The Gifted Child

Pediatricians may face questions from families about a child’s exceptional abilities and the special services available for such a gifted child; familiarity with the issues can facilitate a supportive and helpful conversation.Although most commonly associated with intellectual abilities, giftedness in children may present in various ways. Child development specialists find that gifted children can manifest exceptional skills in one or more particular domains. The areas of superior ability may be academic, for example, mathematics, or may take form in other areas, such as in the arts, music, or athletics. No widespread consensus exists for a single definition of giftedness, but in addition to having advanced skills, children with giftedness also make connections easily, display curiosity or love of learning, and acquire new skills rapidly.Discerning how to measure giftedness may be even more challenging. The National Association for Gifted Children defines gifted individuals as “those who demonstrate outstanding levels of aptitude (defined as exceptional ability to reason and learn) or competence (documented performance or achievement in the top 10 percent or rarer in one or more domains).” The US Department of Education is even more vague when defining how to measure giftedness but introduces an important feature regarding sociocultural background that is worth noting. The Department of Education describes gifted children as “those with remarkably high levels of accomplishment when compared with others of their age, experience or environment…outstanding talents are present in children from all cultural groups, across all economic strata, and in all areas of human endeavor.”Identification generally occurs in the early/middle school years. Although requirements vary, schools often use standardized tests measuring academic aptitude and achievement as initial screening, sometimes defining academic giftedness as the top third percentile. However, superior IQ and achievement scores alone do not predict academic success, in part because they do not fully take into account creativity and practical intelligence, as well as the important personality characteristics contributing to giftedness. Furthermore, such methods fail to identify children who may be exceptional in only one domain. Sociocultural differences contribute significantly as well in performance on standardized testing, and some cultures may value giftedness in certain domains over others. Poverty or discrimination may limit opportunities, and thus identification of some students may be based on potential or aptitude rather than on achievement. The diversity of skills is vast among those with high ability, and using a “one size fits all” approach to label giftedness is not appropriate.Children who are gifted not only have intrinsic high ability but generally also have specific personality characteristics that are fundamental for maturation of their gift. They tend to have remarkable enthusiasm, diligence, and perseverance. They also have a deep-seated curiosity for expanding their own knowledge in the domain of special ability. In the academic arena, the gifted child is often described as having a “love for learning.” Gifted children, especially those with extremely elevated cognitive abilities, usually have good emotional adjustment, although exceptions exist. Last, but maybe most important, these children truly enjoy expressing their natural ability. Their personal gratification may very well be the driving influence for transforming an innate gift into an exceptional talent.Not uncommonly, gifted children exhibit vulnerabilities or challenging personality traits. Gifted children may struggle in finding peers with whom they can connect and may experience social isolation as a result. At times the heightened perceptions of gifted children may lead to strong emotional reactions in situations undetected by peers, such as with social injustice. Other children may be self-absorbed with pursuing their own interests rather than engaging with peers. Perfectionism is often a positive attribute, but when extreme it may pose difficulties for a child who is overwhelmingly self-critical and cannot accept failure. Perfectionism may also contribute to isolation if the child is unable to tolerate the inconsistencies of others. Gifted children may also demonstrate their creativity by engaging in nonconforming activities. At times, their independence may lead to intense defiance.Sometimes the area of exceptional talent is considerably out of sync with other areas of the child’s development, warranting a secondary diagnosis. Children who experience coexisting giftedness and neurodevelopmental or psychiatric conditions may be referred to as “twice-exceptional.” For example, a child may exhibit superior ability in mathematics but have below-average language and social skills, making it difficult to form relationships with age-matched peers. Such developmental asynchrony is not an uncommon finding in children diagnosed as having autism spectrum disorder. Other disorders that may coexist in gifted children include learning disability, attention-deficit/hyperactivity disorder, anxiety, and depression. It is imperative to identify these comorbidities because one condition can mask the other, and vice versa. Parents and teachers may, at times, have poor understanding of developmental asynchrony, which may lead to the expectation that a gifted child should be able to perform with equally high ability in all academic areas.Once a child has been deemed gifted in certain areas, whether by the school system, leaders of extracurricular activities, or parents, there are a variety of ways to provide enrichment. Providing advanced opportunities for creative learning can help gifted students remain engaged, learn new skills, and make rapid progress. In general, enrichment activities for gifted children may be classified under 3 main umbrellas: push forward, go deeper, and broaden horizons. Providing enrichment can happen while a child remains with peers of all abilities or may happen when a gifted child is grouped with students of like abilities.One way to meet the learning needs of gifted children is to push them ahead. Some parents and educators advocate that children who exhibit scholastic aptitude should skip a grade (or more) to be in classes with peers who are learning higher-level concepts. Although advancement may enable children to be in an environment where they are adequately challenged in their area of special ability and accelerate them toward graduation, it does not necessarily take into account all areas of development. Some children who are academically gifted may find the social, emotional, or behavioral environment among older children to be more of a challenge. Another consequence is that such advancement also effectively accelerates and shortens childhood.Another way to provide enrichment to children with a special aptitude is to allow them to go deeper into their area of expertise. Educators, parents, and community leaders who can teach skills to children of all abilities are able to provide educational opportunities targeted to each student’s specific needs. While a class is learning about a certain topic in mathematics, history, music, etc, a child with particular skill and interest can be encouraged to research the topic further, to work through harder problems, or to gain more experience. This strategy can help stimulate significant learning while keeping a child engaged.Children who learn with eagerness and curiosity are prime candidates for further opportunities. When certain subject areas come more easily to some students, it may be an opportunity to also expand their horizons in other directions as well. For example, a child who has mastered the reading or mathematical concepts for her/his grade level may be allowed to take up studies in logic, learn a new language, explore music or art history, or begin studying geography.Pediatricians are often first in line to answer parents’ questions about providing appropriate academic or extracurricular opportunities for a child with particular learning abilities. It may be helpful to begin by talking with parents about their educational options for the child. Pediatricians can then help families advocate for their child’s unique learning needs, while at the same time providing perspective on preventing overscheduling the child; allowing time for the typical daily activities of childhood, such as chores and recreation; and perhaps offering opportunities for the child to become a volunteer and learn to care for others.COMMENTS: When last we published an In Brief on the gifted child in 2010, I commented on how the educational system in the United States, similar to our health-care system, lags well behind those of other highly developed countries in measures of quality, despite our preeminent wealth. Unfortunately, we have not made progress over the past decade, according to the Organization for Economic Cooperation and Development, doing no better than the average for all 72 countries evaluated in reading and science and below average in mathematics. Our neighbors to the north, Canada, ranked in the top 5 overall, along with Singapore, Finland, Japan, and Estonia. Of particular note, at one end of the spectrum we ranked 28th in the percentage of 4-year-olds receiving early childhood education, and at the other end only 14th in the percentage of young adults with higher education. And the chance that an American child will go on to higher education if her/his parents did not graduate from high school puts us in the group at the bottom of the list. Interestingly, one area in which we did excel is that immigrant students in the United States do substantially better than the Organization for Economic Cooperation and Development average.Henry M. Adam, MDAssociate Editor, In Brief

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