During her son’s well-child visit, a mom tells you she is concerned because the youth doesn’t have any friends his age. On further questioning, you discover he has an intense interest in computers and above-average math scores but has trouble focusing in school and has frequent outbursts.
You decide to screen for autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD) and anxiety.
You could, however, be missing an important diagnosis — giftedness.
“These kids have a high vulnerability of being misdiagnosed as just having one of these other developmental conditions,” said Daniel Peters, Ph.D., a licensed psychologist and executive director of the Summit Center in California.
Dr. Peters will describe the behavioral characteristics and developmental trajectory of children who have advanced abilities during a session titled “The Gifted Child: Misunderstood, Mislabeled, Misdiagnosed” from 3-3:45 p.m. Sunday (F2150) in Room 3024 of Moscone West and from 8:30-9:15 a.m. Monday (F3037) in Room 3018.
He also will discuss a national campaign to educate physicians on misdiagnosis of gifted people (www.sengifted.org/SENG_Misdiagnosis).
Too often, giftedness is defined in terms of IQ scores or academic achievement, Dr. Peters said. However, it is “more than just smart kids in smart classes.” Individuals also can be advanced artistically, have strong leadership abilities or excel in the visual and performing arts.
A gifted child’s intensity can manifest itself as the body always moving; a thirst for knowledge that drives him to search the internet constantly; heightened sensory awareness that may include discomfort with certain types of clothing; an active imagination; or emotional sensitivity that can cause frequent meltdowns.
“We easily see how quickly these kids can be misdiagnosed,” Dr. Peters said.
Constant movement can look like ADHD. Emotional over-excitability can look like a mood disorder. A vivid imagination can be mistaken for inattentive ADHD.
“What I tell people in all of the medical and allied professions is by having an understanding of what this profile presents like, you’re over 50% there because you’re actually opening up another possibility,” Dr. Peters said.
Once giftedness is on their radar, it’s important for pediatricians to be aware that gifted children often have asynchronous development. For example, they may be advanced in math or reading but have poor fine motor or social skills. It also is thought that gifted children react to and are affected more by their environment than others.
“There is a developmental trajectory and profile, and intensities and sensitivities that come with it,” Dr. Peters said.
The key is to determine whether giftedness explains the intense, sensitive or difficult behavior or if the child is gifted and has a co-occurring condition like anxiety or a learning disability. Gifted children who have another condition are referred to as twice exceptional.
Parents also might be confused about their child’s behavior, so pediatricians can help them understand that uneven development is common and advise them on how to advocate for their child’s needs.
One of the primary myths about gifted people is that because they have advanced abilities, they are going to be just fine.
“They actually are at high risk for having a number of challenges if they’re not understood and their different behavioral trajectories are not supported,” Dr. Peters said. “We need to focus on the social and emotional trajectories as much or more at times than their intellectual or academic merits.”For more coverage of the AAP National Conference & Exhibition visit http://www.aappublications.org/collection/cme