ADHD and Giftedness: What
Do We Really Know?
by Kaufmann, Kalbfleisch, and Castellanos
For more articles on disabilities and special ed visit
What Is ADHD and How Is It Diagnosed?
What do we know about Attention-Deficit/Hyperactivity Disorder
(ADHD) and gifted kids? ADHD, especially in the gifted, has
been in the spotlight of attention, concern, and passion.
Three experts in the field conducted an exhaustive study and
share their findings with us.
What is ADHD?
The core symptoms of ADHD are impulsivity, inattention, and
hyperactivity. Estimates vary but the average occurrence of
ADHD in school-aged children is two percent.
In 1999, the Individuals with Disabilities Education Act
(IDEA) recognized, for the first time, ADHD and ADD as
disorders that should be classified as Other Health Impaired.
What causes ADHD -- genetics or the environment?
Genetic factors are very important in ADHD, as studies of the
family, adoption, and twins have shown. However, environmental
factors can also cause the ADHD syndrome: factors such as
premature birth, head injury, fetal alcohol syndrome, lead
toxicity, prenatal maternal smoking, rare endocrine
abnormalities, and prenatal exposure to drugs like cocaine.
How is ADHD diagnosed?
There are four subtypes of ADHD, according to the DSM-IV:
Not Otherwise Specified
There are nine symptoms of both inattention and hyperactivity.
Six of the nine symptoms must be present to be diagnosed.
Also, the symptoms must occur in more than one setting (for
example, school and home), must persist for at least six
months, and must impair your child enough so that he is not
displaying age-appropriate behavior.
Your child often --
1. Makes careless mistakes and doesn't pay attention to
2. Has difficulty paying attention for long periods of time
3. Doesn't seem to listen to someone speaking directly to her
4. Fails to finish work or projects, and does not follow
5. Has difficulty organizing herself around tasks and
6. Avoids or dislikes projects or games that require
7. Loses necessary tools (pencils, toys, etc.) for projects or
8. Is easily distracted by things going on around her
9. Forgets daily activities
Your child often --
1. Fidgets or squirms
2. Leaves his seat or other places where he is expected to
3. Runs or climbs or feels restless in inappropriate
4. Finds it difficult to play or work quietly
5. Seems driven or always on the go
6. Can't stop talking
7. Blurts out answers before questions have been completed
8. Finds it difficult to wait his turn
9. Interrupts or intrudes on others
Who should diagnose my child?
Ideally, a team -- including a qualified clinician such as a
pediatrician, family physician, psychiatrist, neurologist, or
psychologist -- should make the diagnosis of ADHD, because
only a specialist can tell the difference between ADHD and
other physical and psychological problems that mimic ADHD.
Information about these other conditions is rarely available
to school personnel, no matter how observant, experienced, or
For the majority of children, symptoms become clear-cut when
they can be observed regularly and compared to other children
over a long period of time. Because of this, the classroom
teacher is often the best person to make these comparisons
(when provided with the proper ratings, checklist, and
information). Having said this, remember that only specialists
can exclude any other medical, psychological, or psychiatric
conditions from the possibility of ADHD.
When the child is also gifted, a specialist in giftedness
should also be included to provide information about the
child's behavior in comparison to other children of similar
Gifted and ADHD
Are gifted kids labeled as having ADHD instead of being
It's actually possible that the two conditions may coexist.
Recently, some researchers have expressed concern that
children who are gifted are mislabeled as ADHD, and that this
mislabeling has been getting out of hand. While there are
cases of mistaken diagnosis, no empirical data in the medical,
educational, or psychological literature confirms the extent
of this concern.
Careful attempts to avoid over-diagnosis must be balanced
against a child's need for evaluation and treatment. Again,
giftedness and ADHD can coexist in the same child.
Can a gifted child who spends hours focused on a task still
Some parents and professionals assume that a child who can
concentrate for a long time cannot have ADHD. This is
incorrect. It's understandable that an observer might dismiss
the possibility of ADHD, because from all appearances the
child is so absorbed in a task that everything around her
fades into oblivion.
While this state of rapt attention may be the sign of a
creative mind, it may also be "hyperfocus," which is a similar
condition that individuals with ADHD frequently experience.
You can't tell children with and without ADHD from how they
engage in high-interest activities -- such as videos, computer
games, or reading for pleasure. The key is effort. How your
child performs during projects that require effort -- but
aren't necessarily high-interest -- can mark the difference.
So a child with ADHD can concentrate for long periods of time?
ADHD is not characterized by a child's inability to pay
attention, but rather is marked by his inability to control
his attention. A child with ADHD has great difficulty paying
attention to tasks that are not immediately rewarding, that
While "hyperfocus" can be a positive sign of commitment to a
task and a sign of motivation, it becomes a problem when a
gifted child is asked to shift from one task to another. In
other words, while this intense concentration can be positive
for the child's thinking, it can also cause problems in her
How do gifted kids show ADHD?
ADHD may be less apparent in a gifted child than in a child
who struggles more obviously. By virtue of their giftedness,
the range of tasks that are perceived as "effortless" is
broader for gifted children. And so, missing the symptoms of
ADHD may be even more common in gifted kids than misdiagnosing
them with ADHD. Some children are able to compensate for their
ADHD -- and neither they nor their parents or teachers may be
aware of it. Others are more seriously handicapped.
A gifted child's over-reliance on her strengths
unintentionally obscures her disability. While emphasizing
strengths may highlight a child's gifts and talents, it does
not eliminate the reality of the condition. It can, in fact,
lead to an even worse dilemma: She can doubt her abilities
because of her struggle just to maintain them. If a child is
allowed to acknowledge her difficulties as a disability, she
may learn appropriate coping skills.
The single most relevant consideration in evaluating ADHD is
the degree of impairment a child experiences as a result of
his behaviors. A child whose behavior causes him to be
impaired academically, socially, or in the development of a
sense of self, should be examined from a clinical/medical
perspective to exclude potentially treatable conditions, even
if his behavior may be recognized as creativity or giftedness.
Should I put my gifted child on medication?
Every child who is impaired does not necessarily need
medication. Non-medical interventions can be used at school
and at home, and should be tried before more intrusive
Where Do We Go from Here?
ADHD is not a defect that must be "cured." More:
· LD and ADHD Reading List
· ADHD Message Boards
· Gifted Message Boards
In fact, ADHD can not only inhibit, but can also enhance the
realization of gifts and talents.
Educators of gifted children with ADHD face a difficult task
of providing opportunities for students to apply their
strengths while also improving upon their deficits. Although
the same might be said of any sound educational program, this
is more daunting for gifted children with ADHD because of the
striking gaps in ability, behavior, and performance it can
Educators, parents, and children themselves can meet these
challenges only through consistent attention, immeasurable
creativity, and enduring patience.
1. Be aware that ADHD and giftedness can coexist.
2. Explore many perspectives in your pursuit of information
3. Remember that the most important measure for diagnosing
ADHD is the degree of impairment experienced by the child in
two or more settings.
4. Use a multidisciplinary team to arrive at a diagnosis and
to develop a comprehensive treatment plan.
5. Familiarize yourself with a variety of educational and
behavioral strategies to determine which combinations might be
effective for your child.
6. Be cautious about "quick-fix" promises -- whether
behavioral, educational, or medical. Find more in the books,
ADD/ADHD Behavior-Change Resource Kit, and Answers to
Distraction. See also this article's bibliography.
7. Be aware that the greatest difficulty for a child with ADHD
lies in communicating what he's learned.
8. Determine whether shifting attention is a point of
vulnerability for your child, when she is asked to change
9. Model and support the process of "knowing thyself."
Remember that everyone has strengths and weaknesses. You can
point out to your child how you yourself use your best skills
and compensate for weaker areas. You can then help your child
to do the same.
10. Advocate for and support research into ADHD within the
gifted population. Contact the NRC/GT website if you know of
identical twins (ages 5-16) of which only one has ADHD or ADD.
Source: "Attention Deficit Disorders and Gifted Students: What
Do We Really Know?" by Felice Kaufmann , M. Layne Kalbfleisch
, and F. Xavier Castellanos