ADHD overdiagnosis is harming gifted children

In recent years, diagnoses of attention deficit hyperactivity disorder (ADHD) have multiplied. More and more children are being labeled as inattentive or impulsive, and many are receiving medication, which can be as unnecessary as it is harmful. This is not only due to the potential and as-yet-undocumented long-term consequences of altering a still-developing brain that doesn’t require it with psychotropic drugs, but also because of the implicit message it conveys: “You’re not okay, you have to take pills.” This isn’t about being against medication, but about being against misdiagnosis.

In recent studies and in our daily clinical practice, we see a clear overdiagnosis of ADHD and its confusion with giftedness. In many cases, what is seen as distractibility or lack of control is actually a mismatch between the child’s pace and that of the educational environment.

Much of this stems from teachers’ limited training on how the brain works and how gifted students learn. Teachers are the first observers, but without specific training, they tend to pathologize behavior. A bored student may come across as inattentive, and one who asks questions, as disobedient. As psychologists Juan E. Jiménez and Ceferino Artiles point out, a lack of understanding of advanced cognitive development leads to labeling adaptive behaviors indicative of talent as pathological symptoms.

Gifted children process information very quickly and their attention is selective. They concentrate deeply when something interests them, but tune out when faced with monotony, repetition, or slowness. Unlike ADHD, their attention is not impaired, but rather influenced by motivation, challenge, and the complexity of the task. Their divergent thinking may manifest as off-topic questions or creative interruptions, easily mistaken for impulsivity.

In 2020, the Ayalga Center, specializing in psychology and education, published a study on brain function in gifted children through the systematic observation of executive functions. These studies conclude that gifted children have difficulties with specific tasks: they are restless children who frequently act impulsively, tend to lose control more than others, get up from their chairs when they shouldn’t, speak out of turn, and struggle to recognize that certain actions bother others or to distinguish between their strengths and weaknesses.

In terms of flexibility and emotional control, we’re talking about children who frequently feel uncomfortable in new situations, dwell on the same issue repeatedly, struggle to accept alternative solutions to problems, experience frequent mood swings, and overreact to minor details. Regarding initiative, they find it difficult to start activities on their own, even when they are willing.

These children have difficulty remembering information: for example, if you give them three things to do, they only remember the first or the last. Related to this is their planning and organization skills: they struggle to estimate the time they need to complete a task, have difficulty putting their ideas into writing, or become overwhelmed by lengthy assignments. These tasks can result in sloppy execution: poor handwriting, lack of proofreading, and careless mistakes. They frequently forget to bring home school assignments, hand in homework—even if they have completed it—or even find their own belongings. They are driven by curiosity and a desire for meaning. When learning lacks challenge, frustration and boredom arise, easily mistaken for inattention. Furthermore, they often exhibit emotional hypersensitivity and react intensely to inconsistency or injustice, which may appear impulsive but reflects great emotional depth.

Overdiagnosis of ADHD in gifted students leads to unnecessary medication and clinical labeling, obscuring the child’s potential. The opportunity to adapt the educational environment to their pace is lost, and demotivation is fostered. Many gifted adolescents show up at our office feeling that they are the problem.

The goal is not to reject diagnoses, but to refine our perspective. The evaluation should analyze situational attention, motivation, cognitive profile, and learning style. It is essential to observe whether inattention is generalized or context-dependent, and whether restlessness stems from curiosity or difficulty with self-control. A rigorous diagnosis requires distinguishing between structural deficits and situational or motivational differences.

The challenge is not to diagnose more or less, but to diagnose better. Mistaking high intellectual ability for a disorder causes emotional wounds. When a highly gifted child is treated as a problem, the implicit message is devastating: “It’s not okay to be the way you are.” Understanding high abilities involves changing our perspective: from deficit to difference, from pathology to potential.

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