ADHD and Gifted Children

by Peter W. Welty, M.D., F.A.A.P.

March 8, 2004

Many children who are diagnosed as having ADHD also share some of the characteristics of children who are considered gifted. Frequently, bright children are referred to a specialist because they exhibit certain behaviors, such as restlessness, boredom, inattention, impulsivity, and daydreaming that children with ADHD have.

Let’s review the DSM criteria for ADHD:

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 waiting 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. This is 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.
10. Often talks excessively.
11. Often interrupts or intrudes on others, e.g. butts into other people’s games.
12. Often does not seem to listen to what is being said to him or her.
13. Often loses things necessary for tasks or activities at school or at home, e.g. toys, pencils, books.
14. Often engages in physically dangerous activities without considering possible consequences, not for the purpose of thrill seeking; e.g., runs into street without looking.

Almost all of these behaviors are found at one time or another in bright, creative, talented and gifted children, as well as in “normal” kids. Recently there has been insufficient attention given to the similarities and differences between these two groups of children. This, therefore, raises the possibility for misidentification in children who are ADHD or who are gifted.

Behaviors associated with giftedness often include:

1. Poor attention, boredom, and daydreaming.
2. A low tolerance for persistence on tasks that seem irrelevant.
3. Judgment lags behind the child’s development of intellect.
4. Possible power struggles with authorities.
5. High activity level, with possible less need for sleep.
6. Questions rules, customs and traditions.

It is important that the parent and the pediatrician embark on a rigorous work-up of the child who possibly has ADHD, and the child who might be gifted. A determination of when a child’s behaviors are problematic is important. He may have trouble with one teacher and not with another. There may be other components that are contributing to misbehaviors. In contrast, a child with ADHD generally exhibits his behaviors in many settings, including at home, in the community and at school.

In school, a gifted child might appear to be distracted and inattentive, but actually may be bored. Such children often respond to a slow moving or non-challenging classroom by engaging in off-task activities, such as daydreaming, disruptions or other attempts to entertain himself.

A child with these ADHD-types of behaviors or concerns and who may be gifted needs a thorough evaluation and psycho educational testing. These are frequently done by the child’s school district, to evaluate intelligence, achievement, and personality style. Rating scales by the teacher and parents that evaluate ADHD and continuous performance tests are also frequently used. It is imperative that an expert in evaluating ADHD and giftedness appraise the child so that he or she can be placed in an educational setting that will maximize his or her talents and potential.