MisDiagnosis of Children

Many gifted and talented children (and adults) are being mis-diagnosed by psychologists, psychiatrists, pediatricians, and other health care professionals.

The most common mis-diagnoses are: Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (OD), Obsessive Compulsive Disorder (OCD), and Mood Disorders such as Cyclothymic Disorder, Dysthyinic Disorder, Depression, and Bi-Polar Disorder.

These common mis-diagnoses stem from an ignorance among professionals about specific social and emotional characteristics of gifted children which are then mistakenly assumed by these professionals to be signs of pathology.

In some situations where gifted children have received a correct diagnosis, giftedness is still a factor that must be considered in treatment, and should really generate a dual diagnosis.

For example, existential depression or learning disability, when present in gifted children or adults, requires a different approach because new dimensions are added by the giftedness component.

Yet the giftedness component typically is overlooked due to the lack of training and understanding by health care professionals (Webb & Kleme, 1993).

Despite prevalent myths to the contrary, gifted children and adults are at particular psychological risk due to both internal characteristics and situational factors.

These internal and situational factors can lead to interpersonal and psychological difficulties for gifted children, and subsequently to mis-diagnoses and inadequate treatment.

Internal Factors

First, let me mention the internal aspects (Webb, 1993). Historically, nearly all of the research on gifted individuals has focused on the intellectual aspects, particularly in an academic sense. Until recently, little attention has been given to personality factors which accompany high intellect and creativity.

Even less attention has been given to the observation that these personality factors intensify and have greater life effects when intelligence level increases beyond JQ 130 (Silverman, 1993; Webb, 1993; Winner, 2000).

Perhaps the most universal, yet most often overlooked, characteristic of gifted children and adults is their intensity (Silverman, 1993; Webb, 1993). One mother described it succinctly when she said, “My child’s life motto is that anything worth doing is worth doing to excess.”

Gifted children — and gifted adults– often are extremely intense, whether in their emotional response, intellectual pursuits, sibling rivalry, or power struggles with an authority figure.

MisDiagnosis of Gifted Children

Impatience is also frequently present, both with oneself and with others. The intensity also often manifests itself in heightened motor activity and physical restlessness.

Along with intensity, one typically finds in gifted individuals an extreme sensitivity to emotions, sounds, touch, taste, etc. These children may burst into tears while watching a sad event on the evening news, keenly hear fluorescent lights, react strongly to smells, insist on having the tags removed from their shirts, must touch everything, or are overly reactive to touch in a tactile-defensive manner.

The gifted individual’s drive to understand, to question, and to search for consistency is likewise intense, as is the inherent ability to see possibilities and alternatives.

All of these characteristics together result in an intense idealism and concern with social and moral issues, which can create anxiety, depression, and a sharp challenging of others who do not share their concerns.

Situational Factors

Situational factors are highly relevant to the problem of mis-diagnosis (Webb, 1993). Intensity, sensitivity, idealism, impatience, questioning the status quo–none of these alone necessarily constitutes a problem.

In fact, we generally value these characteristics and behaviors–unless they happen 10 occur in a tightly structured classroom, or in a highly organized business setting, or if they happen to challenge some cherished tradition, and gifted children are the very ones who challenge traditions or the status quo.

There is a substantial amount of research to indicate that gifted children spend at least one-fourth to one-half of the regular classroom time waiting for others to catch up. Boredom is rampant because of the age tracking in our public schools.

Peer relations for gifted children are often difficult (Webb, Meckstroth and Tolan, 1982; Winner, 2000), all the more so because of the internal dyssynchrony (asynchronous development) shown by so many gifted children where their development is uneven across various academic, social, and developmental areas, and where their judgment often lags behind their intellect.

Clearly, there are possible (or even likely) problems that are associated with the characteristic strengths of gifted children.

Lack of understanding by parents, educators, and health professionals, combined with the problem situations (e.g., lack of appropriately differentiated education) leads to interpersonal problems which are then mis-labeled, and thus prompt the mis-diagnoses. The most common mis-diagnoses are as follows.

Common Mis-Diagnoses

ADHD and Gifted. Many gifted children are being mis-diagnosed as Attention Deficit Hyperactivity Disorder (ADHD). The gifted child’s characteristics of intensity, sensitivity, impatience, and high motor activity can easily be mistaken for ADHD.

Some gifted children surely do suffer from ADHD, and thus have a dual diagnosis of gifted and ADHD; but in my opinion, most are not. Few health care professionals give sufficient attention to the words about ADHD in DSM-IV( 1994) that say “…inconsistent with developmental level….”

The gifted child’s developmental level is different (asynchronous) when compared to other children, and health care professionals need to ask whether the child’s inattentiveness or impulsivity behaviors occur only in some situations but not in others (e.g., at school but not at home; at church, but not at scouts, etc.).

If the problem behaviors are situational only, the child is likely not suffering from ADHD.

To further complicate matters, my own clinical observation suggests that about three percent of highly gifted children suffer from a functional borderline hypoglycemic condition.

Silverman (1993) has suggested that perhaps the same percentage also suffer from allergies of various kinds. Physical reactions in these conditions, when combined with the intensity and sensitivity, result in behaviors that can mimic ADHD.

However, the ADHD-like symptoms in such cases will vary with the time of day, length of time since last meal, type of foods eaten, or exposure to other environmental agents.

Oppositional Defiant Disorder and Gifted. The intensity, sensitivity, and idealism of gifted children often lead others to view them as “strong-willed.”

Power struggles with parents and teachers are common, particularly when these children receive criticism, as they often do, for some of the very characteristics that make them gifted (e.g., why are you so sensitive, always questioning me, trying to do things a different way, etc.).

Bi-Polar and other Mood Disorders and Gifted. Recently, I encountered a parent whose highly gifted child had been diagnosed with Bi-Polar Disorder. This intense child, whose parents were going through a bitter divorce, did indeed show extreme mood swings, but, in my view, the diagnosis of Bi-Polar Disorder was off the mark.

In adolescence, or sometimes earlier, gifted children often do go through periods of depression related to their disappointed idealism, and their feelings of aloneness and alienation culminate in an existential depression. However, it is not at all clear that this kind of depression warrants such a major diagnosis.

Obsessive-Compulsive Disorder and Gifted. Even as preschoolers, gifted children love to organize people and things into complex frameworks, and get quite upset when others don’t follow their rules or don’t understand their schema.

Many gifted first graders are seen as perfectionist and “bossy” because they try to organize the other children, and sometimes even try to organize their family or the teacher. As they grow up, they continue to search intensely for the “rules of life” and for consistency.

Their intellectualizing, sense of urgency, perfectionism, idealism, and intolerance for mistakes may be misunderstood to be signs of Obsessive-Compulsive Disorder or Obsessive-Compulsive Personality Disorder.

In some sense, however, giftedness is a dual diagnosis with Obsessive-Compulsive Personality Disorder since intellectualization may be assumed to underlie many of the DSM-IV diagnostic criteria for this disorder.

Dual Diagnoses

Learning Disabilities and Giftedness. Giftedness is a coexisting factor, to be sure, in some diagnoses. One notable example is in diagnosis and treatment of learning disabilities.

Few psychologists are aware that inter-subscale scatter on the Wechsler intelligence tests increases as a child’s overall IQ score exceeds 130. In children with a Full Scale IQ score or greater, it is not uncommon to find a difference of 20 or more points between Verbal IQ Performance IQ (Silverman, 1993; Webb & Kleme, 1993; Winner, 2000).

Most clinical psychologists are taught that such a discrepancy is serious cause for concern regarding possible serious brain dysfunction, including learning disabilities.

For highly gifted children, such discrepancy is far less likely to be an indication of pathological brain dysfunction, though it certainly would suggest an unusual learning style and perhaps a relative learning disability.

Similarly, the difference between the highest and lowest scores on individual subscales within intelligence and achievement tests is often quite notable in gifted children.

On the Wechsler Intelligence Scale for Children -III, it is not uncommon to find subscale differences greater than seven scale score points for gifted children, particularly those who are highly gifted.

These score discrepancies are taken by most psychologists to indicate learning disabilities, and in a functional sense they do represent that.

That is, the levels of ability do vary dramatically, though the range may be “only” from Very Superior to Average level of functioning. In this sense, gifted children may not “qualify” for a diagnosis of learning disability, and indeed some schools seem to have a policy of “only one label allowed per student,” and since this student is gifted, he/she can not also be considered learning disabled.

However, it is important for psychologists to understand the concept of “asynchronous development” (Silverman, 1993), and to appreciate that most gifted children show such an appreciable, and often significant, scatter of abilities.

Poor handwriting is often used as one indicator of learning disabilities. However, many and perhaps most gifted children will show poor handwriting.

Usually this simply represents that their thoughts go so much faster than their hands can move, and that they see little sense in making writing an art form when its primary purpose is to communicate (Webb & Kleme, 1993; Winner, 2000).

Psychologists must understand that, without intervention, self-esteem issues are almost a guarantee in gifted children with learning disabilities as well as those who simply have notable asynchronous development since they tend to evaluate themselves based more on what they cannot do rather than on what they are able to do.

Sharing formal ability and achievement test results with gifted children about their particular abilities, combined with reassurance, can often help them develop a more appropriate sense of self-evaluation.

Sleep Disorders and Giftedness. Nightmare Disorder, Sleep Terror Disorder, and Sleepwalking Disorder appear to be more prevalent among gifted children, particularly boys.

It is unclear whether this should be considered a mis-diagnosis or a dual diagnosis. Certainly, parents commonly report that their gifted children have dreams that are more vivid, intense, and more often in color, and that a substantial proportion of gifted boys are more prone to sleepwalking and bed wetting, apparently related to their dreams and to being more soundly (i.e., intensely) asleep.

Such concordance would suggest that giftedness may need to be considered as a dual diagnosis in these cases, or at least a factor worthy of consideration since the child’s intellect and sense of understanding often can be used to help the child cope with nightmares.

A little known observation concerning sleep in gifted individuals is that about twenty percent of gifted children seem to need significantly less sleep than other children, while another twenty percent appear to need significantly more sleep than other children.

Parents report that these sleep patterns show themselves very early in the child’s life, and long-term follow up suggests that the pattern continues into adulthood (Webb & Kleme, 1993; Winner, 2000). Some highly gifted adults appear to average comfortably as few as two or three hours sleep each night, and they have indicated to me that even in childhood they needed only four or five hours sleep.

Multiple Personality Disorders and Giftedness. Though there is little formal study of giftedness factors within MPD, there is anecdotal evidence that the two are related.

The conclusion of professionals at the Meiminger Foundation was that most MPD patients showed a history of childhood abuse, but also high intellectual abilities which allowed them to create and maintain their elaborate separate personalities (W. H. Smith personal communication, April 18, 1996).

Relational Problems and Giftedness. As one mother told me, “Having a gifted child in the family did not change our family’s lifestyle; it simply destroyed it!”

These children can be both exhilarating and exhausting. But because parents often lack information about characteristics of gifted children, the relationship between parent and child can suffer. The child’s behaviors are seen as mischievous, impertinent, weird, or strong-willed, and the child often is criticized or punished for behaviors that really represent curiosity, intensity, sensitivity, or the lag of judgment behind intellect.

Thus, intense power struggles, arguments, temper tantrums, sibling rivalry, withdrawal, underachievement, and open flaunting of family and societal traditions may occur within the family.

“Impaired communication” and “inadequate discipline” are specifically listed in the DSM4V (1994) as areas of concern to be considered in a diagnosis of Parent-Child Relational Problems, and a diagnosis of Sibling Relational Problem is associated with significant impairment of functioning within the family or in one or more siblings.

Not surprisingly, these are frequent concerns for parents of gifted children due to the intensity, impatience, asynchronous development, and lag of judgment behind intellect of gifted children.

Health care professionals could benefit from increased knowledge concerning the effects of a gifted child’s behaviors within a family, and thus often avoid mistaken notions about the causes of the problems.

The characteristics inherent within gifted children have implications for diagnosis and treatment which could include therapy for the whole family, not in the sense of develop coping mechanisms for dealing with the intensity, sensitivity, and herwise may cause them problems later (Jacobsen, 1999).


Some of our most brightest and most creative minds are not only going unrecognized, but they are being given diagnoses that indicate pathology. For decades, psychologists and others have given great emphasis to the functioning of persons in the lower spectrum.

It is time that we trained health care professionals to give correct assessments to gifted, talented, and creative children and adults. At the very least, we must help professionals gain sufficient understanding so that they no longer misinterpret characteristics of giftedness.


Article By James T. Webb, Ph.D.



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12 thoughts on “MisDiagnosis of Children

    • Although it says Indigo Children were “discovered” or born after 1978 (that’s what I had read somewhere), I don’t believe it matters your age. I’m physically only 16, yet I believe if this is something that interests you a great deal, or you simply feel a calling towards the whole idea of being an Indigo, then perhaps you are indeed an Indigo. Only you can know for sure. I wish you the best of luck on your journey! (:

      • I was born Easter Sunday March in 1978. When I was 11 it was that same holiday again. One would think that every 22 OOPS, 11 years rather, point is; there isn’t one. Except that I thought Easter Sunday would come round’ again when I turned 22. Alas, it did not. And guess what? That’s okay. I’m more of a Buddhist anyway. Giggles. 😉

    • Hello Karen, 2 years after your comment, I have come across it. I am now the same age (54). Just the other day I had an angel reading done and was told I was an Indigo. I had heard about this, however, only now did I check it out. It definitely resonates with me! I had a head injury in 2006 which caused my executive functions to be slightly impaired, which I noticed in myself after returning to work several months later. About a year later, on the advice of a friend I had myself checked for ADHD, and was subsequently tested and this diagnosis was confirmed. In some ways, it explained a lot to me. In light of my injury I insisted on some special testing (about 4 or 5 hours of what seemed to be intelligence testing), and found out that many of my scores were in the 90th and sometimes in the 99th percentile. The working memory portion however was low, and in one specific area as low as the 8th percentile!!! I was considered to be a high functioning ADHD type, since obviously the high scores compensated in a dramatic way, to the extent that it was only much later in life that I was typed. I read the information on this site with great interest and feel that I can use other more holistic ways to conduct my life and mitigate the aspects that are more challenging for me. Perhaps some of this resonates with you, if you happen to come across my reply. Best, C

    • I’ve just recently heard and read abt indigo and star children, I’m 21 years old as of today and I relate to almost all characteristics of indigo children/adults….I’ve been diagnosed with BPD, OCD, ODD, MDD, and bipolar a few years ago… really need some help in understanding of all this and knowing if I’ve found my purpose of being or if I’m just going crazy and over thinking again….thanks in advance:)

  1. I am 18 years of age… and I have always felt misunderstood… the whole description, especially in the part where it talks about diagnosis of depression. Is pretty close to what happened to me during my entire childhood. My family has fallen apart over the years. and I no longer live with them, and am struggling to keep my head above water… sometimes i wonder where I’m gonna sleep at night. I have always been creative.. At the same time.. I’ve always questioned things… things that to me. Seem so easy to question.. Things pop out at me about the world that we live in.. that people laugh at me and call me a conspiracy theorist for even talking about.. even when just stating a question. These things apparently don’t pop out to anyone else but me. And I’m struggling in life. I have a love for music.. and I’m in a band. we are writing original music.. and getting good reviews… I’ve never felt so accepted in my life. It was just about finding that outlet,,, the only struggle I’ve had is keeping a job… and I was unable to finish high school, because what was left of my family moved away from me when I turned 18 so I could fend for myself. I need to know.. how do I do it.. I see little possibility of me even getting on my feet at this point. that in itself scares me immensely.

  2. we never feel that we fit in, as versatile as we are, its seems that to be smarter or excel in any way whether it be physical characteristics or having knowledge that others don’t. for some reason, viewed as a freak or being evil, because witches have these traits, or we are aliens. I often show up in pics with orbs, or I appear semi transparent. but I am all good, mother nature is my closest friend and confidant. cant use anything electrical. yes and turning street lamps off or on. all my life. I know what everyone is thinking or feeling in a room. if someone hurts themselves, I feel it and say ow. I also count every stair and or step I take. oh and lightening, definitely attract lightening

  3. Hello my name is Alexandra Miha and i am 12 years old.
    I am an indigo a gifted one i have the ability to see the future
    It was nice meeting you goodbye

  4. My name is Scott.. I was diagnosed with BPD, ODD, ADHD and Bipolar 2. I currently take seroquel for my issues but I’m starting to think my meds are a bad idea. Ive been taking medication my whole life Seroquel, depakote, lexapro, You know all the shit they want to make you take. My parents tried to get rid of me as soon as I was 18 because i was in and out of hospitals and juvenile delinquent programs. I think I’m an indigo because I have all the traits except lights going out all the time and watches stopping. I feel deeply alone even though I’m married with 2 children. I feel like I’m here to stop something from happening but I dont know what that is. I feel out of touch with the reality that everyone seems to see. I hate the government, religion, and I was kicked out of the military for inability to adapt and extreme depression from child abuse and my tour in Iraq ( which I’m never talking about with just anyone). My wife accepts me the way I am.. but I wish I could be normal for her and stop with my predictions and conspiracys. I feel like I’m a target and a threat to people in leadership of this country. I feel like certain animals were created by the government to watch me and what i’m doing. Anyhow..Ive always had a special relationship with animals and precious stones. I used to hide rocks and crystals under my bed at night because they were my friends. I was an outcast as a kid needless to say. I was bullied alot and became very defensive and paranoid of people hurting me. after getting beat up for so long you start to hate the world and your parents for not being there when you need them the most. I resented my dad for years and was scared of him because he told me if I ever get bullied again he was going to beat my ass. Sorry for dragging on.. this is how I express myself. Sometimes I wonder if i’m indigo or just a victim of abuse and didnt conform to schooling and discipline because the adults in my life failed me. I honestly don’t even know how to be a man for my son because I’m so emotional. If you read this.. and you think you can help me bring out my supposed inner indigo or help me to be the best person I can be. Or if you have a similar upbringing and believe your alone too… my email is gsb8.mwh@gmail.com. I just want to find peace and figure out if I’m indigo or just crazy from my fucked up childhood.

  5. Psychology is a fraud the DSM is a fabrication

    I myself was diagnosed with aspergers for studying geography OCD odd bipolar and depressed for enforcing human rights humanitarian criminal refugee law

    homosexuality was once a mental disorder

    the DSM is voted by psychologists in their annual APA meetings in San Francisco

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