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ADHD and children who are gifted.

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 daydreams 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, daydreaming) 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.

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.

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.

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.

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 might 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 nonchallenging 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 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.

References

American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed. rev.). Washington, DC: Author Barkley, R. A. (1990). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford Press. Clark, B. (1992). Growing up gifted. New York: Macmillan. 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. 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. James T. Webb, Ph.D., is Professor and Associate Dean, School of Professional Psychology, Wright State University, Dayton, Ohio and senior author of Guiding the Gifted Child. Diane Latimer, M.A. is at the School of Professional Psychology, Wright State University.
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Title Annotation:attention deficit hyperactivity disorder
Author:Webb, James T.; Latimer, Diane
Publication:Exceptional Children
Date:Oct 1, 1993
Words:1210
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