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Prevalence Rates of Attention Deficit Hyperactive Disorder in Gifted and Talented Students in Saudi Arabia

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Title: Prevalence Rates of Attention Deficit Hyperactive Disorder in Gifted and Talented Students in Saudi Arabia
Language: English
Authors: Abdulkarim Alhossein (ORCID 0000-0001-7869-9921), Rashed Aldabas (ORCID 0000-0002-3566-4777), C. Matthew Fugate, Salaheldin Farah Bakhiet (ORCID 0000-0002-5091-7402), Juliana Tay, Nouf M. Alzrayer
Source: International Journal of Disability, Development and Education. 2026 73(2):211-226.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 16
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Education Level: Elementary Secondary Education
Descriptors: Foreign Countries, Incidence, Attention Deficit Hyperactivity Disorder, Academically Gifted, Twice Exceptional, Elementary Secondary Education, Teacher Attitudes, Parent Attitudes, Barriers, Public Schools, Private Schools
Geographic Terms: Saudi Arabia
DOI: 10.1080/1034912X.2025.2502043
ISSN: 1034-912X
1465-346X
Abstract: Reports have estimated worldwide-pooled prevalence rates for Attention Deficit Hyperactive Disorder (ADHD) to be 5.2%-7.2%. However, estimated prevalence rates can be difficult to determine due to the variability of diagnoses within and among different countries. Prevalence rates for ADHD among 22 Arab countries has been found to range between 1.3% and 16%. In this study, the researchers examined the prevalence twice-exceptionality -- those students who are gifted with ADHD -- among 766 students aged 5-17 attending private and public schools in Saudi Arabia. Implications for the findings of this study include the need for more education regarding the needs of these students among teachers and parents, as well as the form and type of educational programming provided to them in schools.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1504157
Database: ERIC
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  Value: <anid>AN0191629657;54q01mar.26;2026Feb19.04:40;v2.2.500</anid> <title id="AN0191629657-1">Prevalence Rates of Attention Deficit Hyperactive Disorder in Gifted and Talented Students in Saudi Arabia </title> <p>Reports have estimated worldwide-pooled prevalence rates for Attention Deficit Hyperactive Disorder (ADHD) to be 5.2%–7.2%. However, estimated prevalence rates can be difficult to determine due to the variability of diagnoses within and among different countries. Prevalence rates for ADHD among 22 Arab countries has been found to range between 1.3% and 16%. In this study, the researchers examined the prevalence twice-exceptionality – those students who are gifted with ADHD – among 766 students aged 5–17 attending private and public schools in Saudi Arabia. Implications for the findings of this study include the need for more education regarding the needs of these students among teachers and parents, as well as the form and type of educational programming provided to them in schools.</p> <p>Keywords: ADHD; twice-exceptionality; gifted students; Saudi Arabia; descriptive study</p> <p>The Oxford Dictionary defines exceptionality as something that is unusual or not typical. As giftedness is outside the norm, it is, by definition, an exceptionality (S. M. Moon & Reis, [<reflink idref="bib37" id="ref1">37</reflink>]). Subotnik et al. ([<reflink idref="bib53" id="ref2">53</reflink>]) noted that varying definitions of giftedness are often built around the principles of high IQ, emotional weakness, creative productivity, talent development in talent development in different areas, incommensurate access, and practice. For this paper, we operationalise giftedness in Saudi Arabia using the definition that was developed in 1998 by The King Abdul-Aziz City for Science and Technology and adopted in 1999 by the Ministry of Education in the Kingdom (Ministerial Resolution No. 877).</p> <p>Students who have extraordinary potentials and abilities or performance that is distinct from the rest of their peers in one or more of the areas that the community appreciates, especially in the areas of mental excellence, innovative and creative thinking, educational achievement, skills and special abilities, require special educational care that is not fully compatible with normal study programs. When a student presents a combination of characteristics of giftedness (e.g. advanced academic ability; creativity; leadership) and a learning and/or behavioural deficiency like attention deficit hyperactive disorder (ADHD), they are said to be twice exceptional.</p> <p>Like giftedness, twice-exceptionality has different definitions. A group of representatives from the National Research Centre on Gifted and Talented, the Association for the Education of Gifted Underachieving Students, and the Bridges Academy worked together to develop a thorough definition for twice-exceptionality (Gentry & Fugate, [<reflink idref="bib26" id="ref3">26</reflink>]). As a result, the National Association for Gifted Children has presented this definition for use in identifying and servicing students who are twice exceptional (Gentry & Fugate, [<reflink idref="bib26" id="ref4">26</reflink>]). A student who is twice exceptional has shown a high level of achievement in a variety of areas, including academic, intellectual, creative, and leadership abilities, as well as having been diagnosed with one or more disabilities, such as learning disability and/or physical disability (Baum & Olenchak, [<reflink idref="bib13" id="ref5">13</reflink>]; Reis et al., [<reflink idref="bib47" id="ref6">47</reflink>]). It is necessary to evaluate both giftedness and disability to identify a twice-exceptional student, as the two categories not being mutually exclusive.</p> <p>Also, twice-exceptional students should be provided educational services addressing their giftedness or high abilities and disabilities or deficits simultaneously (Reis et al., [<reflink idref="bib47" id="ref7">47</reflink>]). The twice-exceptional students could be educated using a variety of teaching strategies, including but not limited to, differentiated instruction, specialised instruction, accommodations, and/or modifications. The direct services, acceleration options, and opportunities for talent development are also educational services provided to the twice-exceptional students. Therefore, an individual education plan (IEP) or a 504-accommodation plan should be developed for each individual twice-exceptional student to improve both their abilities and disabilities by addressing their unique educational and developmental needs (Reis et al., [<reflink idref="bib47" id="ref8">47</reflink>]).</p> <p>Gifted students with ADHD face unique challenges as they navigate their academic and social worlds. As with the prevalence rates of ADHD alone, the prevalence of twice-exceptional students identified as gifted with ADHD is not completely known. However, researchers have shown a normal distribution of IQ scores in children with ADHD (Kaplan et al., [<reflink idref="bib32" id="ref9">32</reflink>]), suggesting that there is no indication to suspect that ADHD rates are higher or lower among gifted individuals than the general population (Gentry & Fugate, [<reflink idref="bib26" id="ref10">26</reflink>]).</p> <hd id="AN0191629657-2">Attention Deficit Hyperactive Disorder</hd> <p>According to the <emph>Diagnostic and Statistical Manual, 5th Edition</emph> (<emph>DSM-V</emph>; American Psychiatric Association, [<reflink idref="bib10" id="ref11">10</reflink>]), inattentiveness and hyperactivity-impulsivity are diagnostic signs for ADHD, and the level of these characteristics within an individual can produce one of three subtypes: ADHD as either predominantly inattentive, ADHD as predominantly hyperactive-impulsive, or ADHD as a combined presentation (Gentry & Fugate, [<reflink idref="bib26" id="ref12">26</reflink>]). Reports have estimated worldwide-pooled prevalence rates to be 5.2%–7.2% (e.g. Polanczyk et al., [<reflink idref="bib46" id="ref13">46</reflink>]; Thomas et al., [<reflink idref="bib54" id="ref14">54</reflink>]). Estimated prevalence rates can be difficult to determine due to the variability of diagnoses within and among different countries (Charach et al., [<reflink idref="bib17" id="ref15">17</reflink>]).</p> <p>Prevalence rates for ADHD among the 22 Arab countries has been found to range between 1.3% and 16%. In Saudi Arabia, two studies focused on students with ADHD have found prevalence rates of 2.6% among boys and girls collectively (M. M. J. Alqahtani, [<reflink idref="bib8" id="ref16">8</reflink>]), and 3.5% among female students specifically (Jenahi et al., [<reflink idref="bib31" id="ref17">31</reflink>]). Jenahi et al'.s finding of the prevalence rate among girls in Saudi Arabia is interesting, as it differs from the findings of researchers outside of the region. Generally, researchers have found that boys were identified for ADHD at a rate of 4:1 over girls (Bauermeister et al., [<reflink idref="bib12" id="ref18">12</reflink>]; P et al., [<reflink idref="bib43" id="ref19">43</reflink>]). Additionally, the United States Centres for Disease Control ([<reflink idref="bib16" id="ref20">16</reflink>]) reported that among children diagnosed with ADHD, 13.2% were males and 5.6% were females.</p> <p>It should be noted that students identified with ADHD are likely to also be identified with comorbid disabilities (American Psychiatric Association, [<reflink idref="bib10" id="ref21">10</reflink>]; Zen Tall, [<reflink idref="bib59" id="ref22">59</reflink>]). When M. M. Alqahtani ([<reflink idref="bib7" id="ref23">7</reflink>]) examined data collected from the teachers and parents of 652 primary aged children in Saudi Arabia, he noted that 5% of the students met the requirements for ADHD according to the <emph>DSM-IV-TR</emph> (American Psychiatric Association, [<reflink idref="bib9" id="ref24">9</reflink>]). Of those students, 73% were found to have comorbid symptomologies of oppositional-defiant disorder and conduct disorder. According to the estimates found by M. M. Alqahtani ([<reflink idref="bib7" id="ref25">7</reflink>]), approximately 36% of children with ADHD were likely to have anxiety and depression disorder. Additionally, Alqahtani found that 63% of the students who had ADHD and comorbid disabilities also reported having impairments in academic achievement, while 90% reported impairments in social behaviours ([<reflink idref="bib7" id="ref26">7</reflink>]).</p> <p>Children with ADHD and comorbid disabilities have been considered to be at increased risk of being suspended, expelled, retained, and/or receiving special education services by three to seven times (LeFever et al., [<reflink idref="bib35" id="ref27">35</reflink>]). Their dropout rates are higher, and they have a greater likelihood of failing out of school (Barron et al., [<reflink idref="bib11" id="ref28">11</reflink>]) than their peers without these diagnoses.</p> <hd id="AN0191629657-3">Teachers' and Parents' Perceptions of ADHD</hd> <p>Teachers are often among the first people to refer students for ADHD assessment (Fabiano et al., [<reflink idref="bib21" id="ref29">21</reflink>]; Rinn & Nelson, [<reflink idref="bib48" id="ref30">48</reflink>]; Sciutto et al., [<reflink idref="bib51" id="ref31">51</reflink>]), suggest accommodations or special education for students who may benefit from them, as well as observe and compare behaviours of the target students with normative behaviours of their classmates (Fabiano et al., [<reflink idref="bib21" id="ref32">21</reflink>]). Teachers can provide valuable information for the diagnosis because they interact with these students in a variety of situations and activities daily (Sciutto et al., [<reflink idref="bib51" id="ref33">51</reflink>]). In addition, previous research also indicated that many teachers believed that students with ADHD should stay in the general education classroom most of the time, and they should go to the resource room when needed (Whitworth et al., [<reflink idref="bib58" id="ref34">58</reflink>]).</p> <p>However, not all research on teachers' perceptions about students with ADHD is positive. Researchers found that many teachers blamed families for the students' impulsivity, hyperactivity, and inattention (Bradshaw & Kamal, [<reflink idref="bib15" id="ref35">15</reflink>]; Kos et al., [<reflink idref="bib33" id="ref36">33</reflink>]; Nur & Kavakci, [<reflink idref="bib42" id="ref37">42</reflink>]). Further, some teachers may not have adequate knowledge of ADHD, and some could have misperceptions about students with ADHD (Alkahtani, [<reflink idref="bib5" id="ref38">5</reflink>]; Rinn & Nelson, [<reflink idref="bib48" id="ref39">48</reflink>]; Sciutto et al., [<reflink idref="bib51" id="ref40">51</reflink>]). In Korea, some teachers perceived students with ADHD as having lower intelligence, weaker grades, and stronger representation of disappointment, anger, or sadness than their peers without ADHD (Hong, [<reflink idref="bib29" id="ref41">29</reflink>]). This lack of knowledge about ADHD could lead teachers to use interventions that have not been empirically validated (Kos et al., [<reflink idref="bib33" id="ref42">33</reflink>]; Weygand et al., [<reflink idref="bib57" id="ref43">57</reflink>]).</p> <p>A possible explanation for the misperceptions is that some teachers do not receive enough information about ADHD and/or they may use inappropriate source of information. Research indicated that teachers use magazine articles and newspapers to improve their knowledge about ADHD more than using medical resources (Al-Hakeem et al., [<reflink idref="bib1" id="ref44">1</reflink>]; Rinn & Nelson, [<reflink idref="bib48" id="ref45">48</reflink>]). This meant that teachers are influenced by media more than information based on evidence (Rinn & Nelson, [<reflink idref="bib48" id="ref46">48</reflink>]).</p> <p>In addition, there are teachers who reported that they did not suppose that ADHD was a neurological disorder and that the behaviours of these students should be controlled by using medication and behaviour modification (Glass & Wegar, [<reflink idref="bib27" id="ref47">27</reflink>]). Some teachers reported that they felt they would face a number of challenges when working with these students in the classroom, such as keeping them focused and lacking enough time to provide them with individualised instruction (Kos et al., [<reflink idref="bib33" id="ref48">33</reflink>]). Still other teachers believed that they lacked the necessary skills to teach students with ADHD (Hong, [<reflink idref="bib29" id="ref49">29</reflink>]).</p> <p>Parents are another group who are often the first to observe the symptoms of ADHD in their children (Sparrow & Erhardt, [<reflink idref="bib52" id="ref50">52</reflink>]). Ideally, parents and teachers could work together to address the issues of ADHD in children. Parents' and teachers' knowledge will affect the type of intervention used to manage the child's behaviour. Unfortunately, researchers have found that parents often knew more about the causes of and treatments for ADHD than teachers (Kos et al., [<reflink idref="bib33" id="ref51">33</reflink>]), and teachers frequently gave parents incorrect advice (Kos et al., [<reflink idref="bib34" id="ref52">34</reflink>]). This is quite concerning. Children with ADHD require adequate knowledge from both teachers and parents to ensure an accurate referral for ADHD evaluation to have their needs met (Sciutto et al., [<reflink idref="bib51" id="ref53">51</reflink>]).</p> <hd id="AN0191629657-4">Understanding Giftedness and ADHD</hd> <p>Students who are gifted and who have ADHD experience difficulties specific to their dual exceptionality, positioning them at risk for weakness in self-image and underachievement (Baum et al., [<reflink idref="bib14" id="ref54">14</reflink>]). Because of these difficulties, students with ADHD require unique attention and support in developing social and academic skills to avoid negative effects of this disorder that can affect their development (Gentry & Fugate, [<reflink idref="bib26" id="ref55">26</reflink>]). However, these students may also display certain strengths. For example, Fugate et al. ([<reflink idref="bib25" id="ref56">25</reflink>]) compared divergent thinking skills (i.e. creative thinking) in gifted students with and without ADHD symptomology and found that gifted students with ADHD characteristics displayed higher levels of creative thinking skills.</p> <p>Further, because many gifted characteristics share similarities with those associated with ADHD (e.g. becoming easily bored with routine tasks, disorganisation, carelessness), Pfeiffer ([<reflink idref="bib44" id="ref57">44</reflink>]) alerted that there is a possibility of misdiagnosis of gifted children with ADHD because their gifts may hide the disorders or other disabilities. He went on to point out the equal possibility for the existence of a disability or a disorder to hide the existence of giftedness. In either case, the child goes unidentified as twice exceptional, resulting in lost time in school with not many teachers perceiving either their gifts or their difficulties. As such, teachers' and parents' perceptions play a critical role in identifying and providing appropriate educational services for student with ADHD.</p> <hd id="AN0191629657-5">Academic and Social Challenges</hd> <p>Similar to findings of students with ADHD, when the needs of twice-exceptional students primarily go unrecognised, they run the risk of becoming academic underachievers and developing a poor self-concept. Cognitive processing issues commonly associated with ADHD (e.g. lowered working memory, or poor metacognitive skills) may lead to lowered IQ-scores in these students when compared to their similar ability gifted peers (Hughes, [<reflink idref="bib30" id="ref58">30</reflink>]; Nigg, [<reflink idref="bib41" id="ref59">41</reflink>]). Otherwise, the existence of giftedness frequently postpones the age at which ADHD is identified, hence, the higher a student's IQ, the later a diagnosis of ADHD is likely to happen (S. Moon, [<reflink idref="bib36" id="ref60">36</reflink>]).</p> <p>In addition, gifted students with ADHD experience specific social-emotional difficulties (Gentry & Fugate, [<reflink idref="bib26" id="ref61">26</reflink>]). Foley-Nicpon et al. ([<reflink idref="bib22" id="ref62">22</reflink>]) found that gifted students with ADHD experienced lower self-esteem and overall-happiness compared to their gifted peers without ADHD. Students with ADHD were also characterised with emotional severity (S. M. Moon & Reis, [<reflink idref="bib37" id="ref63">37</reflink>]), accusing others for their failures (Baum et al., [<reflink idref="bib14" id="ref64">14</reflink>]), and failing to control their verbal and/or physical impulsiveness (S. Moon et al., [<reflink idref="bib38" id="ref65">38</reflink>]) could resulting in feelings of isolationism from their peers (Gentry & Fugate, [<reflink idref="bib26" id="ref66">26</reflink>]). One participant in a study by Fugate ([<reflink idref="bib24" id="ref67">24</reflink>]) expressed it this way:</p> <p>I feel like I am judged a lot. I've been pushed aside a lot because I've not exactly gotten along with people when I was younger, and I had a lot of friendships that didn't work out. [They] will work out for the first couple of months, then they start distancing themselves, and then they just stop hanging out with me. I just don't like that, and I don't want that to happen again(p. 80).</p> <hd id="AN0191629657-6">Importance of the Current Study</hd> <p>Neihart ([<reflink idref="bib39" id="ref68">39</reflink>]) noted that ADHD has become one of the most common disorders identified in school-aged children. Although research on the prevalence and effects of ADHD among students in Arab countries has increased in recent years, these explorations still did not close the gap of knowledge and utilised methodologies tools that weaken the generalisability of the findings (Alkhateeb & Alhadidi, [<reflink idref="bib6" id="ref69">6</reflink>]). Additionally, what has been lacking up to now has been research focused on the prevalence of ADHD among the gifted population of Arab students. Although there is no purpose to think that there is any less or greater expectation of the prevalence of ADHD among gifted students in Saudi Arabia as a whole, what makes the Kingdom unique is its structure of public schools supervised by the Ministry of Education and specialised private schools for the gifted, supervised by The King Abdulaziz and His Companions Foundation for Giftedness and Creativity (MAWHIBA). This study sought to add to the literature to determine the rate of occurrence of twice-exceptionality (i.e. gifted and ADHD) among two groups of male and female students ages 7–17 years – those attending both private schools for the gifted and those attending public schools in Saudi Arabia – in order to examine any differences that may exist between these two educational settings.</p> <hd id="AN0191629657-7">Method</hd> <p></p> <hd id="AN0191629657-8">Participants</hd> <p>The sample for this study included 29 private schools in the partnership with schools supervised by MAWHIBA and 32 public schools supervised by the Ministry of Education. There were 766 students assessed in this study: 200 boys and 166 girls in the private schools, representing 30% of the gifted students in the private schools sponsored by the MAWHIBA, and 262 boys and 138 girls in the public schools, representing 10% of the gifted students in public schools sponsored by the Ministry of Education. All 766 students were Saudi Arabian and had previously been identified as gifted in their schools following the established guidelines of the Saudi Ministry of Education. These identification procedures included teacher nominations and a full review of students' academic records, as well as performance on tests of cognitive ability including the <emph>Torrance Tests of Creative Thinking</emph> (Torrance, [<reflink idref="bib55" id="ref70">55</reflink>], [<reflink idref="bib55" id="ref71">55</reflink>]), and the <emph>WISC-R</emph> (Wechsler, [<reflink idref="bib56" id="ref72">56</reflink>]). In addition to these assessments, and in accordance with the Ministries' guidelines, students identified as gifted in Saudi Arabia are assessed using the <emph>Multiple Mental Capacity Scale</emph> (https://<ulink href="http://www.qiyas.sa/ar/Exams/ExamsInfo/Pages/Maohebah.aspx">www.qiyas.sa/ar/Exams/ExamsInfo/Pages/Maohebah.aspx</ulink>) which measures students' mental flexibility; scientific and mechanical reasoning; linguistic reasoning and reading comprehension; mathematical inference and place value; and <emph>The Scale of Multiple Personality Traits of Gifted, Talented, and Creative Students</emph>.</p> <p>These assessments were prepared at a national governmental centre authorised by the State for the identification of the gifted. This centre performs its work according to research performed by international and local experts in giftedness, ensuring that these assessments are standardised with high reliability and validity. In both educational settings, students are identified as gifted if they score in at least the 85<sups>th</sups> percentile in all assessments. Students in both public and private school environments are assessed for identification in grades three, six, and nine.</p> <hd id="AN0191629657-9">Instrument</hd> <p>Arabic versions of the school and home ratings scales of the <emph>ADHD Rating Scales—5 for Children and Adolescents</emph> (DuPaul et al., [<reflink idref="bib20" id="ref73">20</reflink>]) were used in this study. These scales had been translated from the original English to Arabic. This translation was conducted by researchers at a Saudi University, in consultation with professors of translation, 'to ensure that it preserved the format, consistency and content of the English version of the scale' (Hassan et al., [<reflink idref="bib28" id="ref74">28</reflink>], p. 3). The reliability and validity for the translated, Saudi Arabian versions (school and home) of the scale were measured by Alhossein and Bakhiet ([<reflink idref="bib4" id="ref75">4</reflink>]). In their study, a sample of 2356 participants, 1197 parents and 1159 teachers, completed the scale for rating ADHD symptoms in males and females aged from 5 to 17 years. Confirmatory factor analysis results of Saudi versions were high (TLI 0.959 and 0.977; CFI 0.964 and 0.977; <emph>p</emph> <.001, respectively) and a Cronbach Alpha of 0.871 for the school version and 0.948 for the home version indicated high reliability (Alhossein & Bakhiet, [<reflink idref="bib4" id="ref76">4</reflink>]).</p> <p>In addition, the norms of the school version were extracted from administering the scale on a sample of 2881 teachers to assess ADHD symptoms among male and female students aged 3 to 17 years in Riyadh (Alhossein et al., [<reflink idref="bib2" id="ref77">2</reflink>]). The norms of the home version of the scale were also obtained from a sample of 3687 parents to rate the ADHD symptoms in males and females aged between 3 and 17 years based on gender and age (Alhossein et al., [<reflink idref="bib3" id="ref78">3</reflink>]).</p> <p>The school and home versions each consist of two symptom sub-scales – inattentive (9 items) and hyperactive-impulsivity (9 items) using a 4-point Likert-type scale (0–3) (DuPaul et al., [<reflink idref="bib19" id="ref79">19</reflink>]). Items on the sub-scales ask teachers and parents to identify the rate of occurrence of specific behaviours related to each symptomology (e.g. Easily distracted; Fidgets with or taps hands or feet or squirms in seat). Additionally, each sub-scale assesses six common areas of impairment related to academic performance and social interactions, that can be affected by the behaviours related to these symptoms (e.g. Getting along with family members; Getting along with other children; Performing academically in school). The resulting totals provide information related to the occurrence of behaviours related to ADHD inattentive-type, hyperactive-impulsive type, and combined with results identifying those students with ADHD and those 'at-risk' for ADHD symptomology.</p> <hd id="AN0191629657-10">Data Collection and Analysis Procedures</hd> <p>The teachers, who had known the students for at least one academic year, and parents of the students attending the schools included in this sample were asked to complete the school and home versions of the <emph>ADHD Rating Scales—5 for Children and Adolescents</emph>, respectively (DuPaul et al., [<reflink idref="bib19" id="ref80">19</reflink>]). One survey was collected from the teachers and the parents of each student in these schools. If both surveys were not collected for a student, that student's data was excluded from the study. In instances where siblings were attending the same school, a home version of the survey was collected for each. A total of 1,973 surveys were collected. Table 1 provides an itemisation of the number of surveys received for each student by age and gender in each of the learning environments.</p> <p>Table 1. Total surveys collected by learning environment, gender, and age.</p> <p> <ephtml> <table><thead><tr><td /><td>Partnerships with schools program</td><td>Public schools</td><td /></tr><tr><td /><td>Males</td><td>Females</td><td>Males</td><td>Females</td><td>Total</td></tr></thead><tbody><tr><td>School version Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Total</td><td> 0 24 85 59 32 200</td><td> 0 7 48 83 28 166</td><td> 26 89 112 17 18 262</td><td> 24 35 29 40 10 138</td><td> 766</td></tr><tr><td>Home version Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Total</td><td> 0 104 119 127 43 393</td><td> 0 79 71 60 14 224</td><td> 69 102 123 43 15 352</td><td> 53 54 52 55 24 238</td><td> 1207</td></tr><tr><td>Total</td><td>593</td><td>390</td><td>614</td><td>376</td><td>1973</td></tr></tbody></table> </ephtml> </p> <p>After collecting the data, the raw scores were converted to standard scores according to gender and age following Saudi Arabian norms for the school and home versions of the <emph>ADHD Rating Scales—5 for Children and Adolescents</emph> (DuPaul et al., [<reflink idref="bib19" id="ref81">19</reflink>]) based on the works of Alhossein et al. ([<reflink idref="bib2" id="ref82">2</reflink>]) and Alhossein et al. ([<reflink idref="bib3" id="ref83">3</reflink>]). After converting the raw scores to standardised scores, students who were identified as at-risk were in the 80th to 90th percentile, and those who were identified as having ADHD were in the 93rd to 98th percentile based on the scale. These percentages were extracted from the study sample.</p> <hd id="AN0191629657-11">Results</hd> <p>Overall results show that students attending public schools were identified as having or at risk for ADHD by both teachers and parents at a greater frequency than their gifted peers attending the Partnership with Schools (i.e. private schools) programs. This was true for both gifted boys and girls. Interestingly, gifted girls in public schools were identified as at-risk for ADHD by both teachers and parents at rates similar to, and in most instances at greater rates, their gifted male peers.</p> <hd id="AN0191629657-12">School Version</hd> <p>The data collected through the surveys were analysed using the SPSS-24 software package to determine the frequency of behaviours related to ADHD identified by teachers and parents. Prevalence of ADHD in gifted male students attending the Partnership with Schools identified by the teacher ratings using the school version were 2.40% ADHD Inattentive; 2.30% ADHD Hyperactive-impulsive; and 2.02% ADHD Combined type. Prevalence rates for gifted girls in this learning environment were.60%, 2.90%, and 1.72% respectively.</p> <p>The numbers were elevated for students attending public schools with prevalence ratings from teachers for gifted boys at 6.96% ADHD Inattentive; 8.50% ADHD Hyperactive-impulsive; and 7.50% for ADHD Combined type. This increase was also evident in gifted girls in this setting with findings demonstrating 3.98%, 8.24%, and 7.10% respectively for each ADHD type. In most instances, increases were found for both boys and girls in each educational setting when at-risk factors were taken into consideration. Tables 2 and 3 outline the complete findings for the teacher ratings on the school version.</p> <p>Table 2. Percentage of students identified with ADHD and At-risk by age on the ADHD rating scales—5 for children and adolescents-school version in partnership with schools programs.</p> <p> <ephtml> <table><thead><tr><td /><td>ADHD</td><td>At-risk</td></tr><tr><td /><td>Males</td><td>Females</td><td>Males</td><td>Females</td></tr></thead><tbody><tr><td>ADHD inattentive Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> – 0 4.70 1.70 3.10 2.40</td><td> – 0 0 2.40 0.60</td><td> – 8.30 4.70 6.78 3.10 5.72</td><td> – 0 2.08 2.40 10.70 3.80</td></tr><tr><td>ADHD hyperactive-impulsive Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> – 0 5.90 3.40 0 2.30</td><td> – 0 2.08 6.02 3.60 2.90</td><td> – 8.30 4.70 3.40 3.10 4.90</td><td> – 0 0 4.82 3.60 2.10</td></tr><tr><td>ADHD combined Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> – 0 4.70 3.40 0 2.02</td><td> – 0 2.08 1.20 3.60 1.72</td><td> – 4.20 3.50 3.40 6.20 4.30</td><td> – 0 0 3.60 3.60 1.80</td></tr></tbody></table> </ephtml> </p> <p>Table 3. Percentage of students identified with ADHD and At-risk by age on the ADHD rating scales—5 for children and adolescents-school version in public school programs.</p> <p> <ephtml> <table><thead><tr><td /><td>ADHD</td><td>At-risk</td></tr><tr><td /><td>Males</td><td>Females</td><td>Males</td><td>Females</td></tr></thead><tbody><tr><td>ADHD inattentive Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> 11.50 4.50 1.80 5.90 11.10 6.96</td><td> 4.20 5.70 0 10.00 0 3.98</td><td> 19.20 3.40 10.70 23.50 0 11.36</td><td> 4.20 17.10 17.20 17.50 20.00 15.20</td></tr><tr><td>ADHD hyperactive-impulsive Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> 15.40 5.60 4.46 5.90 11.10 8.50</td><td> 4.20 5.70 13.80 7.50 10.00 8.24</td><td> 30.80 6.70 6.25 11.80 11.10 11.33</td><td> 8.30 17.10 13.80 32.50 10.00 16.30</td></tr><tr><td>ADHD combined Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage Mean</td><td> 11.50 5.60 3.57 5.90 11.10 7.50</td><td> 0 8.30 6.90 10.00 10.00 7.10</td><td> 26.90 4.50 8.90 17.60 5.50 12.68</td><td> 8.30 11.40 20.70 22.50 10.00 14.60</td></tr></tbody></table> </ephtml> </p> <hd id="AN0191629657-13">Home Version</hd> <p>Results of the home version of the ratings scales for gifted students attending Partnership with Schools programs showed that parents rated boys at 1.30% for ADHD Inattentive type; 2.02% for ADHD Hyperactive-impulsive types; and 1.40% for ADHD Combined type. Parents rated their gifted girls attending these programs at a rate of 1.40%,.97%, and.62% respectively.</p> <p>As with teacher ratings in the school version, frequency ratings by parents were higher for both boys and girls attending public schools. Parents identified their gifted boys at a rate of 6.90%, 8.30%, and 8.40% for ADHD Inattentive, Hyperactive-impulsive, and Combined type, respectively. In addition, parents identified their gifted girls at rates of 8.40% for ADHD Inattentive; 8.30% for ADHD Hyperactive-impulsive; and 9.98% for ADHD Combined type. Again, when at-risk factors were taken into consideration, there were notable increases among boys and girls in both learning environments. Tables 4 and 5 provide an in-depth look at these findings.</p> <p>Table 4. Percentage of students identified with ADHD and At-risk by age on the ADHD rating scales—5 for children and adolescents-home version in partnership with schools programs.</p> <p> <ephtml> <table><thead><tr><td /><td>ADHD</td><td>At-risk</td></tr><tr><td /><td>Males</td><td>Females</td><td>Males</td><td>Females</td></tr></thead><tbody><tr><td>ADHD inattentive Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> – 1.92 0.79 2.30 1.30</td><td> – 2.50 0 3.30 0 1.40</td><td> –.96 3.40 3.90 2.30 2.60</td><td> – 0 4.20 0 0 1.05</td></tr><tr><td>ADHD hyperactive-impulsive Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> – 1.90 0 1.60 4.60 2.02</td><td> – 2.50 1.40 0 0.97</td><td> – 6.70 5.04 6.30 2.30 5.10</td><td> – 2.50 4.20 1.70 7.10 3.90</td></tr><tr><td>ADHD combined Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> – 1.90 0 1.60 2.30 1.40</td><td> – 2.50 0 0 0.62</td><td> – 1.90 2.50 3.10 0 1.90</td><td> – 0 4.20 3.30 7.10 3.65</td></tr></tbody></table> </ephtml> </p> <p>Table 5. Percentage of students identified with ADHD and At-risk by age on the ADHD rating scales—5 for children and adolescents-home version in public school programs.</p> <p> <ephtml> <table><thead><tr><td /><td>ADHD</td><td>At-Risk</td></tr><tr><td /><td>Males</td><td>Females</td><td>Males</td><td>Females</td></tr></thead><tbody><tr><td>ADHD Inattentive Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> 11.60 2.90 6.50 13.90 0 6.90</td><td> 3.80 7.40 5.80 12.79 12.50 8.40</td><td> 11.60 13.70 12.20 11.60 13.30 12.48</td><td> 20.70 11.10 9.60 14.50 4.20 12.02</td></tr><tr><td>ADHD hyperactive-impulsive Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> 11.60 5.90 8.10 9.30 6.70 8.30</td><td> 9.40 9.30 3.80 10.90 8.30 8.30</td><td> 0 19.60 8.10 18.60 13.30 11.90</td><td> 16.98 16.70 13.50 25.50 12.50 17.04</td></tr><tr><td>ADHD combined Ages 5–7 Ages 8–10 Ages 11–13 Ages 14–16 Age 17 Percentage mean</td><td> 10.10 4.90 6.50 13.90 6.70 8.40</td><td> 7.50 7.40 3.80 14.50 16.70 9.98</td><td> 17.40 14.70 11.40 9.30 6.70 11.90</td><td> 16.98 1.80 9.60 14.50 4.20 9.40</td></tr></tbody></table> </ephtml> </p> <hd id="AN0191629657-14">Discussion and Implications</hd> <p>The purpose of this study was to extend the existing literature to examine the prevalence rate of ADHD among gifted students attending two educational environments – private and public – in Saudi Arabia. This was accomplished through the collection of 1,973 surveys from teachers and parents of students attending 29 Partnership with Schools programs and 32 public schools. The results show that teachers and parents in public schools have identified their children at a higher rate than those in private schools. One explanation for this result is that in Saudi Arabia, as in countries around the world, private schools have specific admission requirements when accepting students for their school.</p> <p>Specifically, these private schools admit those students who demonstrate the highest achievement levels on the assessments used to identify giftedness in Saudi Arabia (above the 95<sups>th</sups> percentile). Because these schools serve those who achieve at the highest levels within the gifted population, there may be greater instances of the masking effect outlined by Pfeiffer ([<reflink idref="bib44" id="ref84">44</reflink>]) with gifts masking ADHD symptomologies. Further, classrooms sizes in private schools are generally smaller than in public schools, allowing teachers to more easily individualise instruction to better address students' needs. By incorporating opportunities for gifted students to explore personal interests through authentic learning experiences, such as project- and problem-based learning, teachers may mitigate the effects of ADHD symptomologies (Dunlap, [<reflink idref="bib18" id="ref85">18</reflink>]).</p> <p>Positive effects of these authentic experiences in the classroom have been self-reported by twice-exceptional students as young as Grade 2 and reported by their teachers (Zen Tall et al., [<reflink idref="bib60" id="ref86">60</reflink>]). Further, students in private schools tend to be from higher socio-economic status (SES) households than students in public schools. Russell et al. ([<reflink idref="bib49" id="ref87">49</reflink>]) indicated that there were significant correlations between financial difficulties within families and ADHD. These financial struggles often were a strong predictor for ADHD, with students from low-SES households more likely to be diagnosed with ADHD than their peers from more affluent families (Russell et al., [<reflink idref="bib50" id="ref88">50</reflink>]).</p> <p>Particularly, the findings of this study indicated prevalence rates for ADHD among gifted populations within the Partnership with Schools programs to be.60–2.90% and.62–2.02% when rated by teachers and parents, respectively. These findings would indicate that both teachers and parents see similar behaviours at school and at home and evaluate these behaviours in similar ways. These findings are also lower than worldwide prevalence rates of 5.2–7.2% reported by past researchers (Plancyk et al., [<reflink idref="bib45" id="ref89">45</reflink>]; Thomas et al., [<reflink idref="bib54" id="ref90">54</reflink>]). This may be explained by the quality and type of professional development provided to teachers that is targeted specifically towards serving gifted students, as well as the more collaborative environment between teachers and parents within the Partnership with Schools programs compared to public school environments. Nielsen ([<reflink idref="bib40" id="ref91">40</reflink>]) asserted that quality professional development in the areas of giftedness and twice-exceptionality were vital for teachers to serve and advocate for the needs of their students.</p> <p>Teachers in public schools reported higher incidence rates of ADHD (3.98–8.50%) within the gifted populations in their classrooms than did the teachers within the private school environment. Interestingly, parents of the students in these same classrooms reported higher incidences of ADHD symptoms (6.90–14.50%) than the teachers of these same students. Further, when at-risk factors across the range of ADHD symptomology were considered, these same parents reported a greater concern for their daughters (9.40–17.04%) than they did for their sons (9.30–12.48%). This differs from the reporting of at-risk factors made by the parents of students enrolled in the private schools. This is also counter to past research indicating that ADHD is identified at a higher rate in boys than in girls (e.g. Bauermeister et al., [<reflink idref="bib12" id="ref92">12</reflink>]; Centres for Disease Control, [<reflink idref="bib16" id="ref93">16</reflink>]; P et al., [<reflink idref="bib43" id="ref94">43</reflink>]). These findings may be the result of differing behavioural expectations within these families, who value more traditional gender roles for boys and girls.</p> <p>Based upon the difference in findings regarding the prevalence rates of ADHD symptomology identified by parents in public school settings, as opposed to their private school counterparts, this indicates the need for increased efforts to raise awareness of traits associated with giftedness, ADHD, and twice-exceptionality. Further, differences in ratings between teachers in private and public schools may be explained by the specialised training in both giftedness and twice-exceptionality received by teachers in the private school setting. Differences may also be attributed to the larger class sizes in public schools, making it more difficult for students to receive the individualised attention that students in private schools may receive. As a result, teachers in private schools may provide their students with more opportunities for differentiated instruction that meets their academic and social-emotional needs, for hands-on learning experiences, and problem-based learning.</p> <p>Finally, cultural diversity among faculty may be a factor in the differences in how teachers view ADHD. Researchers have noted the importance of the inclusion of multicultural perspectives, concepts, and materials in gifted classrooms (Ford & Trottman, [<reflink idref="bib23" id="ref95">23</reflink>]), particularly for students who are twice exceptional (Nielsen, [<reflink idref="bib40" id="ref96">40</reflink>]). Most teachers in public schools are Saudi Arabian compared to teachers in private schools who tend to come from a variety of Arab countries. This diversity in culture and nationality may explain differences in perceptions and awareness of the needs of gifted students with ADHD.</p> <hd id="AN0191629657-15">Limitations and Directions Further Research</hd> <p>The current study provides a foundation for future research examining the lived experiences of students who are gifted and have ADHD in Saudi Arabia. The scope of this research was limited to prevalence rates of giftedness and ADHD and did not address specific academic and social-emotional needs of this population of students. Further, although input from teachers and parents was sought regarding their perceptions of ADHD symptomologies in the students, they were not asked their thoughts as to potential causes or beliefs regarding proper care to meet their needs both at school and at home; such questions that could be examined in future research.</p> <hd id="AN0191629657-16">Acknowledgement</hd> <p>The authors extend their appreciation to the Researchers Supporting Project number (RSPD2025R705), King Saud University, Riyadh, Saudi Arabia, for funding this work.</p> <hd id="AN0191629657-17">Disclosure Statement</hd> <p>No potential conflict of interest was reported by the author(s).</p> <hd id="AN0191629657-18">Data Availability Statement</hd> <p>Data sharing not applicable to this article as no datasets were generated or analysed during the current study.</p> <p>Correction Statement</p> <p>This article has been republished with minor changes. 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  Label: Title
  Group: Ti
  Data: Prevalence Rates of Attention Deficit Hyperactive Disorder in Gifted and Talented Students in Saudi Arabia
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Abdulkarim+Alhossein%22">Abdulkarim Alhossein</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-7869-9921">0000-0001-7869-9921</externalLink>)<br /><searchLink fieldCode="AR" term="%22Rashed+Aldabas%22">Rashed Aldabas</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-3566-4777">0000-0002-3566-4777</externalLink>)<br /><searchLink fieldCode="AR" term="%22C%2E+Matthew+Fugate%22">C. Matthew Fugate</searchLink><br /><searchLink fieldCode="AR" term="%22Salaheldin+Farah+Bakhiet%22">Salaheldin Farah Bakhiet</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-5091-7402">0000-0002-5091-7402</externalLink>)<br /><searchLink fieldCode="AR" term="%22Juliana+Tay%22">Juliana Tay</searchLink><br /><searchLink fieldCode="AR" term="%22Nouf+M%2E+Alzrayer%22">Nouf M. Alzrayer</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Disability%2C+Development+and+Education%22"><i>International Journal of Disability, Development and Education</i></searchLink>. 2026 73(2):211-226.
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  Data: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
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  Label: Peer Reviewed
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  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 16
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2026
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Elementary+Secondary+Education%22">Elementary Secondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Incidence%22">Incidence</searchLink><br /><searchLink fieldCode="DE" term="%22Attention+Deficit+Hyperactivity+Disorder%22">Attention Deficit Hyperactivity Disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Academically+Gifted%22">Academically Gifted</searchLink><br /><searchLink fieldCode="DE" term="%22Twice+Exceptional%22">Twice Exceptional</searchLink><br /><searchLink fieldCode="DE" term="%22Elementary+Secondary+Education%22">Elementary Secondary Education</searchLink><br /><searchLink fieldCode="DE" term="%22Teacher+Attitudes%22">Teacher Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Attitudes%22">Parent Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Barriers%22">Barriers</searchLink><br /><searchLink fieldCode="DE" term="%22Public+Schools%22">Public Schools</searchLink><br /><searchLink fieldCode="DE" term="%22Private+Schools%22">Private Schools</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Saudi+Arabia%22">Saudi Arabia</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/1034912X.2025.2502043
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1034-912X<br />1465-346X
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Reports have estimated worldwide-pooled prevalence rates for Attention Deficit Hyperactive Disorder (ADHD) to be 5.2%-7.2%. However, estimated prevalence rates can be difficult to determine due to the variability of diagnoses within and among different countries. Prevalence rates for ADHD among 22 Arab countries has been found to range between 1.3% and 16%. In this study, the researchers examined the prevalence twice-exceptionality -- those students who are gifted with ADHD -- among 766 students aged 5-17 attending private and public schools in Saudi Arabia. Implications for the findings of this study include the need for more education regarding the needs of these students among teachers and parents, as well as the form and type of educational programming provided to them in schools.
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  Group: Date
  Data: 2026
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1504157
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1504157
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/1034912X.2025.2502043
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 16
        StartPage: 211
    Subjects:
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Incidence
        Type: general
      – SubjectFull: Attention Deficit Hyperactivity Disorder
        Type: general
      – SubjectFull: Academically Gifted
        Type: general
      – SubjectFull: Twice Exceptional
        Type: general
      – SubjectFull: Elementary Secondary Education
        Type: general
      – SubjectFull: Teacher Attitudes
        Type: general
      – SubjectFull: Parent Attitudes
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      – SubjectFull: Barriers
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      – SubjectFull: Public Schools
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      – SubjectFull: Private Schools
        Type: general
      – SubjectFull: Saudi Arabia
        Type: general
    Titles:
      – TitleFull: Prevalence Rates of Attention Deficit Hyperactive Disorder in Gifted and Talented Students in Saudi Arabia
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