Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, Bipolar, OCD, Asperger’s, Depression, and Other Disorders

263 Pages·2005·1.46 MB·English

by  F. Richard Olenchak & Jean Goerss & Paul Beljan & James T. Webb & Nadia E. Webb & Edward R. Amend [Olenchak

Misdiagnosis and Dual Diagnoses of Gifted
Children and Adults:
ADHD, Bipolar, OCD, Asperger’s, Depression, and
Other Disorders
by
James T. Webb, Ph.D., ABPP-Cl
Edward R. Amend, Psy.D.
Nadia, E. Webb, Psy.D.
Jean Goerss, M.D., M.P.H.
Paul Beljan, Psy.D., ABPdN
F. Richard Olenchak, Ph.D.
Great Potential Press
© 2005; 2012. All rights reserved.
Table of Contents
Foreword by Ronald E. Fox, Ph.D.
Preface
Introduction
Chapter 1. Characteristics of Gifted Children and Adults
Chapter 2. Attention-Deficit/Hyperactivity Disorder
Chapter 3. Anger Diagnoses
Chapter 4. Ideational and Anxiety Disorders
Chapter 5. Mood Disorders
Chapter 6. Learning Disabilities
Chapter 7. Sleep Disorders
Chapter 8. Allergies, Asthma, and Reactive Hypoglycemia
Chapter 9. Relationships Issues for Gifted Children and Adults
Chapter 10. Differentiating Gifted Behaviors from Pathological Behaviors
Chapter 11. How to Select a Health Care Professional or Counselor for a
Gifted Child or Adult
Chapter 12. Resources
Appendix A. Suggested Readings
Endnotes
References
Dedication
Acknowledgments
About the Authors
About the Publisher
Copyright
Try to see your child as a seed that came in a packet without a label. Your
job is to provide the right environment and nutrients and to pull the weeds.
You can’t decide what kind of flower you’ll get or in which season it will
bloom.
~ A modern educator (cited in Mogel, 2001)1
Foreword
In the Summer of 2004, while flying to the 25th reunion of the founding of
the School of Professional Psychology at Wright State University in Dayton,
Ohio, I struck up a conversation with a fellow passenger who turned out to be
the wife of a university president. When she learned the purpose of my trip,
she mentioned that she knew about Wright State University—specifically that
the School of Professional Psychology happened to have a program called
SENG (Supporting Emotional Needs of Gifted) that was dedicated to services
for the gifted and their families and which was “a real national treasure.”
Unaware that, as the founding Dean of the School, I was already familiar
with the SENG program and its founder, Dr. James T. Webb, she proceeded
to tell me all about it. I, of course, was more than willing to listen to her
praise for my obvious good judgment in having agreed to give the program a
home at Wright State, where I was Dean at the time.
Her story was familiar and very much like others I had heard over the
years. Her sister’s nine-year-old son, some years ago, was on the verge of
being expelled from his school’s regular classroom because of poor
performance, lack of attentiveness, poor homework habits, impatience with
classmates, and a fascination—bordering on an obsession—with electric
motors, which he insisted on pursuing regardless of what might be going on
in the classroom at the time. His teacher was not only annoyed, but also quite
puzzled and frustrated because the boy was highly intelligent, yet he had
resisted all efforts to get him to change. Unable to control his disruptive
behavior, this teacher wanted him placed in some kind of alternative
program. The boy’s aunt, my fellow passenger, suggested that his mother
contact a program called SENG located at a state university in Dayton, Ohio.
The parents brought their son to Dayton for evaluation and advice. It was
determined that the boy was so intellectually gifted that his needs were far
from being met in his small-town Indiana school. The parents were apprised
of resources and methods for providing appropriate intellectual stimulation
and were given sound advice about how to deal with his various disruptive
classroom behaviors, as well as practical recommendations regarding how to
deal with his siblings.
The results were quickly apparent. Despite the fact that there was no
available program for the gifted in their Indiana school system at the time, the
help that this family received from SENG allowed these parents to better
provide for their son’s intellectual and developmental needs and to see the
success of their own efforts. Over the course of just a few months, the boy
was transformed from a problem student into a motivated and eager learner.
There was more. The change was so dramatic that the parents of another
student in the same school brought their son for somewhat similar patterns of
behavior and with equally dramatic results.
This encounter vividly reminded me of the early history of SENG, how it
came to be housed in a new School of Professional Psychology (SOPP) at a
young state university in Dayton, Ohio, and how its work resulted in the
present book. The story began in 1980 with the suicide of a gifted and
talented 17-year-old boy named Dallas Egbert. His parents approached Dr.
James T. Webb, then an associate dean in SOPP, about possibly developing a
program at Wright State University for families of gifted children. They were
particularly interested in the emotional needs of such children because of
their own difficulties in finding help for their son. Dr. Webb, a former
Director of Psychological Services at the Children’s Medical Center in
Dayton, recognized the need for such a service and rapidly outlined a
program that would also meet training interests of doctoral students in the
School of Professional Psychology. I approved his proposal, and we were off
and running. The opportunity to work with such a special pool of children,
whose needs are so often neglected in our school system, brought two things
to our School—a unique addition to SOPP’s offerings for child psychology
practitioners, and the opportunity to meet a real social need.
The new SENG program quickly attracted students, funding, and public
attention. The financial support from the Dallas Egbert Fund, as well as a
local nonprofit venture and other more traditional sources, soon made it one
of the School’s best-funded programs in terms of student support. An
appearance of Dallas’s parents and Dr. Webb on the Phil Donahue Show in
1981 brought responses from more than 20,000 viewers across the country. It
was clear that the program was addressing a real need.
The SENG program was simple and directly to the point of the need. First,
formal intellectual and personality assessments were provided by
psychologists at the School, who then consulted individually with the gifted
children and their families. Second, in response to requests from around the
country, consultation services were developed for psychologists, counselors,
teachers, and other professionals both individually and through workshops
presented. Third, SENG developed and implemented a sequence of guided
discussions with parent groups—a weekly series of 10 key topics of concern
to families with gifted children. Through this experience, parents shared ideas
and learned from each other. They became better able to anticipate problems,
find solutions, and prevent difficulties from occurring. What was learned was
that parenting a gifted child requires skills for which few parents are
prepared.
By any of the measures typically used to evaluate public university
academic programs, SENG was a success. It met a real social need, it led to
the development of new knowledge and new methods of intervention, it
resulted in numerous contributions to the scientific literature, it contributed to
better professional training, and it attracted outside funding. Unfortunately, as
the program matured, its backers moved on to other things. Typical to the
modern university, an influx of new faculty and administrators brought new
priorities and new opportunities that led in other directions. SENG at Wright
State University was allowed to wither and die. Fortunately, SENG reformed
itself as an independent nonprofit organization (www.sengifted.org) and
continues to do good works through conferences, research grants, and
speaker grants, as well as through continuing education programs for
psychologists.
The greater issue, and the sad fact of the matter, however, is that the
emotional needs of the gifted and talented have never been high on the social
agenda of American education, nor have either the counseling or the health
professions made it a priority. Focus on gifted children and adults seems
somewhat elitist and undemocratic in a society in which the concerns of the
poor and the needy seem to take precedence. Giving money and support to
support programs for gifted children seems to many to be “gilding the lily”
when other needs are so numerous. This is not a new phenomenon.
In 1919, a psychologist named Leta Stetter Hollingworth founded the field
of gifted education when she began teaching the first college-level course on
the subject at Columbia University’s Teachers College. Seven years later, her
pioneering work led to the publication of the fist textbook in gifted education,
Gifted Children: Their Nature and Nurture (Hollingworth, 1926). In that
book, Hollingworth elaborated on several themes that could well have been
written by Webb and his associates almost seven decades later—public
schools were failing to serve their exceptional students, gifted children are
not necessarily all alike, asynchrony is inherent within giftedness,
environment determines future attainments of the gifted, and children of
superior intelligence may have special problems with social adjustment.
Forcing a democratic society such as ours to focus attention and energy on
the social and emotional needs of gifted children has been problematic since
the founding of this country and is likely to continue to be so into the
foreseeable future, despite the fact that such students are the “intellectual
gold” of our society. Concerned, creative, and energetic parents, teachers, and
other professionals, through strong advocacy for these children, can
sometimes reverse the tendency of society to look the other way, but it
requires constant and exhausting effort. As when pressing a finger into an
inflated ball, the ball will yield to the pressure only as long as the pressure is
maintained. When the finger is relaxed, the ball returns to its previous
position.
Without the constant pressure of groups like those represented by the
authors of this book (two of whom, Dr. Ed Amend and Dr. Paul Beljan, were
trained in the SENG program at Wright State University), the needs of this
special group will go unmet and unacknowledged, and many gifted children
and adults will be misdiagnosed as suffering from a mental disorder. The
authors and their publisher, Great Potential Press, are to be commended. The
legacy of Leta Hollingworth is preserved in their work, and American
education as well as society at large is the better for their work. Health care
professionals, as well as parents, will benefit greatly from the information in
this book, and the numbers of gifted children and adults being misdiagnosed
will decrease.
Ronald E. Fox, Psy.D., Ph.D.
Executive Director, The Consulting Group
of HRC, Chapel Hill, NC
Former President, American Psychological
Association
Preface
This book describes a modern tragedy. Many of our brightest, most
creative, most independent thinking children and adults are being incorrectly
diagnosed as having behavioral, emotional, or mental disorders. They are
then given medication and/or counseling to change their way of being so that
they will be more acceptable within the school, the family, or the
neighborhood, or so that they will be more content with themselves and their
situation. The tragedy for these mistakenly diagnosed children and adults is
that they receive needless stigmatizing labels that harm their sense of self and
result in treatment that is both unnecessary and even harmful to them, their
families, and society.
Other equally bright children and adults experience another misfortune.
Their disorders are obscured because, with their intelligence, they are able to
cover up or compensate for their problems, or people mistakenly think that
they are simply quirkily gifted.
And there is another group of intellectually gifted children and adults who
suffer from very real disorders, but neither they nor the treating professionals
are aware that their disorders are related in any way to their brightness or
creativity.
We—the six authors of this book, all of whom are practicing clinical health
care professionals—independently came to the alarming conclusion that
many very bright people are suffering needlessly because of misdiagnosis
and dual diagnoses. Each of us, during the past 20 or more years, became
aware that in our clinical practices, we were seeing patients who were
misdiagnosed by other practitioners—professionals who were well-trained
and well-respected. Sometimes the characteristics of giftedness were
misinterpreted. Other times the characteristics of gifted children and adults
obscured the clinical disorders. And in still other situations, the diagnosis was
accurate, but the giftedness component needed to be incorporated into
treatment planning.
In 2003, after talking informally at several professional meetings about
these issues, we decided—somewhat hesitatingly—to write this book. We
hesitated because we knew that our ideas were not in the mainstream of either
psychology or medicine. We knew also that our ideas would be controversial
to some. But we also believed that our information was accurate and would
be very helpful to children, parents, and professionals. We frankly hope that
our ideas will soon be more widely accepted in the health care professions.
As a reader, you need to know our credentials, and you may wish to turn to
the last pages of this book to read the “About the Authors” section. Here, we
will just point out that we include two clinical psychologists, two
neuropsychologists, one counseling psychologist, and one pediatrician. The
only way we differ from other professionals in our fields is that each of us
has an interest in developmentally advanced persons, as well as many years
of working with gifted individuals and their families. We want to share our
accumulated knowledge with others. We think that the descriptions,
conceptualizations, and case studies in this book will strike chords that
resonate with many parents and health care professionals and perhaps will
result in a paradigm shift—a new way of looking at behavioral, educational,
and health care concerns of many gifted children and adults.
This book is written for two audiences. The first group consists of health
care and counseling professionals—pediatricians, family practice specialists,
psychiatrists, psychologists, clinical social workers, nurses, nurse
practitioners, and counselors. It is also written for parents of gifted children
and for bright adults who are not health care professionals. Our experience
tells us that many parents of gifted children are searching eagerly—
sometimes desperately—for information that might help them understand
which behaviors are due to giftedness and how many of the behaviors are due
to some behavioral or medical disorder. We know that many adults are
searching for information to help them understand themselves and why they
feel so different and out of step with their world.
All of the vignettes in this book are real. They have not been modified
except for clarity and to protect identities, and we believe that they represent
an honest cross-section of experiences. Readers can find similar stories by
parents of gifted children in chat rooms on the Internet at sites like
www.hoagiesgifted.org or at http://disc.server.com/Indices/9457.html.
Finally, we want you to know that half of the royalties from this book will
go to support the ongoing efforts of a nonprofit organization called SENG
(Supporting Emotional Needs of Gifted). This organization—which arose in
1981 from the tragic suicide of a 17-year-old highly gifted youngster—has
been approved by the American Psychological Association to conduct