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Before Referring a Gifted Child for ADD/ADHD Evaluation

This article by Sharon Lind explains that highly gifted children are easily misdiagnosed as having attention deficit disorder (ADD or ADHD). Lind provides a valuable checklist of behaviors and charachteristics for educators to use before referring a student for testing. The checklist is designed to differentiate between confusing factors.
  • Topics
  • Author
    Lind, S.
  • Publications
    The Communicator
  • Publisher
    California Association for the Gifted
  • Volume
    Vol. 31, No. 4, pp. 20
  • Year
    Fall 2000

Parents and gifted educators are asked with increased frequency to instruct gifted children to conform to a set of societal standards of acceptable behavior and achievement-to smooth the edges of the square peg in order to fit into a "normal" hole. Spontaneity, inquisitiveness, imagination, boundless enthusiasm, and emotionality are being discouraged to create calmer, quieter, more controlled environments in school. An extension of this trend is reflected in an increase in referrals for medical evaluation of gifted children as ADD/ ADHD (Attention Deficit Disorder/ Attention Deficit Hyperactivity Disorder). There is no doubt that gifted children can be ADD/ ADHD. However, there are also gifted children whose "inappropriate behavior" may be a result of being highly gifted and/or intense.

This intensity coupled with classroom environments and curriculum, which do not meet needs of gifted, divergent, creative, or random learners, may lead to the mislabeling of many children as ADHD. To avoid mislabeling gifted children, parents and educators may want to complete the following check list to help them decide to refer for medical or psychological evaluation.

If, after addressing these questions, parents and teachers believe that it is not an unsuitable, inflexible, or unreceptive educational environment which is causing the child to "misbehave" or "tune out," or if the child feels out of control, then it is most certainly appropriate to refer a gifted child for ADD/ADHD diagnosis. Premature referral bypasses the educational system and takes control away from students, parents and educators. By referring before trying to adjust the educational environment and curriculum, educators appear to be denouncing the positive attributes of giftedness and/or to be blaming the victim of an inappropriate educational system.

When deciding to refer, parents should search for a competent diagnostician who has experience with both giftedness and attention deficit disorders. It is never appropriate for teachers, parents or pediatricians to label a child as ADD or ADHD without comprehensive clinical evaluation that can distinguish ADD/ ADHD from look-alikes with other causes.

GIFTED? Need More Information ADD/ADHD?
Contact with intellectual peers diminishes inappropriate behavior Contact with intellectual peers has no positive effect on behavior
Appropriate academic placement diminishes inappropriate behavior Appropriate academic placement has no positive effect on behavior
Curricular modifications diminish inappropriate behaviors Curricular modifications have no effect on behavior
The child has logical (to the child) explanations for inappropriate behavior Child cannot explain inappropriate behavior
When active, child enjoys the movement and does not feel out of control Child feels out of control
Learning appropriate social skills had decreased "impulsive" or inappropriate behavior Learning appropriate social skill has not decreased "impulsive" or inappropriate behavior
Child has logical (to the child) explanations why tasks, activities are not completed Child is unable to explain why tasks, activities are not completed
Child displays fewer inappropriate behaviors when interested in subject matter or project Child's behaviors not influenced by his/her interest in the activity
Child displays fewer inappropriate behaviors when subjuect matter or project seems relevant or meaningful to the child Child's behaviors do not diminish when subject matter or project seems relevant or meaningful to the child
Child attributes excessive talking or interruptions or need to share information, need to show that he/she knows the answer, or need to solve a problem immediately Child cannot attribute excessive talking or interruptions to a need to learn or share information
Child who seems inattentive can repeat instructions Child who seems inattecitve is unable to repeat instructions
Child thrives on working on multiple tasks-- gets more done, enjoys learning more Child moves from task to task for no apparent reason
Inappropriate behaviors are not persistent-- seem to be a function of subject matter Inappropriate behaviors persist regardless of subject matter
Inappropriate behaviors are not persistent-- seem to be a function of teacher or instructional style Inappropriate behaviors persist regardless of teacher or instructional style
Child acts out to get teacher attention Child acts out regardless of attention

Permission Statement

Permission to reprint this article has been granted by Sharon Lind and California Gifted Association's The Communicator.

This article is provided as a service of the Davidson Institute for Talent Development, a 501(c)3 nonprofit dedicated to supporting profoundly gifted young people 18 and under. To learn more about the Davidson Institute’s programs, please visit www.DavidsonGifted.org.

Comments

Parent on 2/20/2020
I am the parent of a highly gifted 7.5 year old boy who was recently diagnosed with borderline ADHD. I am uncertain about the diagnosis and obviously the concerns that come with medicating (though we are doing a combination of medication and behavioural therapy). My son´s teacher completed the checklist and I was surprised to see that she checked more of the gifted boxes. It is irrelevant, as some people have commented above, whether a child can be both ADHD and gifted (if you believe ADHD exists) because this checklist attempts to distinguish typical ADHD behaviours/responses from those of typical gifted behaviours/responses. It is important to ensure that a gifted child is not diagnosed or labelled as having ADHD when behaviours can be very similar - you end up medicating a child who doesn´t need medication, but a more suitable curriculum and opportunities to connect with like minded peers, to work on projects that are of genuine interest and in ways that are far more stimulating. Modifying curriculums "to suit gifted kids" need not be implemented purely for the gifted children as ALL CHILDREN would benefit from such educational approaches. I think teachers/schools are afraid to digress from the mainstream way of teaching.
Other on 2/20/2019
This list really adds to the stigma of ADHD. Most people who have ADHD are also "gifted" in many ways. There are qualities and skills of immense brilliance, creativity, connection and pattern recognition, productivity, hyper-focus, empathy, and intuitive strengths that occur with ADHD. A list that splits ADHD and giftedness is a list that only leads to further stigma and obscures the wonderful qualities that come with ADHD brains.
Parent on 7/3/2017
This list seems more useful for kids who have hyperactive-type ADHD, but not necessarily inattentive type ADHD. My son is both highly gifted and has inattentive-type ADHD, and this checklist probably wouldn't help to identify him because it concentrates to such a great degree on inappropriate behaviors and lack of control. Those are minimal in both my son and my ADHD husband, but they're focus and attention issues are huge.
Student on 12/9/2013
I am a student in public school. I understand that I am gifted and my school has an excellent gifted program. I was designated gifted in 5th grade and understand what it means. The only problem I have is I can't tell if I am bored with a subject or if I am ADD. I found this evaluation on the internet and found it useful. I haven't though, taken it into very much critical thinking. I know that I am a "B" student because in many of my classes I get easily distracted and don't feel like participating. I just make it a point to pay more attention in class. I am obsessive-compulsive about many things, but not everything. I am 14 years old and am not sure if I am or am not ADD/ADHD. I have many friends who are so I have a good idea about how you feel when you are. I am still going to talk to my councelor about getting tested for ADD/ADHD. I really think that this survey was a good step in the right direction.
Parent on 11/2/2012
This list seems to apply to younger kids exhibiting behavioral issues. I have an older kid who has concentration and organizational issues - definitely not ADHD, but I suspect ADD. He is highly gifted and in a private school for highly gifted kids, so the environment should be appropriate. How do I figure out whether his issues are par for the course or need to be addressed?
Student on 5/13/2005
My daughter is both gifted and ADHD, but it is getting harder for her stay focused. She tested above the 99.9 percentile in kindergarten, the older she gets the harder is for her to keep her mind on what she needs to do.
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