Are Gifted Kids being Misdiagnosed with ADHD and Other Disorders?
Are gifted kids being misdiagnosed with ADHD and other disorders such as obsessive compulsive disorder, oppositional defiant disorder, and mood disorders? Unfortunately, the literature shows that the misdiagnoses of exceptionally bright children continues to occur. The most common misdiagnosis of gifted children tends to be attention-deficit-hyperactivity disorder (ADHD), as these children may present with ADHD like behaviors, such as restlessness, moving rapidly from task to task, not paying attention, excessive talking and interrupting frequently, blurting out answers, impulsivity, being the center of attention, and poor frustration tolerance/impatience in the classroom, on the playground, in sports, and other social situations. Based on these behaviors, the child may be referred for an assessment for ADHD at the school or privately. If we simply use a checklist and behavioral observations to make the diagnosis, we may come to the false conclusion that the child has ADHD, and might recommend an ADHD focused behavioral plan and medication.
In the above situation, the risk of a gifted child being misdiagnosed with ADHD is that we have not taken into consideration the typical characteristics/behaviors/personality traits of gifted children. As we learn more about gifted kids, we realize that their blurting out answers, moving rapidly from task to task, not paying attention, not following directions, excessive talking, etc. may be more a reflection of their superior intelligence, creativity, higher cognitive functioning, boredom, and intense need to obtain and share information than ADHD. It is imperative that teachers, parents, clinicians, and pediatricians assess the child’s intellectual functioning and personality traits as part of the assessment to better determine if the child is gifted or ADHD. Of course there are some children who will fall into both camps and will have dual issues and a dual diagnosis. But our job is to tease apart the differences and overlap of these complicated behavioral presentations by conducting a gold standard assessment that includes comprehensive testing, behavioral observations, adult and self reports, and assessment interventions that can help us tease apart giftedness from ADHD.
The latter point is critical and two excellent articles guide us on conducting a more accurate assessment of gifted children. The SENG organization (Supporting Emotional Needs of the Gifted) identifies and provides us with an excellent list of factors and interventions to consider before we make an ADHD referral to better clarify if the child may be gifted and/or has ADHD. Dr. Hahn at Tufts Medical Center also provides us with excellent guidelines to better distinguish between giftedness and ADHD, and asks us to consider the possibility of giftedness in some children when diagnosing ADHD.
The recent research and literature highlights that it is also essential to pay attention to typical personality traits of gifted children, including exceptional creativity, high emotional intensity, emotional and physical sensitivities, insatiable curiosity, questioning, and challenges, and drive to understand and master when diagnosing depression, anxiety, bipolar disorder, obsessive compulsive disorder, and oppositional defiant disorder in some children. This very helpful resource facilitates a better understanding of how certain strengths and characteristics of gifted children can be easily misunderstood, misinterpreted, and misdiagnosed in gifted kids as mood disorders and/or oppositional defiant disorder. A highly recommended and informative book can further guide parents, teachers, clinicians, and pediatricians on how to better respond, assess, and intervene with gifted children that minimizes the potential for misdiagnoses of gifted kids.