Maybe He Doesn’t Have ADHD. Maybe Your Curriculum Just Isn’t Good Enough.

Let me tell you about a guy I knew in high school named Pravin. Pravin was known as the kid who could drive teachers insane because he could not for the life of him sit still and be quiet. We used to laugh as more than one teacher would whip out, “Shut up, Pravin!” in the middle of a lesson. One time a history teacher got so frustrated by Pravin’s incessant banging on his desk that he literally flipped the desk over as Pravin drummed. By senior year teachers were giving Pravin hall passes to stroll the halls with instructions to “just be quiet already.” Pravin never stopped moving, never stopped talking, never stopped smiling. To my knowledge, he was never medicated, either. His disruptions weren’t classified as bad behavior because Pravin was gifted. Sure, his sneakers were Velcro because he couldn’t tie his shoelaces, but he scored a 1590 on his SATs in an era when 1600 was the max. In an era before ADHD, Pravin’s behavioral issues were chalked up to his giftedness and left at that.

If Pravin was in public school today, his parents would most likely be advised to medicate him for ADHD by the time he was in first grade. According to new research, students who are the youngest in their class are twice as likely to be medicated for ADHD. If they’re male they are three times as likely to be diagnosed with and medicated for ADHD. Being both male and on the younger side in his class, Pravin would’ve been a guidance counselor’s and pediatrician’s prime target for drugging. The only thing that might save him now is what probably saved him then: He is damned smart.

According to SENG (Supporting Emotional Needs of the Gifted), it is almost too easy to misdiagnose a gifted child as one having ADHD:

Seeing the difference between behaviors that are sometimes associated with giftedness but also characteristic of ADHD is not easy, as the following parallel lists show.

Behaviors Associated with ADHD (Barkley, 1990)

  1. Poorly sustained attention in almost all situations
  2. Diminished persistence on tasks not having immediate consequences
  3. Impulsivity, poor delay of gratification
  4. Impaired adherence to commands to regulate or inhibit behavior in social contexts
  5. More active, restless than normal children
  6. Difficulty adhering to rules and regulations

Behaviors Associated with Giftedness (Webb, 1993)

  1. Poor attention, boredom, daydreaming in specific situations
  2. Low tolerance for persistence on tasks that seem irrelevant
  3. Judgment lags behind development of intellect
  4. Intensity may lead to power struggles with authorities
  5. High activity level; may need less sleep
  6. Questions rules, customs and traditions

The key difference is purely situational. If a gifted student is a classroom disruption but perfectly content at home or with friends, he most likely does not have ADHD. But, how would a teacher who never sees a student outside of the classroom ever know that? Some of the world’s most brilliant minds would be diagnosed with ADHD in this day and age.

There are plenty of advocates out there railing against the overabundance of ADHD diagnoses among school-aged children. Most of these advocates are great at focusing on the fact that boys are specifically targeted for behaviors that are common to their gender: Rambunctiousness and a draw to kinesthetic learning, two traits that grossly contradict Common Core’s push for academic excellence via seat work. These advocates proffer one simple answer to problematic ADHD diagnoses and the failings of Common Core: Recess. Fair enough, but not good enough. Some students labeled as behavior problems don’t just need more leg work, they need more mind work.

Yes, by all means, physical activity is important. Repeated studies have shown the importance of exercise and free play for healthy growth and development. But, simply shouting out "recess" isn't enough. We must also address intellectual boredom if we want to put an end to the gross medical and educational misconduct of drugging far too many children for a behavioral disorder they do not have.