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A patient walks into the physician's office and presents with a unique set of symptoms. To the physician, this is an unknown illness—the symptom presentation is unusual, like nothing he has ever seen before. Despite a thorough search, there is no information about it in the medical journals, and he hadn't heard about anything like it in medical school. He consults with colleagues and finds they haven't seen this either. He wonders, ‘What is going on here?’ He realizes he is in uncharted territory and attempts to fit the patient's symptomatology into his existing knowledge, finally determining that it is close to Disorder X, but not completely. In the absence of information about the specific situation, the physician uses his current knowledge and framework to explain the situation as best he can. Does this situation sound unusual? Is this something one might expect? When it comes to gifted children, this situation is often more the norm than the exception. Gifted children come with a set of characteristics that are often unknown to a typical medical or mental health professional because professionals receive little, if any, training about the characteristics, social/emotional development, or special needs of gifted individuals. When a gifted child presents to a professional who has no knowledge of gifted children, it is likely that the professional will fit the presenting behaviors or ‘symptoms’ into a framework with which he is familiar, perhaps saying that it looks like this disorder or that disorder, but has an unusual presentation that does not fit any diagnostic criteria completely. He may use the Not Otherwise Specified label for the condition, and it is unlikely that the professional will use giftedness as a frame to explain the behavior, due to lack of experience or knowledge about giftedness. This paper explores and explains much of the inadvertent misdiagnosis of gifted individuals.

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