As we prepare for the official release of College at 13, Great Potential Press is giving away 26 copies  of this outstanding examination of radical acceleration for gifted learners. Simply send an email to info@greatpotentialpress.com with “Win” in the subject line, and we may pick you as one of our winners! The official release date is only ten days away – enter to win while you still can!

Want to learn more about College at 13? Click here.

Annemarie Roeper founded the Roeper School; authored more than 100 articles and book chapters, as well as three solo works;  was a civil rights activist, mentor, and educator; and a pioneer in the gifted educational community. She led the movement to emphasize the emotional needs of gifted learners alongside their intellectual needs, and through her work left the world of gifted education forever changed. A more complete, but hardly comprehensive list of her accomplishments appears in her obituary, available on the Roeper School’s website.

In celebration of a life so richly lived, Great Potential Press is proud to present an excerpt from her brilliant and inspiring book, The “I” of the Beholder. The complete book may be purchased in our store.

The “I” of the Beholder Excerpt (PDF)

 ”…I will apply, for the benefit of the sick, all measures that are required, avoiding those twin traps of overtreatment and therapeutic nihilism . I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug…”

Modern version – Hippocratic Oath (1964)

In 2004, the National Federation of Families for Children’s Mental Health began a public children’s initiative to occur on the first full week of May each year. National Children’s Mental Health Awareness Week is this week: May 6th-May 12th.

One in five children and adolescents have lives complicated by mental health and learning challenges. Early identification and proper support is essential to help children thrive in a complex world. Suicide is the third leading cause of death in adolescents after accidents and homicides. Victims of bullying, and children with sensitivities and personal challenges, can be depressed and engage in self-harm.  Statistics indicate that over half of high school dropouts have some type of mental health concern. Thus, many kids enter adulthood with unmet mental health needs.

Gifted children, with “different minds” and intense sensitivities, can be similarly affected. Mental health encompasses (or should encompass) the whole child including one’s social, emotional, intellectual, and spiritual needs. Mental health is comparable to physical wellness and quality of life. Unmet intellectual and/or mental health needs can complicate a gifted child’s life, leading to depression, anxiety, and a variety of other mental and physical health conditions.

The current DSM-IV, and planned 2013 DSM-V, both provide guidelines for physicians to diagnose and treat patients with suspected mental health conditions. This blog series has thus far explored two diagnoses (autism, ADHD) where the guidelines do not always serve the good of all patients. We examined how misdiagnoses can occur, both under-diagnosis and over-diagnosis.

Physicians do not typically receive giftedness education, and thus they are at a disadvantage to recognize giftedness in their practices. Mental health training is also a weakness within primary care medicine. This week, the American Psychological Association met in Philadelphia to discuss the DSM-V, and found that the statistical reliability of a number of diagnoses were far lower than they anticipated, making the accuracy of the proposed DSM-V even poorer than the DSM-IV.  Concerns are now rising [6] whether release of the DSM-V should be withheld.  Already, the DSM-V panel is considering making some changes to the proposed guidelines.

Meanwhile, hopeful news is coming from the Academy of Pediatrics (AAP). This month they released a policy statement addressing the negative effects of early childhood adversity and toxic stress, and the need to produce a fundamental change in supporting development, learning abilities, behavior and resilience. Within the policy, I was overjoyed at the additional mention that shortly another AAP policy statement will be released addressing childhood social-emotional needs and specific recommendations for physicians in screening these needs.

Parents of gifted children understand the importance of supporting the social and emotional needs of their children. Sometimes the intensities and asynchronous development of gifted children can be misunderstood as autism, ADHD, conduct disorder, OCD (obsessive-compulsive disorder), ODD (oppositional-defiant disorder), bipolar disorder, and more. Other times, a gifted child may over-compensate for true mental health or learning disorders in such as way that conditions like ADHD, depression, dyslexia, and others are entirely overlooked. Having the AAP actively recognize the connection of social and emotional needs to mental health wellness is a strong step forward for all children.

The gifted world continues its own ongoing work. In 2011 the NAGC Gifted Terminology Task Force released a new position paper on giftedness. This position paper, which attempts to more clearly define giftedness, is by its nature layered with complexity. The gifted world as a whole must continue to make assurances that any definition of giftedness must always embrace the social-emotional message of support, as well as awareness of twice-exceptionality and underachievement and co-morbid mental health disorders. Giftedness should never be “what a child does”, but instead “who a child is”.

The term “giftedness” is wrought in its own difficulties. Many people avoid the term. Clarifying giftedness is necessary to increase acceptance, reduce stressors and avoid misunderstandings that gifted children and adults live with each day. The topic of giftedness needs to be an active contribution to conversations of health, as in many cases “it is” the conversation. Silence on giftedness serves no one, yet silence is a powerful message unknowingly shared with gifted children. Giftedness, when left unspoken, is sometimes perceived by children as a thing of shame or embarrassment, rather than a way of being. Strengths to be cherished are now weaknesses to be hidden away or used inappropriately.

The same can be said of mental health issues. Hiding all these issues away or silencing society to the needs of people with mental health issues produces shame in just the individuals who need help the most. As a society, we need to address the full social, emotional, intellectual, and spiritual needs of all people, young and old, with mental health issues. Giftedness should afford the same support.

This is National Children’s Mental Health Week, and the focus is on child mental health. The term “health” is not accidental. Let’s therefore support not just illness, but also the health and strengths of the child. The whole child. Strengths and weaknesses are sometimes simply two sides of a coin. Parents of gifted children recognize this too well. Edweek just published an article [11] that emphasizes the need to look holistically at the needs of children, in particular twice-exceptional children in whom giftedness is often overlooked.  A determined focus on both health and wellness by physicians, teachers, and parents that includes the complexities of giftedness can be an opportunity for society to do far more for all children.

Next week, we turn to you to direct the discussion. What are your questions, comments, and experiences with Misdiagnosis and Giftedness? Join the conversation on GPP’s Facebook page and through Twitter (@giftedbooks), and you may see your comments featured in next Thursday’s article! Then, stay tuned as the authors of Misdiagnosis and Dual Diagnosis of Gifted Children and Adults join Dr. Kuzujanakis to conclude this series with a Q&A.

Be sure to catch the previous posts in this series:

Part 1: “ADHD, Autism, and Giftedness: An Invitation To A Conversation“

Part 2: “Autism, Giftedness – and Human Diversity“

Part 3: “Giftedness, ADHD, and the Complexities of Society“

Don’t miss another blog post — add Great Potential Press on Facebook and Twitter today!

Additional Resources:

Websites

1) SENG Video: The Misdiagnosis of Gifted Children

2) University of Wisconsin Grand Rounds presentation by James T. Webb Ph.D.: “Accurate Assessment? Asperger’s Disorder, and Other Common Misdiagnoses and Dual Diagnoses of Gifted Children”

3) “Health Care Providers Know Little about Gifted Children,” by Goerss, J., Clouse, R., & Webb, J. T. (2008). National Psychologist. 16(2),12. Available online.

4) “Where does a pediatric doctor fit in the care of gifted children?” by Kuzujanakis, M. (2011). SENGVine, October 2011. Available online.

5)  “Discovering Gifted Children in Pediatric Practice,” by Liu, Y.H, & Lien, J. (2005). Journal of Developmental and Behavioral Pediatrics. 26, 366-369. Abstract available online.

6) “Gifted and Talented Children: Issues for Pediatricians,” by Robinson, N. M., & Olszewski-Kubilius, P. M. (1996). Pediatrics in Review, 17(12), 427-434. Available online (PDF).

What Wordles will you make?

Where to begin?

Do I discuss the effects of recession and poverty on children’s psychological development? Do I speak of the dysfunction of the dopamine neurotransmitter system in the area of executive functioning? Do I address the ethics of using psychotropic medications in sometimes very young children? Do I entertain the topic of “the wired society” and its effects on attention? Do I turn the topic towards the child’s own perception of being diagnosed, as was done in Kaitlin Barnett’s recent book “Dosed”? What too of the achievement-oriented emphasis in some sectors, inadvertently encouraging students and adults to use stimulants outside the realm of ADHD – as performance enhancers for wakeful endurance at work or leisure, and even as part of a weight-loss regimen?  Do I explore the possibility of secondary gain for ADHD diagnosis for children or adults? Do I try to decipher genetic manifestations behind some of the increases? Do I emphasize the variations in diagnosis relative to U.S. geographic region? Do I speak about pharmaceutical profit? Do I expound upon the negative changes in schools and society, which frequently are less accepting of individuality? Or do I simply grasp onto misdiagnosis in the gifted?

Perhaps beginning at the early days of our crisis may place light upon the long road left to walk.

Last year, when the CDC reported ADHD in nearly one in ten U.S. children (5.4 million), we became concerned. High-risk groups included boys, African-Americans, and foster children. Another study group this year suggested ADHD is seen in 10.4 million U.S. children (a rise of 66% in one decade).

Since the DSM-IV first was released in 1994, people began to question ADHD diagnosis and treatment. The Hoover Institute in 1999 and PBS’s Frontline in 2001 both spoke to the lack of precision in understanding ADHD.  The chairman of the DSM-IV recently spoke out to the mistakes made at that time in trying too hard to serve as a safety net to prevent under-diagnosis.

Symptoms suggestive of ADHD may be a result of many other etiologies. Anxiety, depression, abuse & neglect at home or school, family stressors, side effects of allergy medications, high caffeine use, the use of legal and illegal drugs, exposure to toxins, and chronic lack of sleep or nutrition can all appear similar to ADHD. Immaturity, whether by chronological age, developmental variability, or lack of guidance, can look like ADHD. Unidentified learning disabilities, and specific neurological and medical disorders that are not controlled, can suggest ADHD. Hearing loss, seen now in 1 in 5 children, may also mimic ADHD. Family history or gender alone may influence diagnosis. Yet children with any of these other conditions can also have ADHD, and the combination of two of more conditions makes diagnostic accuracy even more difficult.

Gifted children are misdiagnosed with ADHD, yet some also have ADHD, and any of the just mentioned diagnoses. If educational (and social/emotional) needs are not met, giftedness alone may look very similar to ADHD. For gifted children who do have ADHD, the child’s intellect may over-compensate for the ADHD, thus sometimes masking ADHD for many years until a limit is reached where problems occur. This is particularly true of gifted girls. ADHD and giftedness can also entirely mask each other, making both invisible. In this situation, the child’s giftedness is not supported, nor is the child’s ADHD properly diagnosed. Minorities, the poor and boys are often least recognized as gifted, and boys in particular are most commonly misdiagnosed with ADHD.

Thus far, the recent American Academy of Pediatrics guideline on ADHD and the proposed 2013 DSM-V ADHD criteria are silent on giftedness. The DSM-IV only briefly mentioned giftedness in the text revision of 2000 (DSM-IV-TR) by saying “Inattention in the classroom may also occur when children with high intelligence are placed in academically understimulating environments.” Nothing was said of the intrinsic traits of giftedness of which parents are only too aware.  Giftedness has never been a topic routinely addressed in medical training.

Today we know a little bit more about ADHD, and fMRI’s are beginning to define variations in appearance and rates of cortical development. We also see suggestions hinting at differences between the impulsiveness that leads to substance abuse, and a separate impulsiveness associated with ADHD. An article last month by Dr. Damien Fair further reports that there exists wide variability in the presentation of ADHD, a heterogeneity that strongly implores the need to individualize ADHD diagnosis and treatment.  For all of our children, and in our quest to decrease misdiagnosis, this news may be the best we’ve heard thus far.

Meanwhile what can parents do to determine if their gifted child has ADHD or not? A few links and book suggestions are shown at the end of this article. If seeking an evaluation, it is important to locate an expert in both giftedness and ADHD, and barring that at least locate someone who is supportive of giftedness and thus will consider giftedness as an essential part of the whole child. Please realize that there are only 8000 child psychiatrists in the U.S., and 600 developmental behavioral pediatricians, though more child psychologists. Much responsibility ultimately falls upon the primary care practitioners, at a time of severe limitation in both time and training. Much falls too upon parents.

The more thought I put into defining the issues surrounding ADHD, the more questions I uncover, and the more I agree with Dr. Allen Francis, chairman of the DSM-IV, who so succinctly said, “This is a societal issue that transcends psychiatry”.

One thing is for certain…it is imperative that ADHD remain a diagnosis of exclusion.

Be sure to catch the previous posts in this series:

Part 1: “ADHD, Autism, and Giftedness: An Invitation To A Conversation“

Part 2: “Autism, Giftedness – and Human Diversity“

Don’t miss another blog post — add Great Potential Press on Facebook and Twitter today!

Additional Resources:

Websites

http://www.uniquelygifted.org/

http://www.sengifted.org/resources/resource-library

http://www.davidsongifted.org/db/browse_articles_219.aspx

http://www.hoagiesgifted.org/adhd.htm

http://www.cec.sped.org

http://www.2enewsletter.com/

Books 

1. Bright, Not Broken: Gifted Kids, ADHD, and Autism by Diane M. Kennedy, Rebecca S. Banks, and Temple Grandin

2. Different Minds by Deirdre V. Lovecky

3. Dosed: The Medication Generation Grows Up by Kaitlin Bell Barnett

4. Living With Intensity: Understanding the Sensitivity, Excitability, and the Emotional Development of Gifted Children, Adolescents, and Adults by Susan Daniels, Ph.D. and Michael M. Piechowski, Ph.D.

5. Misdiagnosis and Dual Diagnoses of Gifted Children and Adults ADHD, Bipolar, OCD, Asperger’s, Depression, and Other Disorders by James T. Webb, Edward R. Amend, Nadia E. Webb, Jean Goerss, Paul Beljan, and F. Richard Olenchak 

6. The Mislabeled Child: Looking Beyond Behavior to Find the True Sources and Solutions for Children’s Learning Challenges by Brock & Fernette Eide – On Sale for $15.00!

7. Uniquely Gifted: Identifying and Meeting the Needs of the Twice-Exceptional Student by Kay Kiesa

 The World’s Biggest, Highest, Longest Roller Coaster

Parenting a gifted child is like living in a theme park full of thrill rides. Sometimes you smile. Sometimes you gasp. Sometimes you scream. Sometimes you laugh. Sometimes you gaze in wonder and astonishment. Sometimes you’re frozen in your seat. Sometimes you’re proud. And sometimes the ride is so nerve-racking you can’t do anything but cry.

Any and all of these reactions are normal, depending on your child and his development at any given time. Gifted children can be an enormous challenge for parents. These children go through the same developmental stages other children do, but often much earlier, more intensely, and not in the same way. A gifted child’s intellect and thinking ability are typically “older” or more advanced than his other abilities, such as his judgment and social and emotional development. This situation is called asynchronous development because the child’s intellect is out of sync with his less-developed emotional, social, and sometimes physical abilities. Asynchronous development can leave a gifted child, as well as parents or teachers, feeling frustrated and confused. Adults may say, “For someone so bright, he seems really immature sometimes.”

Imagine, if you can, that you are five years old, but you can think like a fourth grader. Where do you find your friends? The other five-year-olds are too immature, and the 10-year-olds don’t take you seriously. If the older kids want you around at all, it’s as a sort of mascot, not as a peer. Physically, you can’t do the things the fourth graders can: you can’t hit a ball very well; you have trouble riding a two-wheeler; you can’t run as fast. No matter how hard you try, you’ll always be behind the physical and emotional curve set by older classmates. It’s like being a person who speaks only German and travels to Italy and France. You like being there, but because the language and cultures are different, it’s hard to be understood and to get what you need.

Fitting in with neither their average-ability age peers nor their older intellectual peers, gifted children all too often are teased, put down, and ridiculed by both other children and adults. It’s no wonder, then, that they sometimes feel out of place, weird, inept, and even angry, particularly because they are generally more intense and sensitive than other children. Their emotions, already exquisitely sensitive, often are exposed, raw, and tender, and their lack of emotional maturity can make their lives—and yours—a challenge at best and a nightmare at worst.

Gifted children have many wonderful, enjoyable qualities, but when those qualities are combined with emotional and social immaturity, the flip side of those same attributes can look a lot less appealing.

Excerpt from  Helping Gifted Children Soar, 2nd Edition

by Carol Strip Whitney, Ph.D. and Gretchen Hirsch

The following is a helpful guide to some of the challenges that accompany gifted children’s strengths. For more information, be sure to pick up your copy of Helping Gifted Children Soar today!

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Temple Grandin exemplifies the role of eloquent spokesperson for those on the autism spectrum. The feeling of not quite fitting in, of needing to pretend in uncomfortable social situations, and of having specific strengths yet intense sensory issues hindering the ease of what should be a natural emotional relatedness to the world. Hearing her words, it is clear that those with autism (including the related Asperger Syndrome), do not feel less, but may feel far more. The profound effects of autism, a condition diagnosed 4-5 times more frequently in boys, encompasses every aspect of the lives of families.

Recently I’ve begun watching Touch (a television drama about a nonverbal child with apparent autistic traits including a strong predilection towards numbers and patterns). While Hollywood always puts its own twist upon subjects, I find myself deeply drawn into this program. Though the autism community does not universally approve of the show, perhaps I am a sucker for unanticipated superheroes, hopeful possibilities, deep parental love, and the positive acceptance of non-neurotypical individuals. Perhaps my interest also is because the drama mentions giftedness and misdiagnosis.

Some twice-exceptional gifted individuals indeed have autism spectrum disorders, yet misdiagnoses routinely occur: both over-diagnosis and under-diagnosis. There are times when the distinction between giftedness and autism is unclear, and symptoms can overlap, especially in the asynchronous gifted. Difficulties with social interactions and friendships may occur with both autistic individuals and gifted individuals, as can tantrums, focused (and unusual) interests, sensory intensities, and even a lack of motor coordination. Excessive talkativeness can also be seen in both. The American Academy of Pediatrics has useful diagnostic and management articles on the topic, but a full evaluation by someone with expertise in giftedness and multi-exceptionality is crucial.

The proposed 2013 DSM-5 changes might further complicate the current diagnostic criteria of autism by no longer listing Asperger Syndrome, folding it within autism spectrum disorder, and narrowing the inclusion criteria. Both sides of the debate are outspoken, with the many who support those who are higher functioning concerned that they may be left without a defined medical diagnosis, resulting in a possible end to their already established support.

Other people look with promise to the proposed DSM-5 changes, as autism diagnoses have risen by 78% in the past decade. 1 in 88 people are said to have an autism spectrum disorder. The rise, while it may be associated with better awareness, may in part be a result of misunderstandings about autism and/or giftedness, and a possible excess of diagnoses (and self-diagnoses) of high functioning autism and Asperger Syndrome. It is believed that a majority of individuals currently diagnosed with an autism spectrum disorder fits this profile.

I am deeply uneasy about individuals in need who may be at risk of losing life-changing services, but particularly I also am concerned with what happens to children who learn they have autism or Asperger Syndrome, and then have that diagnosis taken away. How could the changes affect a child’s self-identity?

Yet watching the media present endearing portrayals of characters like Jake from Touch, I feel hope that one of the most important things we can do as a society is to tirelessly strive to achieve unquestionable accuracy in diagnosis and management, to lessen the knee-jerk urge to identify and compartmentalize people by labels, and to fully and without question heartily embrace the entire vibrant and powerful spectrum…the spectrum that is our human diversity.

Make sure to catch all the posts in this series:

Part 1: “ADHD, Autism, and Giftedness: An Invitation To A Conversation“
Part 3: “Giftedness, ADHD, and the Complexities of Society“

Don’t miss another blog post — add Great Potential Press on Facebook and Twitter today!

Additional Resources:

Websites

http://www.uniquelygifted.org/

http://www.davidsongifted.org/db/Articles_id_10167.aspx

http://www.hoagiesgifted.org/aspergers.htm

http://www.cec.sped.org

http://www.2enewsletter.com/

http://www.wrightslaw.com/

Books 

1. A Parent’s Guide to Asperger Syndrome and High-Functioning Autism by Sally Ozonoff and Geraldine Dawson

2. Different Minds by Deirdre V. Lovecky

3. Misdiagnosis and Dual Diagnoses of Gifted Children and Adults ADHD, Bipolar, OCD, Asperger’s, Depression, and Other Disorders by James T. Webb, Edward R. Amend, Nadia E. Webb, Jean Goerss, Paul Beljan, and F. Richard Olenchak 

4. The Mislabeled Child: Looking Beyond Behavior to Find the True Sources and Solutions for Children’s Learning Challenges by Brock & Fernette Eide – On Sale for $15.00!

5. The Unwritten Rules of Social Relationships by Temple Grandin

6. Uniquely Gifted: Identifying and Meeting the Needs of the Twice-Exceptional Student by Kay Kiesa

Photo by Zul.Rosle / Creative Commons

The world celebrated Earth Day this past Sunday, April 22nd. Some walked or biked instead of driving, others turned off electronics not in use, others led recycling efforts in their communities. One gifted learner deserves special note: Davidson Young Scholar Ambassador Emma Freedman founded the Jungle Heroes project to raise awareness about the endangered orangutans of Borneo while raising funds for the Orangutan Appeal UK. Thirteen-year-old Emma has taken up the cause of ending the use of palm oil in commonly-consumed products, as the growth of plantations responsible for producing palm oil threatens the rain forest homes of numerous endangered species in Indonesia and Malaysia. One species in particular caught her eye: the Borneo Orangutan.

“Their eyes are so emotional that I just fell in love with them. I felt I needed to do something to help them.” Emma has done something, founding Jungle Heroes in November 2009 when she was 9 years old, and working with fellow students to raise over $1,000 dollars to donate to the Orangutan Appeal UK as of October 2011.

Great Potential Press salutes Emma Freedman and her work. You can learn more about the Jungle Heroes project on Facebook.

For our part, Great Potential Press is proud to publish our books using recycled materials while practicing green office techniques to further reduce our environmental impact. We also maintain our commitment to the environment through our use of a U.S. printing company, Malloy Inc., for all of our book-printing needs, reducing the carbon footprint created by our books when being shipped from printer to publisher.

Thank you for allowing us to keep doing what we do, so that you can do what you do — and gifted learners like Emma can inspire us all.

Additional sources for this post: http://www.mercurynews.com/california/ci_19223611