Just because you’re really smart doesn’t mean you are supremely self-confident. That’s according to University of Iowa researchers who report that gifted children with attention deficit hyperactivity-disorder have lower self-esteem than their intellectual peers.

It’s the first study to examine how gifted students with and without a behavioral disorder like ADHD feel about themselves, the researchers report in the paper, published this month in the Journal for the Education of the Gifted.

“It's kind of a myth that gifted kids will be fine, and we should leave them alone,” says Megan Foley Nicpon, counseling psychology assistant professor at the UI and the paper’s lead author. “Research shows that gifted children can and do experience social and emotional difficulties, and our research suggests that this may be even more so for gifted students with ADHD."

About 9.5 percent of the school-age population in the U.S. has ADHD, according to the Centers for Disease Control and Prevention, using information from parents. It’s not clear what percentage of that group is gifted, Foley Nicpon says.

In the study, the researchers gathered data from 112 children, ages 6 to 18, using the Behavioral Assessment Scales for Children and the Piers-Harris Self Concept Scale. All were identified as intellectually gifted children with high cognitive ability (an IQ of 120 or in the 91st percentile or above). Fifty-four of the participants were diagnosed with ADHD.

The study found that despite having similar IQs, gifted students with ADHD were twice as likely to have lower self-esteem, had less positive perceptions about their behavior, and were significantly less happy than gifted students without ADHD.

Paradoxically, the gifted students with ADHD felt just as smart, popular, and self-reliant as their gifted peers without ADHD. They also reported the same quality of interpersonal relationship with peers.

This is why it's often easy to overlook the fact that gifted youth with ADHD may require intervention or added support, Foley Nicpon contends.

"It's really raising awareness with educators, clinicians, and parents that being twice exceptional is something real," says Foley Nicpon, whose appointments are in the College of Education's Department of Psychological and Quantitative Foundations and the Belin-Blank Center for Gifted Education and Talent Development. "Just because you're high ability or have academic talents doesn't mean that everything else is automatically going to be okay. That is not always true, and we need more awareness about how to help these youth."

Twice-exceptional students are those who are intellectually gifted and have a behavioral or emotional disorder, such as ADHD.

"This is really critical because the assumption many people make is that gifted students with ADHD will be buffered by their giftedness and do just fine," Foley Nicpon adds. "The results of this study suggest that intervention and additional support may be necessary for these students to reach their full potential."

Gifted in Iowa

Of the 64,000 students identified as gifted students in Iowa, 2.8 percent, or 1,793 students, have either an IEP or a 504 plan. Foley Nicpon says this number likely underrepresents those who are twice exceptional, because not all students who are gifted and have an emotional or behavioral disorder qualify for special and/or gifted education.

Foley Nicpon says parents should listen to their intuition: "If your child isn't performing in school as well as you think he or she should, go with your gut feelings and seek help for your child."

Foley Nicpon says she hopes this will ultimately help create awareness for parents and educators and inspire action for future research that will benefit twice-exceptional students.

"I think the perspective we're taking is recognizing that children are complex. An approach is recommended where students' talent areas are celebrated at the same time as their difficulties are assisted. We have to move away from only recognizing a student's diagnosis or disability."

She adds, "These are the kids who are going to change the world. You want every child to be given the best possible chance that he or she can be given to actualize his or her areas of talent as well as remediate difficulties. Every human being should be given that chance."

Contributing authors include Susan Assouline, professor of school psychology and associate director of the College of Education's Belin-Blank Center for Gifted Education and Talent Development; Heather Rickels, a research assistant in psychiatry; and Allison Richards, a graduate teaching assistant in the counseling psychology program.