ADHD and Children Who Are Gifted

By James T. Webb and Diane Latimer.

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 groups 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