The phenomenon of a “gifted child” is one of the most misunderstood and underdiagnosed conditions throughout the western world. Claims of “giftedness” arouse strong (and mostly negative) reactions in many adults, including educators. These feelings seem more a product of adults’ own personal experiences than objective analysis, impeding the identification and nurturing of these children’s gifts. Attitudes toward giftedness reflect a deep paradox in western culture. While society may value outstanding intellectual achievement, such as breaking the genetic code or inventing the microchip, a deep abiding distrust of precocity in children prevails. Society often perceives gifted children as “misfits” whose intellectual power develops in direct proportion to diminished attractiveness.

Primary care providers can play a vital role in correcting this situation. If providers become more aware of some of the presenting signs of intellectual giftedness, then they can be persuasive advocates for these children, both with parents and teachers. Consequently, these children will be able to realize more of their promise. This chapter provides the reader with an understanding of some of the observable behaviors and varieties of intellectually gifted children. It also gives suggestions for supporting gifted youngsters and their parents.

Ever since the Terman (1905) studies began and the Stanford-Binet intelligence test was designed to sort out unsuitable soldiers from service in World War I, psychologists have defined giftedness as a kind of unitary hereditary factor. They assumed intelligence to be a general kind of special prowess present from birth and waiting for the right conditions to appear. The Marland Report (1972) proposed a more encompassing description of giftedness that included at least six domains, describing children who demonstrate outstanding potential or performance in any one of these areas:

Howard Gardner (1993) examined the effects of trauma on differing sites in the brain. He posits eight separate kinds of intelligence, including the following:

In 1995, The World Council on Gifted and Talented Children adopted this definition of giftedness:

“Giftedness is asynchronous development in which advanced cognitive abilities and heightened intensity combine to create inner experiences and awareness that are qualitatively different from the norm. This asynchrony increases with higher intellectual capacity. The uniqueness of the gifted renders them particularly vulnerable, requiring modifications in parenting, teaching, and counseling if such children are to develop optimally” (Tolan, p. 172, 1998).

Are emotional problems the cause or result of giftedness? Until the 1920s, psychologists, physicians, and teachers believed that most highly gifted children were emotionally disturbed. Some early studies linked giftedness with madness (Lombroso, 1891). Seminal work by Hollingsworth (1926, 1931, 1942), however, showed that the social isolation felt by many highly gifted students did not result from emotional instability, but from the absence of a compatible peer group. The more extreme the child’s gift, the more acute the discomfort he or she experienced in a traditional school setting. Hollingsworth found that between the ages of 4 and 9, highly gifted children were particularly vulnerable to this isolation. Twenty-five years of work at the Johns Hopkins Center for Talented Youth shows that when young, precocious students (as identified on off-level tests, such as the SAT-M and SAT-V) study advanced material with intellectual peers, their social development flourishes (Benbow & Stanley, 1997). Association with intellectual peers in play and study often eliminates social isolation and concomitant loneliness.

In studies of extraordinary talent development, both Bloom (1985) and Csikszentmihalyi, Rathunde, and Whalen (1993) found that children best actualize their potential when parents and teachers recognize their specific gifts and when positive school experiences and challenging mentor relationships in their areas of talent are available during the teen
years. Adults should not view gifted children as a homogeneous group. Giftedness varies by domain and degree of variation from the normal population. Generally, the estimate of intellectually gifted children ranges from 2% to 3% of the population, with some educators including as many as 15% of children (Marland, 1972). Different levels of intellectual ability are associated with attendant differences in cognitive and emotional functioning. Differences in high performance can be seen in Table 20-1.

The potential for unusual intellectual ability is present in all ethnic, racial, and cultural groups and in both sexes. One example of stereotypical thinking is the designation of Asian children as mathematically or musically gifted. It is true that early training in music is widespread for some Asian children. It also is true that the mathematics curricula in most Asian countries are much more demanding than those in U.S. schools (Peak, 1996; Stevenson & Stigler, 1998). For these reasons, a logical consequence is that more Asian children display accomplishment in music and math. But Asians also excel in other ways. Asians with writing talent often are neglected because of the prevalence of the math myth. Another similar display of stereotypical thinking is the belief that native Americans and other aboriginal peoples (including those of Australia, the Pacific Rim, and Central and South America) display giftedness in the specific areas of spatial and natural arts.

Providers should recall that manifestations of giftedness differ according to what opportunities a culture presents. Wayne Gretzky would not have achieved his level of hockey playing without someone introducing him to ice and skates. Mozart required the musical culture of the 18th century, early immersion in music, and constant practice on the piano to develop his composing genius. Booker T. Washington needed someone to teach him to read before he could go on to create a new intellectual institution at Tuskegee.

Socioeconomic factors influence the identification of intellectual giftedness. More middle class parents are aware of the significant precursors for potential giftedness in linguistics or numeracy than are poor families.

Both extreme deficit and high ability can coexist. Providers should assess closely various apparently handicapping conditions for evidence of possible high ability. Certain challenges, such as dyslexia, learning disability, Asperger’s syndrome, and extreme emotional impulsivity mask high potential for skill. Emotional immaturity may disguise extreme intellectual capacity in one or more domains.

Conversely, discriminating between giftedness and Asperger’s syndrome is important (Neihart, 1998). Children with Asperger’s need proper diagnosis so that they receive essential services. Developmental history is critical to distinguish between the gift and the deficit (Klin & Volkmar, 1995). For instance, misbehavior can stem from boredom in a routine classroom that offers only tasks the student has already mastered (Guevremont, 1990). Without knowledge of these factors, such behavior may lead to an improper diagnosis of attention deficit hyperactivity disorder (ADHD). Refer to Chapter 19 (Asperger’s Syndrome and Pervasive Developmental Disorders: The Different Child) and Chapter 21 (School Problems) for a more in-depth examination of these topics.

Intellectual giftedness presents independent of any specific physical characteristics. Direct evidence of giftedness in the provider’s office usually is limited to observation of a child’s verbal skills, but other factors may inhibit even these. Parental reports have been determined to be quite accurate (Silverman, 1993). Taking a careful developmental history is very important. The provider should listen when parents report any of the following presenting characteristics about their child: