Psychological Misdiagnosis of Gifted and Talented Children

Psychological Misdiagnosis of Gifted and Talented Children
by Amy Scholten, MPH

Contrary to popular belief, gifted, talented, and creative children face many challenges.One challenge is being correctly identified as gifted. The other is living in a world where their personal traits are often poorly understood.

Such challenges put gifted and talented children at risk for having certain difficulties at home and school. To make matters worse, giftedness is often misdiagnosed or overlooked by psychologists, psychiatrists, and other healthcare professionals.

What It Means to Be Gifted or Talented

Unfortunately, there is no universally-accepted definition of giftedness, although psychometric “IQ” testing has been among the most commonly used standardized tools to assess ability. Many experts feel that such tests may fail to recognize many truly gifted individuals.
According to the Institute for the Study of Advanced Development in Denver, Colorado, gifted and talented children possess greater than average awareness, perception, and sensitivity. This may be expressed in one or more areas, such as art, music, language, science, or math.

Common traits of gifted and talented children include:

Creativity and strong imagination
Perfectionism and idealism
Intensity
Strong absorption in their interests
Complexity and intense inner turmoil
Deep compassion for others
Questioning established rules, beliefs, traditions, and authority
High sensitivity
Keen observation, perception, and insight
Ability to process information at deeper levels
Love of learning


Difficulties Facing Gifted and Talented Children

Because of their finely tuned awareness, gifted and talented children tend to experience life differently and more intensely than others. Unfortunately, peers and authorities at school or home often do not understand these differences.

Gifted and talented children may experience the following problems (none of which are, of course, unique to the gifted):
Boredom and impatience
Frustration and disappointment when ideals are not reached
Disregard for, or open questioning of, rules and traditions
Preoccupation with deep human concerns, sometimes leading to anxiety and depression
Difficulty observing boundaries and channeling their intense energy
Not "fitting in" with their peers

"Most people don't know that what is considered normal for the gifted is most often labeled as neurosis in the general population" says Mary Rocamora, MA, of The Rocamora School, Inc. in Los Angeles, California.
In a clinical situation, the child's intense personal traits and difficulties may be viewed as symptoms of a mental or emotional disorder. Misguided therapy or medication may follow, as the clinician attempts to suppress or "cure" the symptoms of giftedness.

Common Misdiagnoses

In a paper presented at the American Psychological Association's Annual Convention in August 2000, James Webb, PhD discussed common misdiagnoses of gifted children.

They include:

Attention Deficit Hyperactivity Disorder (ADHD)
Traits such as intensity, impatience, sensitivity, and high energy are common in children with ADHD, as well as in gifted children. Some gifted children do have ADHD, but many do not. They are at a different developmental level than other children. As a result, they may be inattentive and impulsive in certain situations.

Oppositional Defiant Disorder

Like children with oppositional defiant disorder, gifted children frequently appear "strong-willed." However, such behavior is often due to their intensity, sensitivity, and idealism. They do not like to be criticized for their different way of thinking. They may question the rules and engage in power struggles with authority figures.

Mood Disorders (Depression and Bipolar Disorder)

Gifted children may have intense mood swings. They notice inconsistencies and absurdities in society and in the people around them. They can feel different and alienated from others. These traits are often found in children with depression, especially those with bipolar disorder. Mood swings, irritability, difficulties with temper control--these symptoms do not mean that a gifted child suffers from a mood disorder, but they should likely lead to consultation with an experienced child psychiatrist.

Obsessive-Compulsive Disorder or Obsessive-Compulsive Personality Disorder

Gifted children like to organize things into complex structures. They tend to be perfectionists and idealists. They can get upset when others do not go along with their ideas, appearing intolerant and "bossy." This behavior may be mistaken for obsessive-compulsive disorder or obsessive-compulsive personality disorder. If obsessive tendencies seem to be getting in the way of a child’s success or happiness, then child psychiatric consultation is suggested.

Asperger's Disorder

Highly gifted children often have different ways of interacting socially. Their unusual comments and jokes may be misinterpreted as signs of Asperger's disorder. People with Asperger's disorder may be gifted—especially in certain specific skills—but they do not respond as well as do normal children to ordinary social or emotional cues. They may not make friends readily and often prefer to keep to themselves.
Gifted children, on the other hand, often show a great deal of concern for others and are highly sociable. If your gifted child gets along well with both adults and children then a diagnosis of Asperger’s disorder is very unlikely. If you are concerned about your child’s socializing skills, then you may want to consult with an experienced child psychologist or psychiatrist.

Dual Diagnoses

Gifted children—like any other young person—may have psychological disorders or problems; not every gifted child’s psychological difficulties are explained solely by giftedness. If this proves to be the case, seeking care from a therapist who commonly deals with the gifted may prove highly beneficial. An inexperienced therapist can offer psychological advice which, failing to take the child's giftedness into account may have a negative impact on the child.

According to Dr. Webb, giftedness adds a new dimension to psychological treatment, a dimension that may perhaps be seen in the 1997 Gus Van Sant Jr. film, Good Will Hunting in which Robin Williams plays a therapist for a highly gifted young man who displays many of the traits and difficulties noted above.

Common concerns in gifted children include:

Learning Disabilities

Gifted children often have hidden learning disabilities. Such disabilities may include auditory processing weaknesses, difficulties with visual perception, writing disabilities, spatial disorientation, dyslexia, and attention deficits.

Gifted and talented children may develop a poor self-image when learning disabilities are present. They tend to dwell on the things they cannot do and may need help in developing a good self-concept. Gifted children with learning disabilities have a great deal of trouble getting needed help in their schools because their academic achievement is usually above grade level despite their disability. Most school systems require a history of academic failure before they will provide remedial services.

Sleep Disorders

Nightmare disorder, sleep terror disorder, and sleepwalking disorder appear to be more common in gifted children. Some gifted children sleep a lot less than other children. Others sleep a lot more. In the presence of unusual sleep patterns, your pediatrician or family doctor can help advise you whether a gifted child needs further evaluation for sleep or psychological problems.

Relational Problems

Parents and family members may lack information about the traits of gifted children. Such children may appear to be willful, mischievous, or strange. They may be criticized or punished for behaviors that stem from curiosity, intensity, and sensitivity. Power struggles, temper tantrums, and other behavior problems may surface. Effective therapy should involve helping the family understand and cope with the child's intensity.

Education Needed

Gifted and talented children often must overcome many challenges to reach their potential. They frequently need help interacting in the mainstream world, finding supportive environments, and channeling their talents. When gifted and talented children are misdiagnosed and wrongly stigmatized, they cannot get the type of support they need. Families, educators, and clinicians need to be better educated about the characteristics and social and emotional needs of gifted and talented children.

RESOURCES:

Gifted Children: Are Their Gifts Being Identified, Encouraged, or Ignored? NYU Child Study Centerhttp://www.aboutourkids.org
Supporting Emotional Needs of the Giftedhttp://www.sengifted.org
Last reviewed August 2006 by Lawrence Frisch, MD, MPH

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