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 Children who are
classified as gifted are, by definition, highly intelligent individuals
who fall at the upper end of the distribution of mental ability. Yet
giftedness is not a guarantee of academic success. Consider that The
National Commission on Excellence in Education (1983) reported that
one half of gifted students do not achieve academically at a level that
is commensurate with their ability. Surprisingly, between ten and twenty
percent of high school dropouts test within the gifted range (Lajoie and
Shore, 1981; Whitmore, 1980). Perhaps the most startling statistic in
this regard is that 40 percent of those who graduate within the top 5% of
their high school classes do not complete college. A number of famous
historical figures who were clearly very intelligent (and who probably
who have qualified as gifted) struggled considerably in school; these
individuals later became highly successful in fields ranging from
politics (Woodrow Wilson and Nelson Rockefeller) to science (Albert
Einstein and Thomas Edison) to the arts (Auguste Rodin and Cher). There
are many possible reasons for this lack of academic success among some of
the gifted population. Environmental factors (both within the school and
at home), emotional and affective issues, motivational difficulties, and
other factors all can contribute to a lack of academic success in
students who would, by virtue of their high level of mental ability, be
expected to be high achievers. Another important factor that can result
in underachievement academically, and the one that I will be discussing
in this article, is the presence of learning disabilities. It comes as a
surprise to many people to hear that learning
disabilities are as prevalent in the gifted population as in the general
population, yet there is nothing in the definition of learning
disabilities (or in their diagnosis) to preclude the gifted from this
category. Rather, this misconception that gifted children cannot have
learning disabilities is, I believe, rooted in the erroneous belief that
learning disabilities are in some way restricted to those children who
are less bright than average. In fact (as I will expand upon later),
children with learning disabilities are by definition of at least average
mental ability. Their problem is one of lowered achievement, not lowered
ability. In this article I will discuss various definitions of learning
disabilities, the diagnostic process, various manifestations of learning
disabilities across the school-age range, and appropriate interventions
for children with learning disabilities. I will also briefly discuss
Attention-Deficit Hyperactivity Disorder (ADHD) which, while not a
learning disability, often co-occurs with learning disabilities and also
frequently manifests itself in ways that are quite similar to learning
disabilities. While some of what I will say is characteristic of all
children with learning disabilities, I will also attempt to highlight
some issues that are particularly relevant to children within the gifted
population who have learning disabilities.
The Definition of Learning Disabilities: The term learning disabilities was first coined in 1963 by
Samuel Kirk, but many other terms were used prior to this time to
describe children with learning problems that are now termed learning
disabilities. Formulating a single definition of learning disabilities
that is acceptable to all professionals in the field has proven
difficult. As a result, several definitions are commonly utilized; these
differ to some degree but generally have the same essential
characteristics. The most commonly used definition first appeared in
Public Law 94-142, the Education for All Handicapped Children Act
(Federal Register, 1977). It was also a part of Public Law 101-476, the
1990 Individuals with Disabilities Education Act (IDEA) and is also a
component of the 1997 Amendments to IDEA, Public Law 105-17. It reads as
follows: The term "specific learning disability" means those
children who have a disorder in one or more of the basic psychological
processes involved in understanding or using language, spoken or written,
which disorder may manifest itself in imperfect ability to listen, think,
speak, read, write, spell or perform mathematical computations. The term
includes such conditions as perceptual handicaps, brain injury, minimal
brain dysfunction, dyslexia and developmental aphasia. The term does not
include a learning problem which is primarily the result of visual,
hearing, or motor handicaps, of mental retardation, of emotional
disturbance, or environmental, cultural, or economic disadvantage (PL
105-17: Federal Register, 1997). This definition of learning disabilities
(and associated features of the Federal law that contains it) is important
for several reasons. First, it was designed to provide an operational
definition of learning disabilities that can be used by professionals to
diagnose learning disabilities in a consistent, reliable manner. Second,
other aspects of the law provided legal safeguards to assure that
children with learning disabilities were provided with appropriate
accommodations to remediate their disabilities. Third, it provided a
system of checks and balances under which parents of children with
learning disabilities could appeal any decisions made about the services
that their children would (or would not) receive. I will not go into a
detailed discussion of all aspects of Federal Law as it relates to
children with learning disabilities, but I do want to elaborate upon the
basic components of the definition provided above. There are multiple
dimensions to the definition, each of which must be considered in
determining whether a child should be diagnosed with learning
disabilities. The following major concepts are essential parts of IDEA
1997: --The child must have a disorder in one or more of the basic
psychological processes. These processes refer to cognitive abilities,
among them memory (auditory and visual), perception (auditory and
visual), intersensory integration (for example visual-auditory
intersensory integration, the ability to associate a letter or letters
with its appropriate sound (s)), attention, and motor skills, among many
others. --The child must have difficulty in learning, manifesting itself
in oral language (receptive or expressive), reading, writing, and/or
mathematics. That is, their achievement is less than would be expected
given their ability. --The learning problem is not attributable to being
primarily due to other causes such as visual or auditory impairment,
severe motor handicaps, low mental ability, emotional disturbance, or
disadvantage due to economic situation, environment, or culture. In other
words, there is no other logical explanation for the child's learning
difficulties. --A significant discrepancy exists between the child's
potential for learning (ability) and his or her actual achievement. That
is, underachievement is evident. Be aware that different states and
individual school districts differ in the size of the discrepancy that is
needed for "significance". Also there are different methods for
calculating a discrepancy that go beyond the scope of this article. Note
that this definition excludes from the diagnosis of learning disabled
many children who are not achieving at a level that is commensurate with
their ability: those who possess low levels of mental ability and who
would therefore not be expected to achieve at age- or grade-appropriate
levels; those who have other problems that are adversely impacting
learning (e.g., vision impairment, depression or anxiety, cerebral palsy,
and those who have not had an adequate opportunity to learn, among
others); and those whose discrepancy between ability and achievement is
not large enough to be considered significant in the clinical sense.
Also, there must be some explanation as to why the child is
underachieving; this is obtained by establishing a connection between the
area of underachievement (e.g., mathematics) and a psychological process
known to underlie mathematical competency (e.g., auditory memory). This
definition, or one quite similar to it, is used by the vast majority of
school systems in the United States to qualify children for learning
disability services. Consider this example of the implications of the
diagnosis for gifted children. A boy, Lucas, with an intelligence
quotient (IQ) of 140 (at the 99th percentile for his age) would be
expected to achieve at a level that is commensurate with that ability
(i.e., that is, at or near the 99th percentile). Let's say that Lucas is
not achieving at this level in an area (reading). For the sake of this
example, assume that Lucas' achievement on several reading decoding (word
recognition) measures places him in the middle of the average range
(i.e., a standard score of 100, corresponding to the 50th percentile).
Despite the fact that Lucas is decoding at a grade appropriate level, by
virtually any definition of a learning disability he is underachieving
due to the significant mismatch between his ability and his achievement
in reading. This points out an essential (and to many people, very
confusing) feature of learning disabilities: among bright children,
achievement at a level that is below grade level is not required for a
diagnosis of learning disabilities to apply. In fact, if we were to
change Lucas' decoding standard score to 110 (corresponding to the 75th
percentile), he would still qualify for the diagnosis even though his
decoding skills are above those of 75 per cent of his same-grade peers.
This type of scenario occurs very often with gifted underachievers, and
confusion about it almost certainly results in them often not receiving
the diagnosis and associated appropriate services to which they are
legally entitled. Thus, it is often the case that parents need to
aggressively pursue testing for the gifted child, since teachers and
school administrators frequently may believe that there is no need for an
evaluation to be conducted (because the child is performing at grade
level). In extreme cases, it may be necessary to seek the assistance of a
special education advocate or attorney in order to convince a school
district of the need for beginning the diagnostic process. Because
evidence indicates that early intervention results in the best long-term
prognosis, it is important to attempt to determine whether services are
warranted when the child is as young as possible.
The Evaluation Process: Once a child is determined to qualify for testing, the
evaluation process can begin. It is often a time consuming and labor
intensive process. If the evaluation is being conducted by the child's
school, often the first step in the process is a screening-- the
administration of a battery of tests that determine whether there appears
to be a need for a more complete diagnostic evaluation to be conducted.
Typically a screening requires no more than three to four hours of total
testing time, and provides an estimate of the child's ability along with
measures of the child's achievement in the relevant areas. If the
decision to continue with a complete diagnostic evaluation is made, and
additional five or more hours of testing will generally be conducted.
These tests typically will provide a more precise measure of the child's
ability, more achievement measures, and a much more detailed look at the processes
underlying learning. Observations of the child's behavior during testing,
an examination of his or her use of strategies in problem solving
situations, and the child's attentional capacity are also important
components of the diagnostic process. Furthermore, one or both parents
will typically be interviewed to provide a detailed birth, medical,
developmental, social, and academic history of the child. An interview
with the child's classroom teacher and observation of the child in the
classroom environment may also be included in the assessment process. The
evaluation process can often take weeks or even months to complete when
conducted within the school setting. Frequently a child will be tested
only for brief periods at a time (e.g., a class period), meaning that a
large number of testing sessions are needed to complete the process. Despite
the fact that Federal law guarantees each child the right to a timely
evaluation to determine whether there is a need for services, it is often
the case (especially with gifted children, since their difficulties may
be masked by their brightness) that school personnel are reluctant to
initiate the process. In this event, parents may need to step in and
advocate as strongly as they can for an evaluation. A reminder to a
school psychologist that Federal law is on the child's side in these
matters may be necessary in order to get the assessment process started.
Still, it may be the case that the district does not agree to conduct an
evaluation; in this case, a parent's only remaining option may be to seek
a private evaluation (at the parent's expense). Private evaluations are
essentially the same as those conducted within the school setting, except
that they can usually be completed in a more timely manner due to fewer
scheduling issues. A number of different types of professionals conduct
learning disabilities evaluations, including learning disabilities
specialists, school psychologists, and clinical psychologists. These
individuals may work in private practice, or in a university or hospital
clinic setting. Be advised that because of the time-intensive nature,
private evaluations are expensive; in the Chicago area, for example, the
cost ranges from about $1000 to well over $2000 Insurance may pay for all
or part of the cost of an evaluation; it is best to check with the
company before beginning the process because different insurers have
varying requirements for co-payment.
Types of Learning Disabilities: Learning disabilities affect anywhere from four to seven
percent of school-age children (in 1995-1996, 5.5% of school children in
the United States received learning disabilities services (U.S.
Department of Education, 1998) and can manifest themselves in many
different ways. Moreover, the ways in which a learning disability affects
a child often change as the child progresses through school. This is in
part due to the maturing child changing in the ways they process
information and in part due to the changing demands of the school
curriculum. The most common type of learning disability results in
underachievement in reading (typically decoding), which also frequently
results in written language difficulties (especially in spelling). Other
children experience significant underachievement only in areas requiring
mathematical calculation. Still others experience a combination of
reading, writing, and mathematics difficulties. For some children,
difficulties in oral language (receptive and or expressive) underlie
their learning disability, while some children have intact oral language
skills. A relatively new category of learning disability, nonverbal
learning disabilities, is being increasingly diagnosed. Children with
nonverbal learning disabilities experience difficulties in areas such as
motor skills, visual-spatial orientation, social relationships,
organization, and aspects of mathematics, while they are often quite
strong in areas requiring verbal abilities. Gifted children with learning
disabilities often experience difficulties that are qualitatively
different than those experienced by their non-gifted learning disabled
peers. By virtue of their high level of mental ability, they are often
able to perform surprisingly well on tasks that allow them to utilize
this strength. For example, a gifted child who is experiencing
significant difficulties in decoding while reading may actually be
capable of comprehending what is read deceptively well, since he or she
is able to utilize strong conceptualization and reasoning skills and a
rich fund of general knowledge to make sense out of the material. Unless
this child is asked to read aloud, it might not even be apparent that
there is a problem in the area of decoding. As another example, a gifted
child with significant difficulties in arithmetic computation might
possess good underlying mathematical concepts (e.g., a solid
understanding of place value) and might also be able to apply this
conceptual understanding to a variety of "everyday"
mathematical activities such as time and money concepts, reading charts,
tables and figures, and utilizing good estimation skills. Given that
there is a large emphasis on computational skills (especially in the
early grades), these areas of strength may go largely unrecognized. Often
a learning disability is not "pure", in the sense that it can
be neatly categorized as belonging to a particular category or subtype.
Rather, frequently the manifestations of a child's learning disability
include those typically seen in two or more subtypes. For example, many
children experience underachievement in reading, written language, and
mathematics. Furthermore, in a number of cases, children with learning
disabilities also meet the criteria for additional, co-morbid,
conditions. For example, affective difficulties (e.g., depression),
anxiety, and attention-deficit hyperactivity disorder, among others, are
commonly diagnosed in children with learning disabilities.
What Are Appropriate Services, and What Can
Parents Do to Assure that Their Children Receive Them: There are many potential services that can be provided for
children with learning disabilities. For most children with a diagnosis
of learning disabilities, in-school services are provided one or more
times per week. These services may be offered in a one-on- one manner in
the child's classroom or in a resource room, or they may be administered
in a small group setting. Typically in a small group setting the children
are matched as closely as possible in terms of grade level and the nature
of the disability. In more serious cases, the child may be placed in a
self-contained classroom with other children who are all experiencing
some type of learning or behavior problem. These self-contained special
education classrooms are generally becoming less common as school
districts increasingly attempt to provide services in the regular
classroom (a process known as 'inclusion' or 'mainstreaming'). Some
children also receive remedial services from trained learning
disabilities professionals during after-school hours. In some instances,
these after-school services are provided in lieu of interventions within
the school setting. Some parents (and children) prefer the after- school
remediation, feeling that it may reduce the possible stigma that can
accompany leaving the child's regular classroom for special services. (My
own observations suggest that this fear is often unwarranted, and that
most children experience minimal trauma as a result of leaving the
classroom. Keep in mind that most classrooms have at least a few children
who require special education services of some type). There are also
activities that are remedial in nature that can be provided within the
home environment. Among this type of treatment are a variety of computer
software programs that aim to strengthen deficient processes underlying
learning and thus enhance academic achievement. A variety of other
materials are also available, although generally I advise against a
parent trying to serve as a primary provider of an intervention.
Successful professionals in the field typically have had substantial
post-graduate training, and it is unrealistic for a parent to expect to
be able to provide the same quality of treatment that a professional can.
Additionally, I have witnessed too many instances where the parent-child
relationship was seriously eroded because of stressors introduced as a
result of one or both parents trying to play the role of remediator as
well as mother or father. Be advised that LD services are generally
required for an extended period of time. It is generally unrealistic to
expect significant improvement in achievement to occur as a result of a
few weeks or months of intervention, no matter how appropriate and
intensive this intervention might be. Although high intelligence
generally is associated with a better prognosis for children with
learning disabilities, the remedial process is still a time-consuming
process. Typically diagnostic re-evaluations are conducted every two to
three years to assess the change that has occurred and possibly identify
new areas of remedial emphasis for the future. Communication is an
important aspect of the remedial process. Those individuals who are
working with the child (i.e., the classroom teacher, LD specialist within
the school, private practitioner, and so on) should be in communication
with each other on a regular basis to guarantee that the services being
provided are appropriate and not overlapping to a significant degree.
Parents should be assertive in stating their expectations regarding
services. Keep in mind, special education services are costly and school
districts are typically not eager to provide such services. Those parents
who attend school staffings, maintain regular contact with school
personnel, and indicate that they will be seeking the services to which
they are entitled by law typically are more successful in receiving the
appropriate interventions for their children. As I mentioned previously,
it behooves parents to be aware of the rights that are guaranteed them
under Federal law. In meeting with parents during conferences, I always
stress the role of parental education. By that I mean that parents should
take it upon themselves to learn as much as they can about the
disabilities that their child possesses. While it is not realistic to
become an expert in the field, there are many books, videotapes, and
other materials available that are oriented towards increasing
parents’ understanding of learning disabilities and what can be
done to appropriately service children with learning disabilities. Today,
most national bookstore chains have entire sections devoted to special
education in general and learning disabilities in particular, Many of
these materials are oriented towards laypersons who lack professional
training in the field. Additionally, professional organizations such as the
Learning Disabilities Association of America (LDA) and the International
Dyslexia Society (IDA) offer publications and hold national and regional
meetings, with much of the content aimed at the parents of children with
learning disabilities. There is also an organization, Parents of Gifted
and Talented Learning-Disabled Children (301-986-1422), that is
specifically oriented to provide information to parents of children who
are "doubly exceptional". The Internet also can be a valuable
source of information for many parents, although my personal experience
has been that there is also considerable misinformation disseminated via
the various forums that the Internet provides. In other words, let the
consumer beware when "surfing the web".
Attention Deficit Hyperactivity Disorder: Approximately one-quarter to one-third of all children with
learning disabilities also qualify for the diagnosis of attention deficit
hyperactivity disorder (ADHD). Additionally, ADHD manifests itself in
ways that are often difficult to distinguish from learning disabilities.
As a result, most evaluations for learning disabilities will also include
at least a consideration that ADHD is a viable diagnosis as well. ADHD
manifests itself in several ways; the behaviors most commonly associated
with ADHD include inattention, hyperactivity, and impulsivity. Under the
current conceptualization of the disorder, some children display
primarily hyperactive and impulsive symptoms, while others show mostly
difficulties in focusing and maintaining attention. Still others with
ADHD display a combination of hyperactive/impulsive and inattentive
behaviors. ADHD does not in and of itself result in academic
underachievement. However, like a learning disability, ADHD often results
in children performing at a level that is below that at which they are
capable. One of the hallmarks of the disorder is inconsistency in
performance; that is, a child with ADHD may be able to perform at a high
level on a particular task on one day, yet show a much poorer level of performance
on an essentially identical task shortly thereafter. As a result of this
inconsistent performance, many children with ADHD are erroneously labeled
as unmotivated, lazy or uncaring. Like children with learning
disabilities, many children with ADHD possess a number of strengths; as
with children with learning disabilities, these strengths often go
unrecognized and/or underappreciated. Moreover, many of the
characteristics of children with ADHD are compatible with giftedness:
these children are often energetic, creative, and excel at tasks
requiring divergent thinking. In fact, there have been suggestions that
the high energy level and high intensity characteristic of gifted
children may at times result in them be inappropriately diagnosed with ADHD,
while their giftedness remains unrecognized. Furthermore, the ways in
which ADHD manifests itself change as a child grows older. Typically,
overactive and impulsive behaviors decrease in frequency with age, while
organizational and time management problems and difficulties related to
social interactions (especially with peers) become more prominent. Unlike
with learning disabilities, a medical intervention for ADHD is effective
in many cases. The most commonly used treatment, stimulant medication, is
effective in reducing symptoms in a large majority of children who take
it. Increasingly, other pharmacological treatments, including tricyclic
antidepressants and antihypertensives, are being prescribed to children
who either do nor respond to psychostimulants or who have adverse side
effects (most commonly insomnia and decreased appetite) to them. There
are also a variety of psychologically based treatments for ADHD as well.
Substantial evidence exists to support the idea that the combination of a
pharmacological and a psychological intervention provides greater symptom
reduction than either type of treatment alone. Among common
psychologically oriented treatments are behavior modification and
metacognitive training. Behavior modification requires the establishment
of a reward system (a 'token economy') to reinforce desired behaviors
(which could range from 'getting homework done in a timely manner' to
'not interrupting conversations' to 'getting ready for school in the
morning without reminders or assistance'). A well planned token economy
is often necessary because children with ADHD have been found to be less
sensitive than their non-ADHD peers to the typical reinforcement
contingencies that are a part of everyday living. Rather, children with
ADHD require reinforcement that is more powerful, more frequent, and more
linked in time to the desired behavior than do their non-ADHD peers.
While many parents feel that establishing a token economy in the home (or
school) must be a fairly simple matter, my experience has shown quite
clearly that they benefit greatly from the guidance of a trained
professional (e.g., a psychologist or social worker) in establishing,
adjusting, and maintaining such a plan. Metacognitive training is an
intervention that focuses on getting the child to think about and analyze
his or her behavior, with the goal of becoming capable of recognizing
problematic situations and dealing with them in an appropriate manner.
Metacognitive training is particularly well suited to children who are
gifted, since success rates are best with those who are highly
intelligent and possess good verbal skills. Again, there are
professionals who specialize exclusively in this type of intervention.
Summary: As I have described, children who are gifted are as likely
to have learning disabilities or attention-deficit hyperactivity disorder
as any other children. Due to some of the characteristics of gifted
children (most notably their high levels of intelligence), however,
gifted children often are not identified as LD or ADHD as accurately or
as early in their lives as their non- gifted peers. Early diagnosis and
intervention is important in reducing the difficulties that gifted
children with co-occurring learning disabilities and/or attention-deficit
hyperactivity disorder experience in their academic, emotional, and
social lives. Parents of children who are gifted need to be aware of the
criteria for inclusion for LD or ADHD and may often be required to
strongly advocate for their children so that they may receive the
appropriate special education services to which they are entitled under
Federal law.
References: Federal Register (1977). Washington, D. C.: U. S.
Government Printing Office. Federal Register (1997). Washington, D. C.:
U. S. Government Printing Office. Lajoie, S.P., & Shore, B. M.
(1981). Three myths? The over-representation of the gifted among drop-
outs, delinquents and suicides. Gifted Child Quarterly, 25, 138-141.
National Commission on Excellence in Education (1983). A nation at risk:
The imperative for educational reform. Washington, D. C.: U. S.
Government Printing Office. U. S. Department of Education. (1998) To
assure the free appropriate public education of all children with
disabilities. Twentieth Annual Report to Congress on the Implementation
of the Individuals with Disabilities Education Act. Washington, D.C.:
U.S. Government Printing Office. Whitmore, J. R. (1980) Giftedness,
conflict and underachievement. Boston: Allyn and Bacon.
Dr. Steven G. Zecker is an associate professor in Communication Sciences and
Disorders at Northwestern University in Evanston, Illinois.
--article from the Center for Talent Development
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