ADHD and high intellectual abilities
We can say that twice-exceptional individuals are those who possess high intellectual and creative abilities and one or more limiting disorders, such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or learning difficulties (dyslexia, dysgraphia, dyscalculia, etc.) (Beckmann & Minnaert, 2018). Detecting this condition is quite complex, both due to the scarcity of information available and its symptomatology (Fernández, 2019). To understand this complexity, we must first explain some important aspects.
ADHD is the most common psychopathological disorder in childhood, with a prevalence of between 5 and 6%, and is characterized by symptoms of inattention, impulsivity and hyperactivity that can be translated into restlessness, nervousness, talkativeness, difficulty waiting for a turn, difficulty in inhibiting irrelevant stimuli or thoughtless behaviors, among others (Rovira et al., 2020) (Guerrero, 2016).
Regarding giftedness , the prevalence of identification in classrooms should be between 3 and 5%; however, these figures are currently much lower. Based on current data from the Spanish Ministry of Education, we can estimate that over 90% of gifted students are not being identified (Tourón, 2020), mostly due to the mistaken association of giftedness with high achievement, poor social skills, or a limited capacity for adaptation (Tourón et al., 2002; Pfeiffer, 2015; López et al., 2019; Baudson & Preckel, 2016). In other words, if the symptoms presented by a person with only high abilities are practically undetected , we can begin to understand the difficulty involved in identifying twice-exceptionality.
According to the Law amending Organic Law 2/2006 on Education (LOE), education must guarantee the right of all students with specific educational support needs to early assessment and intervention, and for this, their identification by teachers is essential. However, the complexity of identifying these needs, the lack of knowledge on the subject, and the belief that these difficulties cannot be compatible with high intellectual abilities mean that these students often go unnoticed or do not receive adequate support.
If the symptoms presented by a person who only possesses high abilities are practically undetectable, we can get some idea of the difficulty involved in identifying double exceptionality.
When a doubly exceptional student arrives in the classroom, we can encounter three very different situations (Baldwin et al., 2015):
- The talents of gifted individuals often mask the limitations of the disorder. They are frequently misidentified as underachieving gifted children.
- The difficulties caused by the disorder prevent high abilities from being seen: the diagnosis is usually only that of ADHD.
- Their abilities compensate for the limitations of ADHD: they are not detected with any of the conditions, being considered average students.
To know the prevalence of this type of double exceptionality, it would be necessary to carry out studies with a large sample of participants from different economic and social levels, different countries, cultures, etc., and unfortunately, no one has carried out such a study on high abilities and ADHD to date.
How to support children with ADHD at school?
Difficulties of students with double exceptionality
What we can say is that, due to their own perception of their abilities and limitations, the difficulties of students with this double exceptionality are more complex than those derived only from ADHD or only from high abilities (Pardo de Santayana, 2012).
It is also important to note that ADHD can lead to lower performance , but it does not, in any case, diminish intelligence (Webb et al., 2004). Despite this, when comparing intelligence tests administered to twice-exceptional children with those of children who are exclusively gifted, it is observed that the lower working memory of the former directly impacts other subtests, which in turn affect the IQ score, potentially resulting in a score up to nine points lower than expected (Antshel, 2008).
The difficulty in this detection is due to the fact that, although their origin is completely different, there are common characteristics in both conditions.
Similarities and differences between high abilities and twice exceptionality (Fernández et al., 2015):
Common characteristics between gifted individuals and gifted individuals with ADHD:
- Altered attention span.
- Impulsive behaviors.
- Difficulty in complying with established rules.
- Lack of consistency in tasks unrelated to their interests.
- High level of activity.
Characteristics of people with high abilities and ADHD that are not found in people with only high abilities:
- Higher likelihood of presenting comorbid disorders, such as mood disorders, learning disorders, or disruptive behaviors.
- Lower scores in working memory, and in math and writing tasks
- Difficulties in their family and social relationships.
- Greater need for school support.
Typically, twice-exceptional individuals can excel academically until the curriculum demands greater attention and the limitations of the disorder become apparent (Foley Nicpon, 2011). Although they develop strategies to overcome difficulties throughout their lives, these strategies may sometimes be insufficient, and they may require additional support (Bell et al., 2015).
ADHD, low performance and school failure
With regard to social and emotional skills , these will be influenced by environmental factors in the same way they influence people without any disorder. However, we can highlight a series of associated problems that are a direct consequence of their condition, such as (Foley Nicpon et al., 2012):
- The frustration and demotivation that occurs when their potential is not reflected in their performance, a fact that can often lead to depression or anxiety.
- Excessive refinement.
- Low self-esteem.
- The difficulty in managing emotions.
- Lack of confidence or low frustration tolerance.
It has also been shown that there is a difference between socio-emotional maturity and high cognitive potential, which can also cause maladjustments in their socialization (Álvarez-Cárdenas et al., 2019).
Twice-exceptional individuals can excel in school until the content demands greater attention and the limitations of the disorder appear.
The perception that a twice-exceptional individual has of themselves will depend on the type of family support and other factors in their life, positively or negatively affecting their self-esteem , self-concept , self-efficacy, and ultimately, their academic performance (Danielian & Nilles, 2015). It is common for the behavior expected of this individual by their environment to be more typical of a gifted student than one with ADHD. Consequently, they are often considered "lazy" or unproductive, are held to higher standards, and are denied the support they need because they are deemed sufficiently capable (Gómez-Arizaga, 2016).
For all these reasons, it is essential to have a greater understanding of this double exceptionality and its symptoms in order to ensure that these students do not go unnoticed and that their individual potential can be assessed and they can be supported in their difficulties.
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