To Label Or Not To Label?

In the US, it is estimated that up to 20% of gifted children may also have a learning disability of some sort, i.e. are twice exceptional. We don’t have figures for Ireland, but I assume they would be roughly similar. Is this accurate? Do these children really warrant a diagnosis or label or are they just plain gifted and displaying behaviour typical of giftedness?

Physical disabilities and some learning disabilities may be easy enough to identify. Others are not so clear-cut, particularly in gifted individuals. What is the difference between ADHD and overexcitability? Does the daydreaming, unfocused child or the one who keeps blurting out the answers in class have a brain which is working at a hundred miles an hour or do they have ADHD? Is a child who does not mix well with their classmates displaying asynchrony or do they have Asperger Syndrome?  Is a child who can be elated one minute and distraught the next, suffering from bipolar disorder or just emotional intensity? Do you see the problem?

In Ireland, very few psychologists, psychiatrists and occupational therapists have expertise in giftedness. So, when faced with these issues, they may be too quick to label. On the other hand, for the very same reason, they may miss the diagnosis of a learning disability if giftedness is masking the problem. It is important to be able to see the big picture because, as Dr Linda Silverman says when describing how the gifted cope with learning disabilities, compensation is a two-edged sword.

Most behaviours or traits have a spectrum and we each display them at different intensities. Much like a graphic equaliser gives a piece of music its overall character, it is the combination of all these behaviours at different levels which gives us each our unique personality. Some of us lie near the centre of the range for all the traits; others fall well to one end or the other of some. Does that indicate a diagnosable condition or are we just a little eccentric?

Let me use ADHD to illustrate my point. I am very disorganised, I procrastinate, I flit from idea to idea without seeing things through, and my house usually looks like a tornado just passed through. Do I have ADHD? Well, I am certainly well up along that particular spectrum! Whether I warrant the label or not, I am not sure. 

Excuse the sexist stereotyping but, consider a married man with ADHD and a personal assistant. His assistant keeps him organised at work and, more than likely, his wife keeps him organised at home. So, it's quite possible that he does fine and may never even know he has ADHD. In contrast, a married woman with ADHD who chooses the traditional role of stay-at-home-mother may be expected to manage the household and organise everyone; herself, her children and her husband. Throw in a child or two with traits of ADHD (it tends to run in families) and a couple of pets and the chances are, she may struggle somewhat. She may, like me, be frazzled! 

So you see, the impact of the “problem” very much depends on life circumstances at any given time. If we choose the “right” job and the “right” partner, we may sail through just fine. Alternatively, we may end up in trouble at various times. My view is that we must be aware of our traits and how they affect us. Firstly, it makes us better able to make good choices and not to be too hard on ourselves when we mess up. Secondly, we can learn strategies that may help us to cope. What works for people with the full-blown disability, may help those with milder traits. It is our job as parents, to help our children to understand themselves in this way and to take responsibility for their behaviour. 

Having said that, there are times when we may need to accept the label and seek help. This is particularly important for our children. It is all very well to say we don’t want them to be stigmatised, but if they are struggling to cope at school, getting a diagnosis or label can be the only way to get support for them. This may make all the difference, not only to their level of achievement, but also to their self-confidence and general well being during their formative years.

References: 

Gifted Children with Learning Disabilities : Lost Treasures by Linda Kreger Silverman 

Overexcitability and the Gifted by Sharon Lind

Asynchronous Development by Jean Goerss

Emotional Intensity in Gifted Children by Lesley Kay Sword

The Two-Edged Sword of Compensation: How the Gifted Cope With Learning Disabilities by Linda Kreger Silverman

Understanding How Gifted and Twice Exceptional Children Can Benefit From OT  by Debra Johnson