ADHD or Gifted?

Giftedness has been defined by several professional groups to describe children that have a talent or exceptional ability outside of that which is expected for a child of the same age.  This talent is a natural ability and is said to be as common as one in 20 children, though often not recognised.

A child who is gifted can present in the same way as a child with Attention Deficit Hyperactivity Disorder with inattention, fidgetiness, constant talking, and impulsivity to name a few.

A gifted child has a brain that is wired differently as seen on functional MRI studies of the brain.  Gifted children see and experience the world in an amplified way because of the many extra neuronal connections they have, these are referred to as over-excitabilities.

Dabrowski was a Polish psychologist who recognised five areas of intense behaviours, or over-excitabilities in gifted individuals.  These are psychomotor, sensual, emotional, intellectual, and imaginational.  These sensitivities can appear as symptoms of ADHD.

To give you a few examples………….


Psychomotor excitability

This is a state of high energy, a constant need to move without tiring.  This can take many forms, but the overlap with ADHD here is the restlessness or fidgety nature.


Sensual excitability

This is a heightened awareness of all of the senses, sight, smell, hearing, touch and taste.  This can present in a myriad of ways.  One example would be being bothered by the feel of some clothing textiles on the skin leading to constant wriggling or moving.


Emotional excitability

This is the feeling and expression of emotion outside of normal and can take many forms.  The child may be labelled as over sensitive or anxious.  This can present as behavioural outbursts.


Intellectual Excitability

This is probably the most easily recognised with children showing heightened inquisitorial nature or curiosity with a love of knowledge and learning.  This can present as agitation in the classroom or inattention because the child has finished their schoolwork faster than their peers.   


Imaginational excitability

Vivid imagination can take many forms, from imagining the worst possible scenario, to imaginary friends, love of fantasy and drama.  In the classroom this would appear as daydreaming.



This is by no means a comprehensive summary, rather a time to pause for thought when looking at the diagnosis of ADHD.


Why is Giftedness important to differentiate from ADHD?

The management strategies to help a child with these conditions is quite different.

For a child with ADHD appropriate academic placement does not have any effect on behaviour.  The child cannot explain their behaviour and they feel out of control.  Teaching social skills here has little impact on impulsivity.

For the gifted child contact with peers that have a similar intellect can reduce the inappropriate behaviour, as can modification to the curriculum to incorporate their superior intellectual function.  This child has logical explanations to their behaviour and does not like to feel out of control.  Here learning social skills can help diminish inappropriate behaviour.



Yes, it can be confusing.  It can take time to work out which of these two diagnoses is affecting the child, at times it can be both.  ADHD has had more airtime or press if you like, so is the common go to diagnosis for a child that is disruptive, hyperactive, or inattentive at school.  Giftedness is less understood and therefore less recognised.

When I see a child for a workup of ADHD, I try to make sure that I look for the other conditions that can present in a similar way and being gifted is one of those.  If this is something that needs investigating I seek the help of professionals in this area, locally I am lucky to work with paediatric occupational therapist Karen Keppel (Leith OT), who I frequently call on for her expertise and assessment.


For more information here are two great websites:

Gifted NZ

NZ Association for Gifted Children