                    ADHD AND CHILDREN WHO ARE GIFTED
         
        ABSTRACT:  This fact sheet summarizes information on children who
        have an attention deficit disorder with hyperactivity (ADHD), are
        gifted, or are both ADHD and gifted. Fourteen diagnostic criteria
        for ADHD from the Diagnostic and Statistical Manual of Mental
        Disorders III are listed.  A comparison of behaviors associated
        with ADHD and with giftedness is offered, noting the many
        similarities.  Parents and teachers are urged to consider the
        situation and setting of problematic behaviors, noting that 
        children with ADHD typically exhibit problem behaviors in all
        settings (both at home and at school) whereas gifted children are
        most likely to exhibit such behaviors in situations where they
        are bored or waiting for other students.  Other differences noted
        include a long attention span (when interested) by gifted
        students and a greater variability in task performance by
        children with ADHD.  Careful evaluation is urged for students who
        may be both gifted/talented and ADHD. 
        
             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 day-dreams 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*
        
        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.
        
        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, 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.
        
        
        BEHAVIORS ASSOCIATED WITH ADHD  (BARKLEY, 1990)
        
        1.  Poorly sustained attention in almost all situations
        
        2.  Diminished persistence on tasks not having immediate          
            consequences
        
        3.  Impulsivity, poor delay of gratification
        
        4.  Impaired adherence to commands to regulate or inhibit         
            behavior in social contexts
        
        5.  More active, restless than normal children
        
        6.  Difficulty adhering to rules and regulations
        
        BEHAVIORS ASSOCIATED WITH GIFTEDNESS (WEBB, 1993)
        
        1.  Poor attention, boredom, daydreaming in specific situations
        
        2.  Low tolerance for persistence on tasks that seem irrelevant
        
        3.  Judgment lags behind development of intellect
        
        4.  Intensity may lead to power struggles with authorities
        
        5.  High activity level; may need less sleep
        
        6.  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 ADHD evaluation.
             
             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 parents.
        
             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 self-imposed standards.
        
        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.
        
                                  REFERENCES
        
        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 Press.
             
        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 Press.
        
