Gifted Students with Learning Difficulties: A Review

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Giftedness and Learning Disabilities

Giftedness and Learning Disabilities: 

Unearthing the Missed Diagnosis

Presented by Paul Beljan, PsyD, ABPdN 

15th March 2012

7.30pm Eastern/11.30pm GMT

Cost: $40 

In this SENGinar, teachers, parents, and counselors will learn how to correctly diagnosis learning disabilities in gifted and talented children.  

Characteristics of gifted and talented children can result in incorrect diagnoses, such as overlooking learning disabilities.Learning disabilities can take the form of academics (reading and math) or innate abilities in general learning that may relate to social learning.

In this SENGinar, Dr. Paul Beljan will review some of the basic tenants of giftedness that include intellect and asynchronous development. He will then turn to the nuts and bolts of learning disabilities: what they look like, how to assess them, and what to do about them in the contexts of the gifted population. The "discrepancy model" of learning disability will be dispelled in favor of understanding the brain basis of learning disabilities. Dr. Beljan will present several anecdotes and case examples to illustrate the process of learning disabilities.

Sign Up Now!    NOTE: Register now and you will receive a link to the recording of this SENGinar the week following the live event.

About Paul Beljan, PsyD, ABPdN Dr. Paul Beljan is a past president of the American Board of Pediatric Neuropsychology. He holds child and adult diplomate qualifications with the American Board of Pediatric Neuropsychology and the American Board of Professional Neuropsychology. Dr. Beljan co-wrote Misdiagnosis and Dual Diagnoses of Gifted Children and Adults, and has authored several chapters and articles in various publications. Dr. Beljan currently is working on his post doctoral master's degree in psychopharmachology. Dr. Beljan's professional focus is on Alcohol/Drug Related Neurodevelopmental Deficit (A/DRND), Gifted Intelligence, Learning Disorders, Traumatic Brain Injury, Trauma, and non-medication-based Attention and Executive Functioning Deficit interventions.

About SENG Webinars

For more information, contact Patricia Petrillo. This webinar is provided by SENG, www.SENGifted.org. SENG is committed to sharing complex issues relating to the social and emotional needs of giftedness. SENGinars reflect the opinions of their speakers and do not necessarily represent SENG's philosophy. SENG invites your comments and discussion about this webinar following the session.

ADHD, Gifted or Both?

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 [5], 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.

About SENG

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.

Additional resources

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