ADHD or giftedness: what each one describes

No, and that is the first thing to settle. On one side you describe attentional functioning: difficulties with attention, organisation or regulation, present for a long time, across several settings, with a measurable impact on daily life. On the other you describe a level of performance on a standardised test, administered individually by a professional and compared with a reference group. A way of functioning and a level are no more comparable than a colour and a temperature.

Giftedness carries an extra difficulty: the notion has no single definition. Carman's analysis, published in 2013 in the Journal of Advanced Academics, reviewed 104 empirical articles across 38 journals that distinguished gifted from non-gifted participants. It reports a lack of consensus about what qualifies someone for that group, and draws the direct consequence: results across those studies are hard to compare with one another.

One practical consequence follows. When two people discuss giftedness, they are not necessarily discussing the same thing: one has a test score in mind, another a way of thinking, a third a school record. ADHD refers to a written set of criteria, which does not make it easier to establish, but does at least make the conversation possible.

The systematic review by Rommelse and colleagues, published in 2016 in Neuroscience & Biobehavioral Reviews, names both mechanisms, running in opposite directions. High intelligence can mimic the symptoms of ADHD in the absence of the pathways specific to the disorder. Conversely, the risk that ADHD goes unrecognised increases in highly intelligent people, because of the compensatory strategies they put in place.

The error is therefore possible in both directions, and adding questions to a questionnaire does not fix it. That review also concludes that, on the criteria examined, ADHD remains a valid construct in the context of high intelligence: features, course and treatment response are comparable, with the possible exception of hyperactivity, which is a less specific marker in this group.

Mullet and Rinn, in a synthesis published in 2015 in Roeper Review, recall that many characteristics attributed to giftedness overlap with ADHD symptoms, and that two symmetrical risks coexist: taking one for the other, and seeing only one when both are present. A decade of work on the subject has not made the second one go away.

• Both descriptions circulate mainly as lists of traits, and a list of traits says nothing about how far back the difficulties go or what they cost.
• Both are often discovered in adulthood, at the same point in life, when external supports fall away.
• Giftedness has no single definition, which leaves everyone free to recognise in it whatever they observe.
• Only one of the two is measured with an instrument administered by a professional, and that difference in method rarely makes it into general-audience content.

This is the most widespread explanation: if a child drifts off in class, it is because they are bored. It is sometimes right, but it does not match what population data show. The study by Rommelse and colleagues published in 2017 in The British Journal of Psychiatry analysed the relationship between IQ score and attention problems in 2,221 children and adolescents aged 10 to 12, using parent, teacher and self-reports.

The result runs against the received idea: a higher score was most strongly associated with fewer attention problems. The authors conclude that attention problems in highly intelligent children are exceptional, that they affect school performance, and that they are on those grounds a reason for concern rather than an expected consequence of the level.

In practice, then, the distinction does not turn on how strong the distraction feels but on its scope. Boredom tied to a task lifts when the task changes. An attention difficulty also turns up elsewhere, including in chosen activities, and leaves measurable traces: lateness, forgotten things, work redone. Those things get written down, they are not guessed at.

• How far back: did the same difficulties exist in primary school, including the years when you liked the subject?
• In which settings: does it lift as soon as the subject is chosen, or does it also come back in activities you enjoy?
• About what: is it attention alone, or also organisation, forgetting and inner restlessness?
• At what price: how much time and energy do the strategies cost that keep it from showing?

Start by dropping the or. The study by Antshel and colleagues, published in 2007 in the Journal of Child Psychology and Psychiatry, compared 92 children with a high IQ and no ADHD with 49 children with a high IQ who met the criteria for ADHD, all from the Massachusetts General Hospital longitudinal family studies. A high IQ was defined there as a full scale score of 120 or above.

Compared with the others, children in the second group more often had a family history, repeated grades more often, performed less well on a visual reasoning task, and showed a greater impact across several domains. The authors conclude that the picture observed is consistent with the one described in children of average IQ. The two configurations therefore coexist, and the or wastes everyone's time.

1. Write down five precise, dated situations where the difficulty showed, with the year and the setting. A dated example is worth more than an adjective, and it is the first thing a professional will ask for.
2. For each one, note what you put in place to keep it from showing, and what that cost you in time. That column is the one most often missing.
3. Check whether the same situations existed in primary school, including the interesting years.
4. Talk to your family doctor and bring those notes. They are the ones who refer you to the right professional, and waiting times are often long.
5. If the question of intellectual performance matters to you in its own right, know that it is a separate act: a standardised test, administered individually by a psychologist. No questionnaire filled in alone, whatever it is, replaces that.

The adult ADHD self-observation questionnaire published here can help put words to what you observe before you raise it. It is reachable from the block at the end of this page. It can neither confirm nor rule out a disorder, and it says nothing about intellectual performance.