Gifted Issues Discussion homepage Forums Twice Exceptional ADHD "type" and gifted

Hi, I haven't posted for a long time. We just finished moving and life has been crazy. Since the last time I was on I finally found a place willing to consider a diagnosis other than ASD and my son has received a new diagnosis of ADHD. They chose to keep the ASD diagnosis because he still has "ASD features". I'm still not at all convinced he actually has autism though. As it is a spectrum I think it makes sense that you can have subclinical levels of autistic like behaviors. He has no stims or restricted interests and no communication difficulty or trouble with recognizing or responding appropriately to emotions. He does present as a bit odd and gets stuck on certain ideas sometimes and is a bit rigid (he got upset at his meet your teacher event because she wrote instructions to finish and turn in a worksheet at the end of the event and he didn't get done on time... he calmed down when she erased what she had written and wrote to turn it in on the first day of school instead, it had to be written on the instruction board to count despite the fact that we were verbally reassuring him turning it in late would be fine).

At any rate, I have of course been searching the internet for info about highly gifted kids with severe ADHD. I can't seem to find anything other than articles saying gifted kids don't have the level of disability associated with ADHD as non-gifted peers do. It's more of a hard to spot inattentive type and may not even present until later in school when more executive function stuff is required.

I on the other hand have a child who (now that he has started on meds) clearly can be seen to be very severely affected by ADHD, to the point where he looks severely disabled without the meds and looks (relatively) normal with them. With his meds he is like a whole new person. He loves his medication because he can function. He can carry on a conversation, not interrupt, wait his turn, control his emotions, sit still for minutes at a time, sit on my lap and snuggle, remember to raise his hand before speaking in school, play happily with toys, etc. Without his meds he is hyper, totally unable to even listen to a whole sentence (usually because he talks over us about an unrelated topic in the middle of our communications), can't get dressed in under half an hour (with prompts), gets easily upset and has episodes of explosive anger (now that he is 6 this no longer includes hitting, he keeps it down to screaming, whining, and crying, yay), etc. The medication has been effective beyond our wildest dreams. It took me 2 years to finally find someone willing to prescribe a stimulant to a child with an ASD diagnosis. Unfortunately they were all too willing to prescribe prozac to a 4 year old though, in addition to other medications at 5. They were looking to try him on an atypical a few months ago and still refused to let us try a stimulant. Couldn't get it at the pediatrician or anywhere else because he was seeing dev peds and "they are the experts". I almost want to sue them for the 2 year delay in help and all of the pain and suffering that resulted because of their preconceived ideas and current popularity of the autism diagnosis.

But back on topic. Does anyone here know anything about severe ADHD with hyperactivity and beyond belief impulsivity in gifted kids? DS also has Tourette's and the stimulant drastically reduces his tics as well. I can tell by volume and frequency of tics the very moment his med starts to wear off. Unlike everything I read my sons giftedness is not being used to compensate for his ADHD leaving behind a kid who looks totally normal in the end. He is a kid who is 6.5 and currently obsessed with chemistry, just completed book 3B of Beast academy, reads at whatever level the Ramona books and According to Humphrey books are, has a great working knowledge of geography, enjoys designing and playing complex games, and loves to talk about history. And that's all him without his meds. With his meds he can even sit down and do writing assignments and concentrate on learning to spell words and work through complex logic problems. But academically he never struggled. He started speaking at 5 months and just picked up tons of academic concepts from a very young age (this was all cited as proof of autism over the years). But he got kicked out of all 3 preschools we tried and I had to pull him out of public school because they could not meet his behavioral needs at all. This is not the gifted ADHD kid I read about all over the internet. Do I just have a really especially unusual kid or did no one write our article yet?

Welcome back and hope you are settling into your new home well.

Thanks for sharing the great news on the success with meds.

aeh recently made an important point on ADD/ADHD, in this post.

For more info on gifted/ADHD, have you looked at the articles and resources on the 2e newsletter?

Thanks indigo. The post by aeh was very well written and a helpful way of thinking about things. I'm guessing based on my responses the articles are all correct and gifted kids tend to have the blended to NT looking ADHD. DS somehow isn't compensating at all. I guess the positive is that at least it doesn't mask his giftedness?

I'll probably start another topic this weekend about his first week of school. Looks like we may be needing some advice already

I don't know of any data that suggest that gifted people are more likely to have ADHD inattentive type than hyperactive type or combined type. I would instead look at it this way: kids whose behaviors are more extreme, or impulsive, or hyperactive, are less likely to be identified as gifted in the first place. The social stigma often gets in the way of correct identification.

ASD and ADHD often go together, by the way. Sometimes people manage this combination with both a stimulant (for attention) and an antidepressant (to manage anxiety).

Many kids would never have had their IQ tested if they weren't suspected to have ASD or ADHD.

I'm not saying there is any data saying such, just that all of the articles I can find on the internet talk about gifted adhd being different from what would be seen in typical children. Here are some quotes from a quick google search of adhd and gifted:

"The more academically inclined and more intelligent the student with ADD (ADHD), the later he or she begins to encounter serious challenges related to ADD (ADHD)."

addvance.com

"Several factors contribute to the delayed diagnosis of gifted students. Inattention and other ADD/ADHD symptoms may result in lower scores on tests used to determine eligibility for gifted programs. Also, teachers are less likely to notice ADD/ADHD symptoms in students who are not disruptive."

additudemag.com

I am used to googling a subject and getting useful information to help me understand the situation and help with improving it. Maybe stuff to pass on to a teacher to help them understand my son better. Most of what is out there is focused on the supposed high prevalence of gifted students being misdiagnosed with ADHD (also no data available to back this up). Much like searching about ADHD and medications brings up mostly articles concerning the terrible dangers of medicating children for made up disorders like adhd (also no data available to back this up). Maybe my trouble is really with the internet and not with the reality of highly gifted but severely adhd children?

I was mostly just wondering if anyone here has a kid like this and how it worked out as they aged. DS is just starting 1st grade (since I home schooled 2/3 of K and he was kicked out of everything else he's ever tried, this is his first real educational experience). DS started private gifted school on Tuesday and I haven't really gotten any feedback yet. I'm hoping it's a no news is good news thing. Seeing as every other program I've had him in I got a day 1 call to either pick him up early or schedule a conference I'm guessing things are going much better than usual. DS also seems happy and wants to go to school, a first for him. Maybe I'm being dramatic, but I feel like the medication saved his life. If he can manage at this school I will be the happiest (and maybe poorest) 2E parent around. I feel like we went from a future of incarceration to a future where there may be real success. Hope is a nice thing

Also there things like this to be found, while a different subject, it still indicates that gifted adhd children present in a unique way that regular adhd kids do not:

"Often, when people describe hyperfocus in children with ADHD, they are referring to the child who watches television or plays video games for hours. This typically is not the same way that hyperfocus is described in gifted children, where a child works on a Lego set or reads about space for hours."

Davidsongifted.org

My son has been making molecules for over an hour now and I guess that's not likely to be something that would interest an average adhd kid. He only reads if I require it, but he could sit and watch tv or play video games for hours if I let him do so. His favorite shows are Cosmos and stuff on HGTV, so maybe that's a little different from average, but he also loves Finding Nemo and Studio Ghibli films and even Peg + Cat. And he hates lego for some odd reason. How weird is that? But I wonder how true it is that gifted adhd kids will naturally gravitate towards more intellectual activities vs. screen based activities, especially in homes where space books and lego are not even available. My son is adhd and gifted and also a kid. It's hard enough to really feel confident in any of this stuff without half the internet making general statements about what gifted adhd kids are like and seeing none of it really relate to my son.

My son was dx aspie prior to the dsm 5.
He is now considered ASD at the highest functional level with a dx of ADHD inattentive type.
The DSM allows that now.

I also have a older chid. Sever ADHD combo. Medicated. Very high scores in standard tests. Straight A kid. Duke Tip for him. He would be so nervous and anxiety ridden that I decline every year for IQ test at school. Our own psych who worked with my youngeset for years told us he probably would not score a 130 needed. So maybe his above level test through Duke Tip this year will give me a better idea.
I may be wrong. I just do not see the PG things I see with my youngest. He is happy and doing well. Never bored, social and has friends in school he can relate to.

You are so much more on top of it! I have struggled with a highly emotional ADHD PG kid for years. He just turned 9.

We had his IQ tested at 6 because we knew he was ahead of his peers and wanted to have the data to help us advocate for him. We were floored by his scores. The tester said he didn't have ADHD because he was able to focus even though there was major construction going on during the testing. Looking back, I think the testing was just so engaging for him he was able to put all his attention into it. It is absolutely a dysregulation where some things are laser-focus and others are worse than a goldfish.

At 6, ADHD wasn't on our radar, but we were dealing with intense emotional outbursts 3-4 times a week that would last hours. I tried to get help with SPD issues, but he is a sensory seeker and not a sensory defensive kid. The doctors didn't even consider that a problem. They weren't dealing with a kid that couldn't just walk on a sidewalk, but had to run, jump, purposely fall down, chewed holes in his shirts, felt his food, loves spicy food, loud music, etc. He was so intense.

He was ok at school, and kept all the emotional upheaval for home. This was coupled with a year with a teacher that wouldn't believe he was gifted even after being presented with his test. She did what she could to prove he wasn't gifted by humiliating him. The poor social emotional and academic fit is what we blamed.

We changed schools and while the academic fit was better, the emotional issues intensified into depression. One of his good friends who was a couple years older was diagnosed with ADHD. That started putting ADHD on the map for us because they were so similar.

All those articles about gifted kids and ADHD made me think twice about pursuing that as an explanation though. It seems like the doctors here are much less likely to suggest any pathology. It requires parents to pursue it, which seems completely backward. His teachers didn't suggest ADHD either, but he was struggling with executive function and staying on task. I let it slide because he loved that year of school.

Last year is when it really became apparent that this wasn't a quirky gifted attribute. He always has had a stream of thoughts that often comes through faster than he has an outlet for. He flailed at school and was disruptive. He got into a lot of trouble. He lost his work and would have to complete assignments at home. We had him begin doing chores and between that and getting ready in the morning, he was devolving because he couldn't focus. It became clear it was an attention issue. We started making lists and doing all the support for ADHD and it helped, a little bit.

We were still dealing with emotional issues and a lot of it was impulsivity. Sure he could play video games or watch The Simpsons for hours. (Not all gifted kids pursue intellectual stimulation - lol!) He could read or complete a hands on activity that took prolonged focus. Sometimes he would focus so intently that that it was hard to get his attention.

When it came to other things he wasn't as interested in, he would just be off in La La Land and unable to finish without constant reminders. He would forget what he was suppose to do in the ten feet between when I told him to get his shoes on when he went down the hallway to get them. Yes, that is an occasional kid thing, but it was more often like that than not. He was just getting lost in his ideas to the point that he was losing function. He couldn't focus on being present in the moment or the task at hand.

Now we are homeschooling and I saw firsthand how debilitating it was for his schoolwork. We pursued the ADHD diagnosis, did therapy, made a ton of lifestyle changes to help him sleep, get tons of exercise before beginning the school day, and give him structure with organization and expectations. It helped a bit, but we just started medication. The difference in just having a coherent conversation is remarkable. A five minute conversation used to be about 10 different things that may not even be relevant. Now he can talk about one or two things in depth.

I understand how it is really tricky with gifted kids to know if it is ADHD because they just have more thinking going on. It took a while for it to get bad enough that we realized it was taking over. There is a tipping point that all those thoughts start to get in the way. The impulse control seems to be key in that as well because my son had very little impulse control. That compounded his ability to stay on task because frankly, ideas are more fun. He just could not stop himself. He couldn't think ahead to consequences because his thoughts wouldn't stay on a single track long enough.

I understand the possibility of misdiagnosis, but it can also be a hindrance to getting help. I waited for a long time and wish I hadn't. I never wanted to medicate my son either, but it has helped him tremendously.

So yes there are other pg ADHD kids that are inattentive. I would say that at 6 my son was hyperactive, but the hyperactivity has waned with age. It also was worse at 9 than at 6 for my son. It has felt like he was going backwards in his development. It has impacted so many aspects of his life. I'm relieved that he is so much happier.

This is such a wonderful, insightful, and helpful post. It should be pinned somewhere.