SENG Embarks on International Campaign to Educate Pediatricians
About Possible Misdiagnosis of ADHD in Gifted Children
Intellectually gifted children whose needs are neglected or misunderstood may exhibit traits and behaviors that resemble those of Attention Deficit Hyperactivity Disorder (ADHD) and be wrongly diagnosed, possibly resulting in unnecessary medication and unintended harm, according to the international nonprofit organization Supporting Emotional Needs of the Gifted(SENG). SENG is developing a public awareness effort to alert the pediatric healthcare community to the potential for misdiagnosis. Giftedness education is currently not a standard teaching component in medical schools and is addressed infrequently in the pediatric medical literature.
SENG recently sent a letter of concern to the American Academy of Pediatrics (AAP) in response to the AAP's new guideline discussed in "ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity in Children and Adolescents" (Pediatrics, 2011, Vol 128 , November, pp. 1-17.). The new AAP-directed guideline extends the range of ADHD diagnosis from ages 6-12 to ages 4-18, and fails to include the critical possibility that a child's intellectual giftedness may contribute to symptoms similar to ADHD. Thus, precocious preschoolers may be at even greater risk for misdiagnosis.
"There is a reasonable amount of professional literature supporting the need for physicians to consider intellectual giftedness...However, the ADHD rating scales have not yet incorporated this consideration into their manuals, and the Diagnostic and Statistical Manual of Mental Disorders (DSM) only mentions it in passing. Our opinion is that a substantial number of intellectually gifted children are being incorrectly diagnosed as having ADHD," according to a letter from SENG leaders James T. Webb, Ph.D., ABPP-Cl; Marianne Kuzujanakis, M.D., M.P.H.; and Rosina M. Gallagher, Ph.D., NCSP.
In response to SENG's letter, the AAP indicated that it will share the information with its committees reviewing the issue, consider the feedback in its next revision of the ADHD guidelines, publish an article on the topic in its newsmagazine, and propose a session on gifted children at its national conference.
James T. Webb, who also co-authored the book Misdiagnosis and Dual Diagnoses of Gifted Children and Adults and is highly published in the gifted field, believes that while ADHD can and does occur in gifted children, many traits and behaviors characteristic of giftedness are frequently misinterpreted as ADHD, particularly in the very young.
"Some of these traits include being strong-willed, impulsive, impatient with the relative slowness of others, and having the tendency towards heightened sensitivity, perfectionism, and intense focus on personal interests and experiences," Webb says.
"As pediatric healthcare providers become better informed on giftedness issues, they better understand the value of correctly identifying giftedness in their patient population, and are better able to make recommendations to meet their needs via strength-based planning and educational strategies prior to traditional behavioral and medical interventions," he adds.
SENG leaders finally propose that future editions of diagnostic manuals (DSM and ICD) provide specific codes for giftedness in the medical record, and recommend that pediatric clinicians routinely consider giftedness in all developmental assessments, particularly when diagnosing ADHD and relevant behavioral and mental conditions.
Founded in 1981, SENG is an organization that empowers families and communities to guide gifted and talented individuals to reach their goals: intellectually, physically, emotionally, socially, and spiritually. With more than 12,000 subscribers to its newsletter, and a board of globally respected authorities on gifted education, SENG offers online resources, shares research, and provides webinars for parents, educators, and healthcare professionals. Its 2012 national conference will be held July 13-14, 2012 in Milwaukee, Wis. For more information, see www.SENGifted.org.