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Tips for Parents: Twice Exceptional Alphabet soup: PG-ADHD

Gifted Resources

The following article expands on highlights and insights from one of our Expert Series events, which are exclusive for Young Scholars and their parents. 

Authored by: Edward R. Amend, Psy.D

Summary

ADHD is a complex condition, which by definition is a disorder that impairs functioning. However, it comes with strengths and is manageable with the right tools.

The three main types of ADHD are predominantly inattentive, predominantly hyperactive-impulsive, and combined (both inattentive and hyperactive). In a PG child, the strengths associated with ADHD, such as high energy, hyperfocus, creativity, high tolerance for risk, and spontaneity can also create challenges like excessive fidgeting, ignoring important things (e.g., eating or completing chores), taking risks, and being impulsive.

Keep in mind that the PG-ADHD child doesn’t have an Information Deficit Disorder, as most know what to do, but have a hard time focusing and doing it in the moment. Other conditions, such as anxiety, trauma, or gifted overexcitabilities, can create behaviors that mimic ADHD, and comprehensive evaluation is typically the only way to avoid misdiagnosis or missed diagnosis so that the most appropriate interventions can be applied. Both misdiagnosis and a missed diagnosis will result in a mismatch between the child’s actual learning or health needs and the perception of those needs by others—and ultimately lead to inappropriate interventions.

Comprehensive assessment usually includes testing and collection of data through checklists, and it is unlikely there will be a single “definitive” test for ADHD any time soon.

Management tools for PG- ADHD often include both medication and behavioral support, such as executive functioning coaching. In my opinion, medication is particularly necessary when quality of life is affected, or the child’s self-esteem is plummeting because of the day-to-day difficulties. It is especially concerning when a PG-ADHD child begins to think they are “dumb” or unable to succeed.

General Tips

  1. Understand giftedness, ADHD, and their implications. Giftedness can explain behaviors, just as ADHD can. But, neither should be used as an excuse for why something happened or why it did not.
  2. Recognize that gifted needs may arise from strengths and that ADHD strengths may also get in the way. ADHD is not a present most people want, but it can be managed.
  3. Use 504 plans and IEPs to get support in school when behaviors “substantially limit” production of work—if a child is unable to consistently demonstrate the full extent of their knowledge and skills, that is a substantial limitation.
  4. I mentioned Dr. Russell Barkley and Dr. William Pelham during the presentation. They have written extensively on ADHD and parents might find their books, videos, and articles interesting and helpful. They are many and easily found via any search engine.

Home Management

  1. Provide frequent positive reinforcement for appropriate behavior.
  2. Focus on strengths and give your child a vote of confidence that they can success. This is important for all children, but especially those who struggle to see their value because perfectionism focuses them on their weaknesses.
  3. Set structure and clear limits when needed.
  4. Enforce set limits—always follow through so the message is clear.
  5. When needed, use clear and meaningful consequences that immediately follow the problematic behavior.
  6. Avoid natural consequences for PG-ADHD. The problem with natural consequences is the time lag between behavior and consequences. ADHD responds best to immediate consequences.
  7. For time blindness, try:
    • Working on mindfulness to improve sense of time.
    • Keep improving in use of routines, reminders, and alarms.
    • Learn time management techniques and ways to avoid procrastination (see resource list).
    • Use visual schedules or work to divide your day into chunks.
    • Add buffer time to increase chances of success.

Helpful Accommodations in School

  1. Provide extended work time (time-and-one-half).
  2. Decrease repetition: Shorten assignments with mastery.
  3. Allow extended deadlines or 24-hour grace period.
  4. Break tasks into manageable chunks.
  5. Allow students to take exams in a quiet room.
  6. Pair visual and verbal instructions.
  7. Allow alternative methods of demonstrating knowledge so students can use strengths to compensate for weaknesses.
  8. Determine preferential and flexible seating options with student input, including appropriate location, size/shape, and feel/texture
  9. Provide support for remembering and organizing work (ADHD or executive functioning coaching can help). Try to:
    • Color-code information to support memory.
    • Provide copies of notes to maximize focus and minimize distraction during class.
    • Assist with using a planner and training good habits.

Resources

How to (Explain) ADHD (youtube.com)

Joanne Foster’s books

Bust Your Buts – Tips for Teens Who Procrastinate (giftedunlimitedllc.com)

Not Now Maybe Later – Helping Children Overcome Procrastination (giftedunlimitedllc.com)

Dr. Amend’s Books:

A Parent’s Guide to Gifted Children: A Resource for Caregivers and Advocates (giftedunlimitedllc.com)

Misdiagnosis and Dual Diagnoses of Gifted Children and Adults (2nd edition) ADHD, Bipolar, OCD, Asperger’s, Depression, and Other Disorders (giftedunlimitedllc.com)

 

Speaker Bio:

Edward R. Amend, Psy.D., a licensed clinical psychologist at The Amend Group in Lexington, KY, focuses on the social, emotional, and educational needs of gifted, twice-exceptional, and neurodivergent youth, adults, and their families. Dr. Amend is co-author of the revised edition of A Parent’s Guide to Gifted Children: A Resource for Caregivers and Advocates, as well as other award-winning books, chapters, and articles about gifted children. He presents nationally and internationally, and his service has included various leadership roles with NAGC, SENG, KAGE, and The G WORD film’s Advisory Board.

 

Permission Statement

This article is provided as a service of the Davidson Institute for Talent Development, a 501(c)3 nonprofit dedicated to supporting profoundly gifted young people 18 and under. To learn more about the Davidson Institute’s programs, please visit www.DavidsonGifted.org.

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