No one knows exactly how many gifted children are misdiagnosed by mental health professionals and doctors who are not trained in the unique emotional difficulties of the gifted. “Are Physicians too Quick to Medicate ADHD?” published in MedPage Today states, “between 1990 and 1998, the number of children and adults diagnosed with ADHD rose from 900,000 to nearly 5 million.”
Some of those 5 million are likely to be gifted.
A common belief is that gifted children do not have any particular social or emotional problems. Yet according to Education News and Notes from the Davidson Institute, “Research indicates that up to 20 percent of high school dropouts test in the gifted range.”
James T. Webb, founder of Supporting the Emotional Needs of the Gifted (SENG), was involved in the early research that exposed the needs of gifted children and adults.
“We found that there is an incredible need and that the whole area of gifted children and later gifted adults is a neglected and overlooked area for psychologists and other professionals. Later we began to realize how many gifted children were being misdiagnosed, many of them being put on medication.”
Gifted children, says Mika Gustavson, a therapist who specializes in the gifted population, may not seem different than other kids in their emotions, but the underlying causes can be different.
“The presenting issues are not unique at all — any child can become withdrawn, aggressive, depressed, anxious, sad or exhibit any number of other problem behaviors given the ‘right’ circumstances,” says Gustavson. “However, there are a couple of aspects of giftedness that create unique challenges.”
Many parents of gifted children are familiar with Dabrowski’s theory of overexcitability in gifted people. However, teachers, therapists, and family doctors are unlikely to have any knowledge or practical training in this area.
Asynchronous development is another phrase familiar to many parents of gifted kids.
“Gifted children, many of whom are also asynchronous (developing at different rates in different areas) encounter difficulties conforming to expectations, have behavior problems due to boredom, or otherwise struggle in a school setting,” explains Gustavson.
Again, the assumption by a professional that gifted kids are “just like everyone else” can lead to false diagnoses and inappropriate treatment. And according to the MedPage Today article, many of those professionals are primary care physicians making a diagnosis on the basis of parent requests.
“Just as one cannot use ‘cookie cutter parenting’ for these kids, one cannot use ‘cookie cutter therapy’ either,” says Gustavson.
Moreover, Webb explains, what used to be accepted as eccentric is now considered something to be treated.
“I think our society has become increasingly less tolerant of quirkiness,” Webb explains. “Our schools, too. … In psychiatry and psychology, the number of diagnoses has proliferated increasingly. … For example, the unruly child is now seen as a diagnosable disorder, Oppositional Disorder. The town drunk now is an alcoholic and that’s a disease. There’s been a redefining. I think it’s been overboard.”
Webb has literally written the book this issue — Misdiagnosis and Dual Diagnoses of Gifted Children and Adults — trying to do something to address the misunderstandings of our medical and mental health professionals.
“I’ve seen 3 and 4 and 5-year-olds being misdiagnosed as bipolar disorder, hospitalized, put on medication that was not tested on children,” Webb points out. “And the issues were clearly not anything like bipolar. It was the fact that gifted children are intense. They do overreact to situations. Unless you understand that it’s easy to fall into a trap of saying, ‘Oh, this is a child who’s disturbed mentally and emotionally’.”
The medical establishment is far behind in recognizing the misdiagnosis of gifted children. In the MedPage article, the author doesn’t even see fit to mention giftedness and the well-known misdiagnosis of concurrent conditions. Instead, the author uses the extreme case of an abused child to illustrate a case where the basis of a child’s misbehavior may be misinterpreted.
It’s clear to those who work with the gifted, however, that many of the physicians and mental health professionals prescribing ADHD drugs are probably dealing with, and not recognizing, gifted children.
“One of the things that I’m working with them on this is to try to educate pediatricians and family practitioners and nurse practitioners as well as psychologists,” says Webb. “Other than Wright State University, there just aren’t graduate programs that specialize in training psychologists about the gifted.”