[SEN Feature — ADHD] My child always has difficulty focusing—is it ADHD? Gifted? Or Dual SEN?

Question: My child constantly struggles to focus. Is it ADHD, or are they gifted? Or could they be Dual SEN? Are the training and intervention methods different for each?

The characteristics of Attention Deficit Hyperactivity Disorder (ADHD) include hyperactivity, impulsivity, and attention deficit, along with an excessively high activity level, like a machine that cannot stop. The characteristics of gifted children include superior cognitive abilities, strong learning abilities, and more. Twice-exceptional children, on the other hand, simultaneously possess the traits of both ADHD and giftedness; while they demonstrate extraordinary talents in certain areas, they are troubled by ADHD in other aspects.

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Characteristics Training methods
ADHD
  • Hyperactivity: Restlessness, constant fidgeting of hands and feet, inability to sit still, running around in inappropriate situations, and talking excessively. Hyperactive symptoms are more obvious in boys, who tend to be more aggressive; girls exhibit fewer disruptive behaviours, and their symptoms tend to be internalized (Rinn & Reynolds, 2012).
  • Impulsivity: Frequently interrupting others’ conversations or activities, blurting out answers, becoming easily agitated emotionally when facing frustration, and lacking patience.
  • Inattention: Difficulty concentrating, acting carelessly, struggling to follow through on instructions and complete tasks, forgetting things easily, and experiencing difficulties in learning or working.
  • Due to neurological deficits, they are unable to control their own behaviour (Gates & Gentry, 2009).
  • Behavioural therapy, cognitive behavioural therapy, parent training, medication, and the adjustment and arrangement of daily activities.
  • Give children more patience and support, and collaborate with professionals to help them overcome the challenges of ADHD together.
Gifted
  • Exhibits psychomotor overexcitability (Karpinski et al., 2018): Superior cognitive abilities, strong learning capabilities, and strengths in emotional and social areas (e.g., rapid comprehension, exceptional memory, rich vocabulary, intense curiosity, and a deep desire to explore questions).
  • Outstanding performance (extraordinary talent) in specific areas, strong interests, and the ability to learn independently and autonomously.
  • Because they have more cognitive resources available, they are able to control their performance.
  • Taking into account their physiological and psychological factors, their abilities can be enhanced through systematic, personalized exercises and strategies.
Dual SEN
  • General Ability Index (GAI) > Cognitive Proficiency Index (CPI) (Cornoldi et al., 2023)
  • Compared to children with ADHD, they more frequently run around in inappropriate situations, talk excessively, and blurt out answers before questions have been completed.
  • Reading and Writing
    • Use visual aids (e.g., charts, flowcharts, flashcards) to help with comprehension.
    • Preview materials before learning.
    • Allow children to express their ideas through drawings or role-playing.
    • Improve oral fluency through role-playing or rehearsal.

    Attention and Memory

    • Give clear, simple instructions.
    • Highlight key information using colours or symbols.
    • Set clear learning goals.
    • Allow children to move around a bit before requiring them to concentrate.
    • Use a timer to improve focus.
    • Teach memory aids (e.g., flashcards, colour-coding).

    Emotional Regulation

    • Understand the triggers for the child’s emotions and provide support.
    • Provide a “calm down corner” for them to take short breaks.
    • Teach them ‘I-messages’ (e.g., ‘I feel… when…’).
    • Help them reflect on how their behaviour affects others.
    • Guide them to accept the difference between their expectations and reality.

    Confidence and Resilience

    • Identify the child’s strengths outside of academics.
    • Encourage peer interaction and teamwork.
    • Let children showcase their talents (e.g., art, performance).
    • Avoid comparing them with other children.

These characteristics may appear as early as childhood and persist into adulthood. Moreover, these traits are not immutable; they vary from person to person or change as the child grows older. Parents should pay close attention to their child’s mental health, providing emotional support and guidance. It is important to note that the underlying causes of inattention in these three groups are different, and a professional assessment is required to prescribe the right approach: ADHD stems from neurological deficits, meaning the child cannot control their lack of focus. However, the psychomotor overexcitability in gifted children primarily stems from having cognitive abilities that surpass their peers, and their hyperactive state can be controlled.

Before the age of 6 is the golden period for intervention. If you have any suspicions, you should have your child undergo relevant assessments or diagnoses early on to avoid missing the optimal time for treatment. Early detection and appropriate education and support can help twice-exceptional children fully realize their potential. If your child is experiencing difficulties with attention, please feel free to call 2244 6614 or WhatsApp 6604 4966 to inquire about the services at SeedlingHeart Child Development Centre.

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Founder of Seedling Heart Child Development Centre

Clinical Psychologist YIU Fong Lee Venus