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Intelligence Tests As Indicator of ADHD

By Inderbir Kaur Sandhu, Ph.D

Q: My 5 yr old was given the WPPSI-IV. We walked in assuming she had ADHD based on some traits. We thought she was minimally bright, possibly moderately gifted. We were not prepared for her results:

FSIQ: 148 GAI: 147
VCI: 135
VSI: 145 **she hit the ceiling in BD
FRI: 139
WMI: 140 **she hit the ceiling in PM
PSI: 145 **she hit the ceiling in Ca (not included in composite)
NVI: 149 **includes BD and PM where she hit ceilings

We were particularly surprised with her WMI and PSI scores, as this is where we expected to see some discrepancy w/ presumed ADHD. We were told to hold off on specific ADHD testing and see how it goes over the next couple of years once she's in a more appropriate educational environment. My questions, is it less likely she has ADHD w/ those WMI and PSI results? Or is that not a good indicator of disability. I recognize it isn't diagnostic, just trying to get more of an understanding of what we're seeing. Thank you.

A: As you have correctly understood, IQ tests are not diagnostic. There is a myth that children with ADHD are smarter which is of course, only a myth. The fact is that intelligence and ADHD do not go hand-in-hand. It is true that some children with ADHD might have higher IQs, however, it is a misconception to assume that they go hand-in-hand. This can even be harmful because it may keep the child from getting the help they need.

Unfortunately, no single test can accurately diagnose ADHD - instead, the process is based on long-term observations of the possible symptoms. There are cases where other conditions such as autism were mistaken for ADHD. While testing a child, we normally look for patterns of behaviour or responses that are consistent with the criteria for ADHD. It is found that children with ADHD often perform at a lower level on intelligence tests than those without ADHD, most likely because these tests require sustained mental effort. Most test (including the Wechsler's), there are no repeated instructions or modification to accommodate any special needs of the child (e.g., a child who may not have listened to the directions carefully or who have a hard time sitting still for testing). This is why for children with such concerns; various test results are combined for a more accurate assessment on intellectual functioning of a child. The fact is that ADHD is just a label for a range of behaviours for which there might be any number of underlying causes.

Since many of the subtests require the child to use sustained attention, deficits can be noted during testing. Speak to the tester if this may be the case. Based on her scores, she scored very high and there is no suspicion of ADHD from the scores based on both her WMI and PSI scores. However, as you are aware, this is not diagnostic and more complicated. But, it does indicate giftedness. Perhaps, there may be no ADHD or the traits you have suspected could be traits (not mentioned in your letter) of a highly intelligent child. It is a good idea to hold off ADHD testing as of now. Perhaps you may want to do some reading into giftedness and ADHD separately and perhaps some that combines the two (see:

Whatever you may decide, you do have a highly intelligent little girl who would need a lot of intellectual stimulation to help her maximise her full potential. She hit the ceilings of subtetst a few time, so it is certain that her overall score is a “floor” in an estimation of true her ability (do note that there is a ceiling effect for gifted 5-year-olds on the WPPSI). For the ceilings, there is no telling if she could go much higher or that is where she stops. Therefore, she has much more room for her potential to be discovered. Perhaps if she indulges in meaningful activities, she may be able to concentrate better (if that is a concern at present). Expose her to various activities with gradual increase of levels of difficulty. Wishing you all the best in your beautiful journey!


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