By Jean Goerss, M.D; Rick Clouse, M.D; and James Webb, Ph.D.
Citation: From National Psychologist. 16(2), 12. Reprinted with permission.
Because giftedness is rare, professionals who help children are often unfamiliar with it. Parents must advocate for their child with each adult who interacts regularly with their child, especially their physician, teacher and psychologist.
Psychologists, pediatricians, and family practitioners are trained to prevent, diagnose and treat common behavioral and health problems. Giftedness, by its very definition, is rare and not usually thought of as a medical or behavioral condition. It is, therefore, not surprising that most psychologists, pediatricians, and family practitioners are unfamiliar with giftedness and its relevance to behavior.
High ability children are seen intuitively as not having a problem. Problems arise when intellectual ability is not recognized and nurtured in supportive environment. Other extreme talents (athletic or musical, for example) may or may not be recognized and nurtured, but do not generally affect behavior because they are not bound up with it the way cognition is bound up with behavior. The daily tasks centered on cognition in schools are often coupled with restricted advancement and virtually guarantee a serious mismatch between the gifted child and his environment that leads to behavior problems or withdrawal. Cognition affects peer interactions as well, and the gifted child may have trouble fitting in. The natural person parents turn to for help is the child’s physician or psychologist.
The issue of giftedness often arises with the onset of problems. Generally, these are behavioral or school issues (or both) and often involve potential diagnoses of ADHD or Asperger’s Disorder. If a child’s physician or psychologist is unfamiliar with the common behavioral issues that arise with gifted children, the relevance of intelligence in evaluation and counseling parents may be overlooked.
Health issues require special attention which may be outside the scope of the primary care giver. Nevertheless, insurance companies often make them the gatekeepers for specialized evaluation and care, which means the psychologist may need their referral to access a specialist. Generally, pediatric neurologists focus on deficits and usually do not delve into the particulars of cognition. Developmental pediatricians focus almost exclusively on delayed development and are more likely to know and refer to a pediatric neuropsychologist who can more thoroughly test a child’s cognitive function. Any gifted child who is being evaluated for a behavioral problem within the school system or other institution needs to have an accurate assessment of cognitive ability. Educational placement, finding friends, and accurately diagnosing behavior problems are influenced by the extent of their intelligence.
There is a saying in medicine: “You do not see what you do not know.” This is especially true in the short period of time most physicians have to evaluate a patient. In fact, most pediatric physicians and family practitioners are not qualified to diagnose and counsel gifted children. Even if they recognize the giftedness, they have little or no training that would prompt them to caution the parent or recommend appropriate preventative measures.
Two nonprofit groups—Supporting Emotional Needs of Gifted (SENG) and the National Association for Gifted Children (NAGC)—have joined efforts to correct this lack of knowledge. A blue-ribbon committee, headed by James T. Webb, Ph.D., consists of clinical psychologists, pediatricians, family practitioners, nurse practitioners, and educators. This committee is preparing a brochure for parents that will be distributed to the waiting rooms of pediatricians and family practitioners throughout the country. This brochure is a first step at beginning to educate parents and health-care professionals about the characteristics and issues for gifted children and their families. Continuing education efforts are already underway by SENG, and plans are being made to expand CE offerings.
The Internet provides ready access to information about giftedness and is often where parents first turn to find information they need to guide their child. Often, parents find that they must then educate their psychologist, pediatrician, or family practitioner about characteristics of gifted children—such as intensity, sensitivity, and asynchronous development—that can lead to misdiagnosis. Other parents provide information about health conditions that are more frequent among gifted children, such as allergies and asthma. Through such efforts, health care and counseling professionals can become supportive allies for families of gifted children.
Professionals who would like to know more about gifted children can look at:
Liu, Y.H. & Lien, J. (2005). Discovering gifted children in pediatric practice. Journal of Developmental and Behavioral Pediatrics.26, 366-369.
Robinson, N. & Olszewski-Kubilius, P. (1996). Gifted and talented child: Issues for pediatricians. Pediatrics in Review.17, 427-434.
Webb, J.T., Amend, E.R., Webb, N.E., Goerss, J., Beljan, P, and Olenchak, F.R. (2004). Misdiagnosis and dual diagnoses of gifted children and adults: ADHD, Bipolar, OCD, Asperger’s, depression, and other disorders. Scottsdale, AZ: Great Potential Press.
Other sources of information both for professionals and parents are websites such as www.NAGC.org, www.sengifted.org and www.hoagiesgifted.com. A new and very relevant book just published is A Parent’s Guide to Gifted Children (2007) by Webb, Gore, Amend, and DeVries.