ERIC Identifier: ED358673
Publication Date: 1993-07-00
Author: Webb, James T. - Latimer, Diane
Clearinghouse on Disabilities and Gifted Education Reston VA.
ADHD and Children Who Are Gifted. ERIC Digest #522.
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, 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
Note: DSM-III-R Diagnostic Criteria For
Attention-Deficit Hyperactivity Disorder reprinted with permission from the "Diagnostic and Statistical Manual of Mental Disorders," Third Edition, Revised,
Washington, DC, American Psychiatric Association, 1987.
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 group 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.
Often talks excessively.
Often interrupts or intrudes on others, e.g., butts into other people's games.
Often does not seem to listen to what is being said to him or her.
Often loses things necessary for tasks or activities at school or at home (e.g.,
toys, pencils, books).
Often engages in physically dangerous activities without considering possible
consequences (not for the purpose of thrill-seeking), e.g., runs into street
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.
ASSOCIATED WITH ADHD (BARKLEY, 1990)
Poorly sustained attention in almost all situations
Diminished persistence on tasks not having immediate consequences
Impulsivity, poor delay of gratification
Impaired adherence to commands to regulate or inhibit behavior in social
More active, restless than normal children
Difficulty adhering to rules and regulations
ASSOCIATED WITH GIFTEDNESS (WEBB, 1993)
Poor attention, boredom, daydreaming in specific situations
Low tolerance for persistence on tasks that seem irrelevant
Judgment lags behind development of intellect
Intensity may lead to power struggles with authorities
High activity level; may need less sleep
Questions rules, customs and traditions
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 is
likely to 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 non-challenging 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
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
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
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 (e.g., depression or anxiety) 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.
Careful consideration and appropriate professional evaluation are necessary
before concluding that bright, creative, intense youngsters like Howard have
ADHD. Consider the characteristics of the gifted/talented child and the child's
situation. Do not hesitate to raise the possibility of giftedness with any
professional who is evaluating the child for ADHD; however, do not be surprised
if the professional has had little training in recognizing the characteristics
of gifted/talented children (Webb, 1993). It is important to make the correct
diagnosis, and parents and teachers may need to provide information to others
since giftedness is often neglected in professional development programs.
American Psychiatric Association (1987). "Diagnostic and statistical manual of mental disorders," Third edition, revised.
Washington, DC: Author.
Barkley, R. A. (1990). "Attention deficit hyperactivity disorder: A handbook
for diagnosis and treatment." Guilford Press: New York.
Clark, B. (1992). "Growing up gifted." Macmillan: New York.
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," pp. 525-538. Oxford: Pergamon
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