 PM.. Reason: Did I just post the same link twice? ;-)
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Old 10-01-05, 10:45 PM
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Teachers are good at pointing out problems with gifted kids. I don't think it's unusual for a gifted kid to slack off, to get low grades. But they can snap out of it like that. ADHD kids don't turn the tap on and off quick like that. When failure or low grades are chronic over a year or so then you begin to wonder. Thing is, a gifted kid can coast for the longest time. It's when they hit high school that often a difficulty becomes more apparent. You usually see this in the maths and sciences. University is another crunch time and sometimes you see them crash and burn there.

This is a good site. http://www.uniquelygifted.org/

I used to get a daily synopsis from the twice exceptional internet group which I couldn't immediately find from this link. There were too many posts to even try and read. I gave up, you had to scroll down and there would be 30 lengthy posts. Lots of intelligent people there and it's a good place to look if you want personal support.

The other thing to consider, is that if a kid is gifted and has ADHD, then they probably have something else also. So they could be thrice exceptional.
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Old 10-02-05, 01:40 AM
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You know what, Scuro...I posted this, with you in mind, actually !!
I absolutlely adore you!
Even when you don't think I do !
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Old 10-02-05, 02:47 AM
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Quote:
The other thing to consider, is that if a kid is gifted and has ADHD, then they probably have something else also. So they could be thrice exceptional.
Scuro, I'm curious - why do you think gifted ADDers are likely to have "something else"? (for lack of a better phrase, LOL) Are you talking in terms of brain chemistry or coping mechanisms?
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Old 10-02-05, 10:30 AM
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A gifted person with ADHD will typically have another problem. Not because they are gifted but because they are ADHD. ADHD ususally has a travelling buddy. The typical other buddies is behavioural issues, anxiety/depression, or an LD. But, it could be any mental disorder.
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Old 10-02-05, 05:16 PM
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i am walking evidence then. I should be the poster child..AD/HD diagnosed at age 6, my school kicked me out, in kindergarten refusing to let me back unless I went to a psychiatrist and got on some type of medication to calm me down. My kindergarten teacher loved me though, she told my parents I was very smart, I was put in a gifted children's program at my school, until I was in 4th grade, I got kicked out b/c I started to refuse to do my book report projects and then I started to refuse to do most other homework in 5th grade. I was almost held back...Big problems arose after being taken off the medication...I just noticed what my problem was about a year ago. I am on meds. again and I am starting to feel like my old self again.

Anyway, that up there, it's just a piece of the story.
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Old 10-02-05, 08:57 PM
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lmao.. I think that ADHD is probably comorbid with more gifted kids than the literature is willing to identify. I was in serious danger of being held back in 7th grade because I refused to do the freehand maps for TX Hist. I past the class by making 100 on the last two grading periods exams...without doing anything but looking over my notes.
I coasted through high school A's & B's with doing no reading and very little studying ever.
Yes it did catch up with me in the math and science end in college although I managed to get enough credits in both for my BS. I went back to graduate school several years ago and managed to keep a 4.0 ... but I also was very interested in every subject i researched.
Of course the ADHD stuff is there too. I set down things without knowing where. I walk into the kitchen and have no idea why I went there. I start out with one task and get sidetracked by 2 or 3 others. All the typical things about ADHD that make the people around us crazy
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Old 10-02-05, 09:14 PM
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Wow, Nova! The scary thing is, that is EXACTLY like me!! Whoa!!
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Old 10-02-05, 09:50 PM
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Ditto here on the accelerated/gifted programs as a child, I hit my wall in middle school when organization and written expression problems started to snowball.

Once giftedness is thrown into the mix, you're opening a whole new can of worms, my experience has been pretty textbook with a lot of those matters.

Probably the most important aspect of that unique combination is the incredible havoc that the doublewide ability-performance gap can wreak on someone who will usually "slip through the cracks" because of homegrown compensation techniques that they can come up with. Often times serious guilt can arise at a young age and become a pattern because of the issues surrounding performing up to one's real ability versus performing up to one's grade level.

Can't even tell you how many times over the years I never considered even seeing a specialist because I was managing to perform well at my grade level, but still falling monumentally short of what I and others knew I was capable of. The frustration was absolutely madenning, and it led to substance abuse problems and damn near killed me before I finally swallowed my pride and managed to get a simple ADD diagnosis a few years ago.

That was one of obviously two or three pieces to my puzzle. I've been procrastinating for three years on going to a specialist who knows to do more than simply include the words "despite exceptional intelligence" in my diagnosis reports sent to college. My current Dr. is unfortunately of the "if your medication has kept you from failing out completely, don't complain" school, so I need to make a change soon.

I've subscribed to the gt-special listserv for a while, and I'll echo what someone else said before about the ludicris number of long posts every day... I haven't even tried to read it for about two years... it's impossible to weed through the endless posts from parents, and it's more in the vein of a support and networking group for those parents than it is a community for people like us to discuss our experiences.

There are some very interesting things I found out from my research in the gt/ADD communities. I posted a thread years ago here about it and have since assembled what I think is a fairly legitimate theory surrounding a very strange type of migraine that I experience on occasion that I think the gt/ADD mix contributes to. Continue on if you can bare the boredome of my explanation...

I have what they call "retinal migraine without headache," and I'm sure at least one person who reads this will have experienced exactly what I'm talking about. More or less sometimes when I'm hyperfocusing or experiencing anxiety a pretty rare type of migraine is triggered and I essentially go blind in one fourth to three quarters of my visual field, but without any pain.

The numbers work out to this being a pretty rare migraine disorder among the general population - it works out to about two or three people out of a million experiencing it. In the aforementioned gt/ADD community, however, I got responses from well over 20 people who have the same exact migraine disorder whether diagnosed or not. That's a huge number among that community.

Learning what I have from my research, it appears that the gt/ADD person is particularly predisposed to this condition because of their extreme intensity that surfaces quite often. Current theories suggest that high levels of norepinephrine can trigger migraines and their nerve spasms, so it makes perfect sense that people like me feel like they're "blowing a fuse in their brain" when they go blind during times of intense focus... because essentially the amounts of norepinephrine their brains are capable of releasing at those times is so much higher than what falls under the "normal spectrum" for the "normal" population... I believe the levels get so high that they cause the retinal nerve spasm... the nerve "hyperventilates" if you will.

LOL, talking about my theories in silly long and boring posts... I guess you are what you say you are, huh?

ADD is already so complex and difficult as it is, giftedness can make it damn near intolerable in the emotional aspect because of the added complications. Hell, all signs are pointing toward me being one of those "thrice-exceptional" individuals myself, as a writing disorder is starting to become glaringly apparent as well.

I wish I could remember some of the better things I've come across relating to the research I've done over the years, but I read most of them in one of those 10-20 day frenzies where I just obsessively devour materials nonstop, so it's all blurred together. (something typical among gt/add individuals, a hyperfocus that is often times super-productive in the learning sense, but horribly destructive at the expense of normal functioning - even moreso than in cases where ADD stands alone)

I found most of my information at my university's education library. I'd say if anyone is really interested, the best thing to do is go to the library at a college with a respected special-ed curriculum and search the online indexes for "dual exceptionality," or "twice exceptional." There's a lot of digging that needs to be done, but there is good material out there in some obscure places.

I'll have graduated college in a few months before I finally get to a specialist who's going to give me the definative IQ and learning disorder tests that are going to solidify those labels... Something I am NOT looking forward to.

To be perfectly honest with you, I really can't wait til I inevitably do get a specialist to concur with me on the whole twice, and possibly three-times exceptional conclusion solely because I want to go back to the horrible SPED people at school who wouldn't help me, wave it in their face and mockingly tell them "told ya so." Let's hope I maintain my maturity and restraint and never bring myself to do that!


(EDIT)

My Lord, that was a bit over the top in length... maybe that's why I've got one of them damn migraines coming on...
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Old 10-02-05, 10:41 PM
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I'm confused... I meet/met almost all the criteria on the gifted list. That story at the top of the article also sounds very familar, it could have been written about me.

So does that mean that I might be gifted, and not ADHD?

I always saw 'gifted' as those kids who didn't have trouble putting those gifts to use. I would qualify by IQ tests, but I would never have been able to maintain the grades.. So where does one draw the line between gifted and ADHD?
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Old 10-02-05, 10:49 PM
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I think what most of us are saying are that the two probably go together frequently, but the disorganization and disinterest in subjects become a huge roadblock to self-actualization
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Old 10-03-05, 01:23 AM
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Quote:
Originally Posted by Jaycee
I think what most of us are saying are that the two probably go together frequently, but the disorganization and disinterest in subjects become a huge roadblock to self-actualization
Incredibly well versed, Jaycee!
I think my goal, by posting these articles, on creative, gifted ADDers, is to hopefully get y'all to see yourself, as you're supposed to see yourself.
No one goes around blind people, and tells them, all day long, 'You're blind'...and I get tired of hearing the negative traits of having ADHD, from age seven, (from birth, actually, but they probably thought I'd grow out of it) on up.
The best thing we can all do, for ourselves, and one another, is to be reminded, as much as possible, of how incredibly talented, we all are-in whatever fields we are in, in whatever classes we take, in getting up each day, and putting up with all the insecure and jealous people, that think because we're late to functions, or, do not understand a question, because it wasn't phrased properly, it gives them rights to verbally assault or ridicule us.

I understand how we all either love or hate something...more than you realize...but don't use that same concept when you judge yourself.
You can be both..simultaneously, or back and forth...ADD/HD AND GIFTED.

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Old 10-03-05, 01:24 AM
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Exactly like 'US'

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Originally Posted by Gil R
Wow, Nova! The scary thing is, that is EXACTLY like me!! Whoa!!
Exactly like 'Us', Gil...
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Old 10-03-05, 07:56 AM
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My lil girl is ADHD combined type and she is VERY good in spelling and writing any kind of story there is and she is only 8 but she struggles very much so in math.
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