Content uploaded by Juan Pedro Serrano
Author content
All content in this area was uploaded by Juan Pedro Serrano on Feb 13, 2017
Content may be subject to copyright.
Psychology, 2017, 8, 319-334
http://www.scirp.org/journal/psych
ISSN Online: 2152-7199
ISSN Print: 2152-7180
DOI: 10.4236/psych.2017.83019 February 13, 2017
Creativity in Children with Attention Déficit
Hyperactivity Disorder (ADHD)
Gracia Gonzalez-Carpio1, Juan Pedro Serrano2, Marta Nieto3
1Child and Youth Mental Health Unit, Castilla La Mancha University Hospital, Toledo, Spain
2Department of Psychology, School of Medicine Castilla-La Mancha, Albacete, Spain
3Department of Psychology, School of Nursing Castilla-La Mancha, Cuenca, Spain
Abstract
Research about creativity in ADHD children is very limited and has shown
discordant results. Some features of cognitive functioning in ADHD,
such as
scattered attention,
difficulty suppressing brain activity of the default neural
network, inefficiency to inhibit irrelevant stimuli that access consciousness, or
common markers-based genetics
, are at the base of the connection between
ADHD and creativity. The aim of this study is to explore whether the
ADHD
children are more creative and obtain better results in the divergent tasks tr
a-
ditionally considered as measures of creativity regarding c
hildren control.
Method:
The sample comprised 68 children, aged 8 to 13 years. A group of 34
children diagnosed with ADHD (M age 10.5, SD = 1.6) was
compared to a
control group of 34 without ADHD (M age = 10.8, SD = 1.7). None were u
n-
der pharmacological treatment. The children were assessed using the To
r-
rance Tests of Creative Thinking Figurative (TTCT).
Results: ADHD children
showed better results in some areas of creativity, showing higher scores in
Fluency, with a greater number of responses, Originality, with a greater nu
m-
ber of unusual or unconventional responses, together with higher scores in
Creative strengths, which include measures for movement or action, em
o-
tional expressiveness, story-telling articulateness, unusual visualization, h
u-
mor or fantasy. Partial
η
2 effect sizes ranged from 0.19 to 0.34. As a cons
e-
quence of those partial superior resultados, the ADHD children show a higher
global creativity index than the control group.
Conclusions:
Our results su
g-
gest that children diagnosed with ADHD are more creative, than typically d
e-
veloping children, not in all evaluated areas but in some of them. This finding
could provide guidance for the use of more effective assessments and inte
r-
ventions to promote this positive quality in children with ADHD.
Keywords
ADHD, Children, Creativity, Torrance Tests of Creative Thinking
How to cite this paper:
Gonzalez-Carpio,
G
., Serrano, J. P., & Nieto, M. (2017). Crea-
tivity in Children with Attention Déficit
Hyperactivity Disorder (ADHD)
.
Psycho
l-
ogy
, 8,
319-334.
https://doi.org/10.4236/psych.2017.83019
Received:
December 14, 2016
Accepted:
February 10, 2017
Published:
February 13, 2017
Copyright © 201
7 by authors and
Scientific
Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY
4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access
G. Gonzalez-Carpio et al.
320
Figurative (TTCT)
1. Introduction
Whether there is a greater disposition for creativity in children with attention
deficit hyperactivity disorder (ADHD) than in typically developing children re-
mains inconclusive (Paek, Abudulla, & Cramond, 2016). Yet, the hypothesis is
attractive insofar as it could highlight positive characteristics of children with
ADHD. According to the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) from the American Psychiatric Association (2013), ADHD is characte-
rized by the appearance of three core symptoms: inattention, hyperactivity and
impulsiveness. It is described as a persistent pattern of personal functioning that
prevents typical normalized development or daily activities and negatively inter-
feres with school activities. ADHD is one of the most frequently diagnosed dis-
orders in the child population. A meta-analysis conducted by Polanczyk, Lima,
Horta, Biederman, & Rohde (2007) initially estimated a prevalence of 5.3%
among individuals under the age of 18. Drawing on a review of 175 studies on
ADHD prevalence, a work by Thomas, Sanders, Doust, Beller, & Glasziou (2015)
estimated an overall pooled estimate of 7.2% in the whole child population.
The most direct consequence of this disorder is the impact on different as-
pects of personal and social relationships (Barkley et al., 2002). Broadly speak-
ing, in comparison with typically developing children, ADHD children are more
likely to drop out of the educational system, less likely to complete a university
degree, more likely to work in lower class employment, more likely to be in-
volved in antisocial activities and high-risk situations, and frequently present
difficulties and conflicts, in relationships with peers and families. In a longitu-
dinal study (Holbrook et al., 2014), over a 6-year period, children ADHD were
aged from 5 to 13 years. They found that inattention symptoms were maintained
until adolescence, and the symptoms of hyperactivity impulsivity decreased with
age. According to Biederman, Petty, Clarke, Lomedico, & Faraone (2011), in
their 11 years of follow-up of children with ADHD, these difficulties tend to ap-
pear in early childhood and persist into adulthood. Their study shows that once
diagnosed, in different degrees and in different areas, the disorder continues to
affect 78% of subjects with ADHD in adulthood, with variations according to
clinical or subclinical symptoms.
Creativity is regarded as an individual’s ability to generate new ideas and po-
tentially useful solutions in different situations (Sternberg & Lubart, 1996). De-
spite multiple theories of creativity (Runco, 2014; Sternberg, Kaufman, & Pretz,
2002), a consensus appears to exist that novelty and utility are two key factors in
the creative process (Plucker, Beggheto, & Dow, 2004; Runco, 2007; Sternberg &
Lubart, 1999). The novelty or originality of a response is defined in statistical
terms by its rarity or singularity; utility refers to the capacity to achieve an objec-
tive in a certain context. For Simonton (2004), the concept of creativity requires
G. Gonzalez-Carpio et al.
321
the willingness to think outside the usual norms, to find novelty and the uncon-
ventional along with the ability to be open to experience. It is for this reason that
the creative people have as characteristics such us unfocused attention, divergent
thought, and behaviors oriented to the independence and nonconformity. This
form of functioning, can also be presented in ADHD people. Cramond (1994a)
warned about possible overlapping functional traits of creative children and
ADHD children. Sternberg & Kaufman (2010) warned about the risk of not
identifying creative people hidden by their ADHD. The relationship between
ADHD and creativity is based on possible overlapping forms of functioning,
similar cognitive or neurological characteristics.
It should also be considered that intellectual ability is one of the factors that
may be affecting creativity, according to (Jauk, Benedek, & Neubauer, 2014) de-
pends on the intelligence the conversion of skills or knowledge gained in re-
markable creative achievements.
In the case of children, there is an added difficulty in evaluating creativity, the
tests measure their creative potential, since recognized creative products may
need time, experience and a level of knowledge not reached in childhood making
it necessary to evaluate their potential creativity (Beghetto & Kaufman, 2007).
Consistent with this consensus on the nature of creativity, one of the most rep-
resentative and widely used divergent thinking tests to measure creative poten-
tial is the Torrance Tests of Creative Thinking (TTCT, Torrance, 1974; 2008). It
measures different creativity dimensions that are defined in Table 1.
Table 1. TTCT figurative Torrance subtests.
Dimension
Creativity Definition Score range
Min.-max
Fluency The number of drawings completed. 40 - 153
Originality The statistical infrequency and unusualness of the response. 40 - 154
Elaboration
The individual’s ability to develop, extend and elaborate
upon ideas: the number of additional details used in
developing the response beyond what would be strictly
necessary for the basic response.
40 - 160
Abstractness
Titles
The ability to produce good titles using synthesizing and
organizing processes. The ability to capture the essence. Such a
title enables the viewer to see the picture more deeply and richly.
40 - 160
Resistance
Premature
Closure
A creative person’s ability to stay open and tolerate ambiguity
long enough to generate novel ideas and perform the mental
leap that makes possible original ideas.
40 - 160
13 Creative
Strengths
Emotional expressiveness, storytelling articulateness (context,
environment), movement or action, expressiveness of titles,
synthesis of incomplete figures, synthesis of line or circles,
unusual visualization, internal visualization, extending
boundaries, humor, richness of imagery,
colorfulness of imagery, fantasy.
1 - 26
G. Gonzalez-Carpio et al.
322
1.1. Neurological Hypothesis
The common nexus between ADHD and creativity is based on forms of cogni-
tive functioning, such as a delay in cortical maturation affecting two aspects, the
maturation process trajectory and final cortical thickness reached. In children
with ADHD this process can be delayed by two or more years, compared to the
typical development expected for children without ADHD, as documented by
authors (El-Sayed, Larsson, Persson, Santosh, & Rydelius, 2003; Shaw et al.,
2007). This delay, from the point of view of Thompson-Schill, Ramscar & Chry-
sikou (2009), would offer an evolutionary advantage since this immaturity in the
prefrontal control, where the executive functions are located, regulates the
thought and the behavior and favors a flexible way of thinking that is not condi-
tioned by expectations or beliefs. Uncontrolled cognition allows us to approach
new solutions or creative ideas without limitations.
Regarding the way to confront the creative task, there are similarities of func-
tioning between ADHD and creative, both groups show difficulties for the deac-
tivation of the default neural network (DNN) to tasks that require more mental
effort, which leads to the maintenance of a dispersed, unfocused mental state
(Mattfeld et al., 2014, Sonuga-Barke & Castellanos, 2007, Uddin et al., 2008).
At the genetic level the common nexus between the creative and the ADHD
group is based on that they can share some genetic markers, all of them related
to dopaminergic neurotransmission. One of the most supportive hypotheses is
the presence of the DRD4-7R gene (Auerbach, Benjamin, Faroy, Geller, & Ebs-
tein, 2001, Dietrich & Kanso, 2010, Munafò, Yalcin, Willis-Owen, & Flint, 2008),
known as the search for novelty gene and at the same time associated with a
greater dispersion and attentional amplitude, present in ADHD, make essential
traits for divergent thinking emerge, (Auerbach et al., 2001). This behavior can
already be identified in very young children, around one year of age, when they
perform tasks of structured play and tasks of information processing that require
a certain degree of attention, this form of carrying operation with more dis-
persed attention and preference for novelty was observed with greater intensity
in children DRD4-7R gene compared to children without the 7R allele (Auer-
bach et al., 2001).
1.2. Experimental Studies with ADHD Children
Other authors have found evidence for widened attentional focus which would
enhance creative processes in ADHD children. Shaw & Brown (1990, 1991) dem-
onstrated that ADHD children used more diverse nonverbal information and
were able to focus attention on different stimuli in their immediate environ-
ment, resulting in higher figural creativity. Other authors suggest the inability of
ADHD children to screen out irrelevant stimuli when performing a task (latent
inhibition) results in the availability of more stimuli for use in creative processes
(Carson, Peterson, & Higgins 2003; Pritchard, Healey, & Neumann, 2006).
A number of studies have addressed the relationship between ADHD and
creativity, with a variety of designs and findings. Healey & Rucklidge (2006)
G. Gonzalez-Carpio et al.
323
found that 40% of creative children showed elevated levels of ADHD sympto-
matology, although none met the clinical diagnostic criteria for ADHD. Using
Torrance’s Figurative TTCT, Cramond (1994b) compared a group of children
with ADHD and a group of creative children, finding that 26% of creative child-
ren had ADHD trends measured on the SNAP-IV scale (Swanson, 2003) and
that 36% of children with ADHD scored high on creativity.
In the study conducted by Abraham, Windmann, Siefen, Daum, & Güntürkün
(2006) on creative cognition in ADHD, adolescents ADHD outperformed
healthy and matched control participants in the task of giving new uses to a toy.
Their poor inhibitory control or being easily distractible make them better able
to override the restrictive influence imposed by relevant or relevant knowledge
when it comes to being creative. And they can expand conceptual structures to
include unusual or new associations. Taylor (2006) found that children with
ADHD had high levels of fluidity and flexibility, understanding that the latter
was the ability to generate varied ideas. According to White & Shah (2006),
young adults with ADHD were more likely to find creative solutions than those
who did not, showing a preference for generating ideas. However, they did not
perform better than the control group when “correct” responses were required
(White & Shah, 2011). In contrast to the above, other authors (Healey & Ruck-
lidge, 2005; Sang, Yu, Zhang, & Yu, 2002) did not find that children with ADHD
were more creative than those who did not.
One of the potential methodological problems in comparing the different stu-
dies is the lack of control of the medication status of research participants, since
pharmacological treatment can improve attention deficit symptoms (Pliszka,
2007; Swanson, Cantwell, Lerner, McBurnett, & Hanna, 1991) but can also de-
crease curiosity, exploratory effort and cognitive flexibility (Hansen & Hansen,
2006). High doses can produce excessive focusing and clinical symptoms of per-
severation (Tannock & Schachar, 1992), findings suggest that methylphenidate
(MPH) may reduce cognitive flexibility temporarily in some ADHD children,
and as recently demonstrated, can decrease fluency, originality and number of
creative strengths and the overall index of creativity, measured by the TTCT-
Figurative (González-Carpio & Serrano, 2016). Other authors have found no re-
lationship between medication and excessive focusing and widened attentional
focus (Douglas, Barr, Desilets, & Sherman, 1995; Funk, Chessare, Weaver, & Ex-
ley, 1993).
Limited research with children with ADHD shows that there is a controversy
surrounding the greater or lesser degree of creativity in people with ADHD, es-
pecially in the child population, the aim of this study was to analyze the possible
differences in creativity in a group of ADHD children compared to a control
group, none of whom were under pharmacological treatment. Our hypothesis
was that children with ADHD would perform better on creativity than the con-
trols.
Creativity was operationalized using the Torrance Tests of Creative Thinking
Figurative (Torrance, 1998, 2008) scored for each of the five dimensions of crea-
G. Gonzalez-Carpio et al.
324
tivity (Fluency, Originality, Elaboration, Abstractness of Titles and Resistance to
Closure), the sum of Creative Strengths, which measure characteristics of crea-
tive personality, and the Creativity Index, which combines the five dimensions
and the creative strengths score.
2. Methods
2.1. Participants
2.1.1. Participants with ADHD
A total of 34 children with ADHD participated in the study, all outpatients re-
cruited from the Child and Youth Mental Health Unit (SMIJ) at the Virgen de la
Salud Hospital, Toledo (Spain). The diagnosis was given by experienced clinical
psychologists, following the DSM-5 criteria. The assessment used a children’s
mental health interview with parents and children covering all developmental
aspects, symptoms over the last six months and current symptoms, and informa-
tion obtained from teachers at the children’s schools. Teachers completed the
SNAP-IV scales (Swanson, 2003). Children with an ADHD diagnosis were in-
cluded if within the age range 8 to 13 years and willing to take part in the study.
All ADHD children taking stimulant medication, or any other type of medica-
tion, at the time of the study or during the previous year, were excluded, as were
those presenting associated disorders, anxiety disorders, mood state disorders,
and child or adolescent onset antisocial behavior and autism spectrum disorders.
We also excluded children with low intellectual capacity, neurological disorders,
or uncorrected visual or hearing problems. Out of 34 children belonging to the
ADHD group 16 were ADHD with no other diagnoses added and the remaining
18 were ADHD with one or more associated disorders, including: four cases of
oppositional defiant disorder; (F91.8), two cases of enuresis, in the younger age
group (F98.1), 12 had reading-writing disorders, (F81.0) along with learning dif-
ficulties, (F81) and because of these difficulties, seven had also repeating a school
year.
2.1.2. Participants without ADHD
A total of 34 children in a similar age range of 8 to 13 years were selected for the
control group. All the participants were below the threshold for ADHD diagno-
sis, confirmed by experienced clinical psychologists. Clinical interviews were
conducted with children and parents and information was collected from teach-
ers by use of the SANP-IV scales. The children’s mental health history was also
consulted. The control group was recruited from patients attending the SMIJ for
various reasons, specifically.
The difficulties of this group of children who attended the consultation were:
six children had unspecified learning disorders (F81.9), six children had repeated
courses due to poor school performance, (Z55.3), a child had somnambulism ,
(F51.3), 10 children with problems related to family breakup by separation,
(Z63.5), five children with problems related to adjustment to vital transitions,
(Z60.0), two cases of bullying, (Z55.4), a child with problems related to inade-
G. Gonzalez-Carpio et al.
325
quate social skills, (Z73.4) and three cases without pathology. We established
two groups matched by age, gender and place of origin. Selection was conducted
simultaneously with the ADHD group. The same exclusion criteria were used as
for the ADHD participants. Table 1 shows the characteristics of the ADHD and
control group.
2.2. Procedure
Participants were recruited from children referred to the Child
and
Youth Men-
tal Health Unit (USMI) by the pediatric neurology service, the pediatrician or
the family physician at the local health centers. For your evaluation, either for
suspected ADHD or other problems. Subsequently, the SNAP-IV scales per-
formed by the teacher were analyzed and punctuated, and the clinical diagnostic
interview was carried out to complete the history of children’s mental health.
Once the information was verified from the three points of view the school,
family and clinical diagnosis was established by clinical psychologists. After the
evaluation, children and families were voluntarily invited to participate in the
study, following the inclusion criteria/Exclusion mentioned above. Once consent
was given, the K-BIT test battery was administered to measure intellectual ability
and in a subsequent session the TTCT-Figurative creativity test was adminis-
tered. The tests were performed by a single investigator, previously trained to
administer and record the test, which facilitated consistent data collection. Each
session lasted between 60 and 90 minutes, depending on the willingness of each
child to collaborate. The TTCT-figurative was administered in a relaxed manner
appropriately. The children were asked to draw pictures, following the instruc-
tions in the test manual. All procedures followed were in accordance with the
ethical standards of the committee responsible for human experimentation (in-
stitutional and national) and with the Declaration of Helsinki of 1975, revised in
2000 (Manzini, 2000).
2.3. Measures
ADHD symptom rating scale.
The SNAP-IV Rating Scale Revised IV-R (Swan-
son, 2003) is a scale with nine Likert-type items (range 0 - 3) for the attention
subscale and nine items for the hyperactivity-impulsivity subscale. The scale is
completed by teachers, who rate the presence of the symptoms. Scores represent
the average rating per item on each subscale and the total scale. Percentile 95 is
used as the cut-off point for normality. Cut-off points for the teacher rating: 1)
For attention deficit: 2.56, 2) For hyperactivity/impulsivity: 1.78, and 3) 2.00 for
attention deficit and hyperactivity/impulsivity.
Intellectual functions.
The Kaufman Brief Intelligence Test (K-BIT) (Cordero &
Calonge, 2000) is a general intelligence measure consisting of two subtests: vo-
cabulary (expressive vocabulary and definitions) and matrices. The scores ob-
tained have a mean of 100 and a standard deviation of 15, for both the vocabu-
lary and matrices subtests and the compound intelligence quotient.
Measure of creativity.
Torrance Tests of Creative Thinking-Figural (TTCT),
G. Gonzalez-Carpio et al.
326
parallel forms A and B (Torrance, 2008), translated into Spanish, consist of three
subtests or games: 1) constructing a drawing, 2) completing a drawing, and 3)
making different drawing using two parallel lines. Five dimensions comprising
creativity are evaluated. Table 1 defines the five subscales or dimensions of crea-
tivity and the thirteen creative strengths. A total Creativity Index is derived from
the five dimensions and the Creative strengths. The battery enables conversion
of test scores to percentiles with a mean of 100 and standard deviation of 20.
Torrance (1998) reported reliability ranging from 0.89 to 0.94, and Torrance
(1990) reported that reliability was over 0.90. According to the study by Kim,
Cramond, & Bandalos (2004), the alpha coefficient for consistency was 0.79.
2.4. Data Analysis
Scores were distributed normally to groups, as assessed by the Shapiro-Wilk
normality (
p
> 0.05). There was homogeneity of variances, as assessed by Le-
vene’s test of homogeneity of variance (
p
> 0.05). Box plots revealed an atypical
value but this was not omitted from the study as it did not affect the results.
One-factor ANOVAs were conducted to compare ADHD and control group
scores on each dimension of creativity and the total score. Effect sizes were cal-
culated for all the comparisons of means, following Cohen (1988), using eta par-
tial squared (
η
2 p) to more accurately determine the magnitude of the difference
(Castro & Martini, 2014). An alpha of 0.05 was set for the statistical analysis.
SPSS version 20.0 was used for data analysis.
No significant differences were found between the ADHD children and con-
trols for age, gender or general intellectual capacity. As expected, the children
without ADHD obtained significantly lower scores and did not meet the cut-off
points on the SNAP-IV questionnaire to assess ADHD symptoms.
No significant differences were found between the ADHD children and con-
trols for age, gender or general intellectual capacity. As expected, the children
without ADHD obtained significantly lower scores and did not meet the cut-off
points on the SNAP-IV questionnaire to assess ADHD symptoms.
Regarding the ADHD group, no significant differences were found between
the two subtypes predominantly inattention or hyperactivity-impulsivity, re-
garding scores on the SNAP-IV scale, according t (33) −1.372,
p
= 0.179 d =
0.23. So, they have not been able to differentiate specific subtypes, being grouped
for subsequent analysis. The control group, also not found significant differences
t (33) −1.630,
p
= 0.113, d = 0.28.
A one-factor ANOVA was conducted to determine whether there were dif-
ferences between the children with ADHD and the controls for the levels of flu-
ency, originality, elaboration, abstractness of titles, resistance to premature clo-
sure, creative strengths and the overall creativity index. Analysis of each variable
showed significant differences for fluency, originality, creative strengths and the
overall creativity index with a large effect size. No significant differences were
found between the children with ADHD and the controls for elaboration, ab-
stractness of titles or resistance to premature change (Table 2), with effect size.
G. Gonzalez-Carpio et al.
327
Table 2. Characteristics of the ADHD and control group samples. Data refer to mean and
standard deviation.
Characteristics
TDAH
(n = 34)
Control
(n = 34)
t
Sig.
d
a
Age 10.5 ± 1.6 10.8 ± 1.0 −0.043 0.966 0.182
Gender (Female./Male.) 10/24 9/25 −0.266 0.791 -
SNAP-IV b
Total 2.42 ± 0.21 0.92 ± 0.19 30.68
-
-
-
0.000*
-
-
-
7.49
-
-
-
H-Ic 2.45 ± 0.28 0.89 ± 0.23
DAd 2.36 ± 0.28 0.83 ± 0.20
IQe Total 102.74 ± 10.65 97.26 ± 12.19 1.97 0.053 0.478
F
Sig.
η2
f
Creativity indexg 109.97 ± 13.54 94.79 ± 13.29 21,756 0.000* 0.248
Fluency 116.09 ± 9.11 100.9 ± 12.05 34.331 0.000* 0.343
Originality 116.5 ± 13.11 103.5 ± 13.96 15.450 0.000* 0.190
Elaboration 81.06 ± 14.85 75.56 ± 11.09 2.993 0.088 0.043
Abstrac. Titles 96.85 ± 20.21 90.62 ± 17.14 1.883 0.175 0.028
Resist Closure 75.38 ± 14.29 71.79 ± 14.83 1.032 0.313 0.015
Cret. Strengths 14.06 ± 4.58 8.82 ± 4.34 23.424 0.000* 0.282
Note. aCohen’s effect size d: insignificant < 0.20, small 0.20 a 0.50, medium 0.50 a 0.80 and > 0.80
large. bSNAP-IV, ADHD symptom rating scale. cH-I hyperactivity-impulsivity. dDA inattention.
eIntelligence quotient on K-BIT. fEffect size
η
2 partial Cohen.: <0.01 small, 0.06 medium y > a 0.14
large. gCreativity index TTCT Figurative Torrance. *Level of significance
p
< 0.05.
3. Discussion
The aim of our study was to verify whether ADHD children are more creative
than typically developing children. Defining creativity as a form of divergent
thinking, we used the TTCT-Figurative as our assessment instrument. Our re-
sults indicate that ADHD children score higher than controls on the Fluency
subtest, a task consisting of generating as many different drawings as possible
from an initial neutral stimulus. Similarly, Shaw & Brown (1999) found that
ADHD children generated a greater number of imaginative responses, especially
when aroused, and Abraham et al. (2006) found that ADHD children performed
better on tasks where they were given a limited time to generate as many novel
ideas for toys as possible.
Our results also show that children with higher fluency scores also score
higher on Originality of ideas. This observation coincides with Kim et al. (2004)
and Torrance & Safter (1999), who found that children who produce a large
number of ideas are also more likely to generate original ideas. According to
Krumm, Lemos, & Filippetti (2014), fluency and originality form part of the in-
novation factor reflects the different ways of approaching creative problem solv-
ing. In their view, the most innovative children prefer to obtain creative results
through “outside the box” thinking, which could be at the core of ADHD child-
ren’s functioning.
Children with ADHD also scored higher on Creative strengths, giving more
G. Gonzalez-Carpio et al.
328
responses implying unusual visualization of perspective, representing internal
content or visualization from unexpected angles, as well as figures, objects or
nature in movement. This is in line with the findings of other studies such as
that by Sahib (2012), in a group of 40 ADHD children of 5 and 6 primary grades
evaluated by TTCT figurative, compared to the control group, in which ADHD
group exhibited more movement responses and a greater number of imaginative
stories than controls, although both groups provided the same number of fanta-
sy responses.
In our study, no significant differences were found between ADHD children
and controls for the other dimensions of Elaboration, Abstractness of titles and
Resistance to premature closure.
So, in the overall Creativity Index that combines the scores of the five subtests
and is a global assessment of creative potential, the children with ADHD scored
significantly higher than control children.
In the present study, 21% of children with ADHD scored at or above 70% for
the overall creativity index, according to the age-adjusted scale for a general
population. This percentage suggests that there are more highly creative children
in the ADHD group than in a general population. The percentage of highly crea-
tive children in the ADHD group in the present study was not as high as that
obtained by Fugate, Zentall, & Gentry (2013), who, using the TTCT-figurative,
found that 41% of their ADHD group scored O above the 90th percentile in the
overall creativity index. In their ADHD group, however, 53% reached or over the
70th percentile in intellectual ability, which may have been a determining factor
in the results (Shaw & Brown, 1990, 1991). With a sample of 34 children with
ADHD, Cramond (1994b) found that 50% scored above the 70th percentile in
TCTT-Figurative, thus exhibiting high intellectual and creative abilities.
Although there is no total agreement on the threshold hypothesis, it establishes
outside IQ range 80 - 120 intellectual capacity becomes independent of creativi-
ty. The relationship between creativity and intellectual ability suggests the need
for further research into this relationship, including other factors such as moti-
vation or personality factors.
In conclusion, our results show that children with ADHD aged 8 to 13 exhi-
bited greater general and specific creative potential in certain areas (fluency, ori-
ginality and creative strengths) but presented no differences from controls in
other areas (elaboration, abstractness of titles and resistance to premature
change). It would be of great interest to know if this creative potential is con-
verted into creative achievements in the future.
3.1. Implications
The correct identification of ADHD children to their full potential would favor
their integration and adaptation to the school system and if the existence of
greater creative ability in ADHD children was revealed as a trend, it could help
in identifying positive aspects of these ADHD children. This would make it
possible to improve the traditional evaluation systems that usually only focus on
G. Gonzalez-Carpio et al.
329
the deficits presented.
This would allow us to have a more complete view of these children and po-
tentially, this could contribute to better designs of treatments that enhance their
creativity, even though ADHD does not possess this characteristic uniformly and
above the rest of the population. First, at the educational level, intervention
plans can be designed to improve their already traditional academic perfor-
mance deficiency. But they also improve the vision that parents and partners
have of these children usually impaired by behavior problems.
Secondly, the diagnosis would also be improved, since as Cramond (1994a)
points out. The consequences of not identifying creative children due to their al-
tered and unconventional behavior may affect their use in all areas. But creativi-
ty can also be hidden in ADHD, due to only considering the negative part of the
disorder, so a misdiagnosis and the use of a pharmacological treatment must be
performed from both perceptive.
The potentialities of this study about children with ADHD were carried out in
a trend to develop an innovative intervention.
Based on this assumption the line of research of the present work has sought
to provide a further advance in the knowledge of the functioning of a group of
ADHD children, for future designs of effective treatments and educational in-
terventions. If, as we have seen, creativity in some areas offers some advantage
for ADHD, it could be evaluated and used as compensatory features of its habi-
tual difficulties.
3.2. Limitations and Future Research
The size of the sample may make it difficult to obtain significant results, but it
has been compensated by obtaining a size effect of the differences obtained from
moderate to large, which has allowed us to generalize results. The sample size
may also affect the originality subtest, as its score is based on the number of un-
usual responses according to the TTCT manual guidelines, some authors found
that originality may be different for each specific culture. Should be considered
for research in large populations, allowing the establishment of scales adapted to
the study population. In this study, we have focused on creativity limited to as-
sessing the creative potential that is expected to be most associated with creativ-
ity in children who have not yet had the opportunity to be evaluated from possi-
ble future achievements. The psychometric evaluation of creativity has been
based on the divergent thinking tests (Runco & Acar, 2012), but the multifaceted
nature of creativity makes it necessary in future research to measure from dif-
ferent perspectives, where self-report measures, information collected from
parents/teachers and real achievements can be included.
Simonton (2014) showed that creativity and psychopathology could share
common traits. Moreover, at the extreme of greater psychopathology this rela-
tionship disappears (Abraham, 2015). Severe mental health disorders were re-
fused in this study to avoid influencing outcomes. Although in future research
the relationship between mental health pathologies clinical and subclinical, in
G. Gonzalez-Carpio et al.
330
children and creativity may have implications for explaining creativity.
Acknowledgements
We would like to give our thanks to Margaret Gatz (University of Southern Cal-
ifornia) for her collaboration in the revision of this article.
Declaration of Conflicting Interest
The authors declared no potential conflicts of interest with respect to the re-
search, authorship, and/or publication of this article.
References
Abraham, A. (2015). Is There an Inverted-U Relationship between Creativity and Psy-
chopathology?
Frontiers in Psychology, 5,
13-15.
Abraham, A., Windmann, S., Siefen, R., Daum, I., & Güntürkün, O. (2006). Creative
Thinking in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD).
Child
Neuropsychology, 12,
111-123. https://doi.org/10.1080/09297040500320691
American Psychiatric Association (2013).
Diagnostic and Statistical Manual of Mental
Disorders (DSM-5).
Washington, D.C.: American Psychiatric Association.
https://doi.org/10.1176/appi.books.9780890425596
Auerbach, J. G., Benjamin, J., Faroy, M., Geller, V., & Ebstein, R. (2001). DRD4 Related to
Infant Attention and Information Processing: A Developmental Link to ADHD?
Psy-
chiatric Genetics, 11,
31-35. https://doi.org/10.1097/00041444-200103000-00006
Barkley, R. A., Cook, E. H., Diamond, A., Zametkin, A., Thapar, A., & Teeter, A. (2002).
International Consensus Statement on ADHD.
Clinical Child and Family Psychology
Review, 5,
89-111. https://doi.org/10.1097/00004583-200212000-00001
Biederman, J., Petty, C. R., Clarke, A., Lomedico, A., & Faraone, S. V. (2011). Predictors
of Persistent ADHD: An 11-Year Follow-Up Study.
Journal of Psychiatric Research, 45,
150-155. https://doi.org/10.1016/j.jpsychires.2010.06.009
Beghetto, R. A., & Kaufman, J. C. (2007). Toward a Broader Conception of Creativity: A
Case for Mini-C Creativity.
Psychology of Aesthetics, Creativity, and the Arts, 1,
73-79.
https://doi.org/10.1037/1931-3896.1.2.73
Carson, S. H., Peterson, J. B., & Higgins, D. M. (2003). Decreased Latent Inhibition Is
Associated with Increased Creative Achievement in High-Functioning Individuals.
Journal of Personality and Social Psychology, 85,
499-606.
https://doi.org/10.1037/0022-3514.85.3.499
Castro, M. C., & Martini, H. A. (2014). Statistical Power and Effect Size Calculating in
g*Power: Complementary Analysis of Statistical Significance Testing and Its Applica-
tion in Psychology.
Salud & Sociedad, 5,
210-224
Cordero, A., & Calonge, I. (2000).
Test Breve de Inteligencia de Kaufman (K-BIT).
Adap-
tación Española. Madrid: Pearson [Kaufman, A. S., & Kaufman, N. L. (1990).
K-BIT:
Kaufman brief intelligence test
. American Guidance Service.]
Cohen, J. (1988).
Statistical Power Analysis for the Behavioral Sciences
. Hillsdale, NJ:
Lawrence Erlbaum Associates.
Cramond, B. (1994a). Attention Deficit Hyperactivity Disorder and Creativity—What Is
the Connection.
Journal of Creative Behavior, 28,
193-210.
https://doi.org/10.1002/j.2162-6057.1994.tb01191.x
Cramond, B. (1994b).
The Relationship between Attention-Deficit Hyperactivity Disord-
G. Gonzalez-Carpio et al.
331
er and Creativity
.
Dietrich, A., & Kanso, R. (2010). A Review of EEG, ERP, and Neuroimaging Studies of
Creativity and Insight.
Psychologica
l
Bulletin and Review, 136,
822-848.
https://doi.org/10.1037/a0019749
Douglas, V. I., Barr, R. G., Desilets, J., & Sherman, E. (1995). Do High Doses of Stimu-
lants Impair Flexible Thinking in Attention-Deficit Hyperactivity Disorder?
Journal of
the American Academy of Child & Adolescent Psychiatry, 34,
877-885.
https://doi.org/10.1097/00004583-199507000-00011
El-Sayed, E., Larsson, J. O., Persson, H. E., Santosh, P. J., & Rydelius, P. A. (2003). “Ma-
turational Lag” Hypothesis of Attention Deficit Hyperactivity Disorder: An Update.
Acta Pediatrics, 92,
776-784. https://doi.org/10.1111/j.1651-2227.2003.tb02531.x
Fugate, C. M., Zentall, S. S., & Gentry, M. (2013). Creativity and Working Memory in
Gifted Students with and without Characteristics of Attention Deficit Hyperactive Dis-
order Lifting the Mask.
Gifted Child Quarterly, 57,
234-246.
https://doi.org/10.1177/0016986213500069
Funk, J. B., Chessare, J. B., Weaver, M. T., & Exley, A. R. (1993). Attention Deficit
Hyperactivity Disorder, Creativity, and the Effects of Methylphenidate.
Pediatrics, 91,
816-819.
González-Carpio, G., & Serrano, J. P. (2016). Medication and Creativity in Attention
Deficit Hyperactivity Disorder (ADHD).
Psicothema, 28,
20-25.
Hansen, D. L., & Hansen, E. H. (2006). Caught in a Balancing Act: Parents’ Dilemmas
Regarding Their ADHD Child’s Treatment with Stimulant Medication.
Qualitative
Health Research, 16,
1267-1285. https://doi.org/10.1177/1049732306292543
Healey, D., & Rucklidge, J. J. (2005). An Exploration into the Creative Abilities of Child-
ren with ADHD.
Journal of Attention Disorders, 8,
88-95.
https://doi.org/10.1177/1087054705277198
Healey, D., & Rucklidge, J. J. (2006). An Investigation into the Psychosocial Functioning
of Creative Children: The Impact of ADHD Symptomatology.
Journal of Creative Be-
havior, 40,
243-264. https://doi.org/10.1002/j.2162-6057.2006.tb01276.x
Holbrook, J. R., Cuffe, S. P., Cai, B., Visser, S. N., Forthofer, M. S., Bottai, M., McKeown,
R. E. et al. (2014). Persistence of Parent-Reported ADHD Symptoms from Childhood
through Adolescence in a Community Sample.
Journal of Attention Disorders, 20,
11-20. https://doi.org/10.1177/1087054714539997
Jauk, E., Benedek, M., & Neubauer, A. C. (2014). The Road to Creative Achievement: A
Latent Variable Model of Ability and Personality Predictors.
European journal of per-
sonality, 28,
95-105. https://doi.org/10.1002/per.1941
Kim, K. H., Cramond, B., & Bandalos, D. L. (2004). The Latent Structure and Measure-
ment Invariance of Scores on the Torrance Tests of Creative Thinking-Figural.
Educa-
tional and Psychological Measurement, 66,
459-477.
https://doi.org/10.1177/0013164405282456
Krumm, G., Lemos, V., & Filippetti, V. (2014). Factor Structure of the Torrance Tests of
Creative Thinking Figural Form B in Spanish-Speaking Children: Measuring Inva-
riance across Gender.
Creativity Research Journal, 26,
72-81.
https://doi.org/10.1080/10400419.2013.843908
Manzini, J. L. (2000). Helsinki Statement: Ethical Principles for Research Medicine about
Human Subjects
Acta Bioethica, 6,
321-334.
Mattfeld, A. T., Gabrieli, J. D., Biederman, J., Spencer, T., Brown, A., Kotte, A., Whit-
field-Gabrieli, S. et al. (2014). Brain Differences between Persistent and Remitted At-
tention Deficit Hyperactivity Disorder.
Brain, 137,
2423-2428.
G. Gonzalez-Carpio et al.
332
https://doi.org/10.1093/brain/awu137
Munafò, M. R., Yalcin, B., Willis-Owen, S. A., & Flint, J. (2008). Association of the Do-
pamine D4 Receptor (DRD4) Gene and Approach-Related Personality Traits: Me-
ta-Analysis and New Data.
Biological Psychiatry, 63,
197-206.
https://doi.org/10.1016/j.biopsych.2007.04.006
Paek, S. H., Abdulla, A. M., & Cramond, B. (2016). A Meta-Analysis of the Relationship
between Three Common Psychopathologies—ADHD, Anxiety, and Depression—and
Indicators of Little-C Creativity.
Gifted Child Quarterly, 60,
117-133.
https://doi.org/10.1177/0016986216630600
Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The
Worldwide Prevalence of ADHD: A Systematic Review and Metaregression Analysis.
The American Journal of Psychiatry, 164,
942-948.
https://doi.org/10.1176/ajp.2007.164.6.942
Pliszka, S. R. (2007). Pharmacologic Treatment of Attention-Deficit/Hyperactivity Dis-
order: Efficacy, Safety and Mechanisms of Action.
Neuropsychology Review, 17,
61-72.
https://doi.org/10.1007/s11065-006-9017-3
Plucker, J. A., Beghetto, R. A., & Dow, G. T. (2004). Why Isn’t Creativity More Important
to Educational Psychologists? Potentials, Pitfalls, and Future Directions in Creativity
Research.
Educational Psychologist, 39,
83-96.
https://doi.org/10.1207/s15326985ep3902_1
Pritchard, V. E., Healey, D., & Neumann, E. (2006). Assessing Selective Attention in
ADHD, Highly Creative, and Normal Young Children via Stroop Negative Priming Ef-
fects. In C. Fletcher-Flinn, & G. Haberman (Eds.),
Cognition and Language: Perspec-
tives from New Zealand
(pp. 207-224). Bowen Hills: Australian Academic Press.
Runco, M. A. (2007). To Understand Is to Create: An Epistemological Perspective on
Human Nature and Personal Creativity. In R. Ruth (Ed.),
Everyday Creativity and New
Views of Human Nature: Psychological, Social, and Spiritual Perspectives
(pp. 91-107).
Washington: American Psychological Association. https://doi.org/10.1037/11595-004
Runco, M. A. (2014).
Creativity: Theories and Themes: Research, Development, and
Practice
. New York: Academic Press.
Runco, M. A., & Acar, S. (2012). Divergent Thinking as an Indicator of Creative Potential.
Creativity Research Journal, 24,
66-75. https://doi.org/10.1080/10400419.2012.652929
Sahib, H. (2012) Qualitative Analysis of Creativity Used TTCT Test about Children with
and without ADHD Tendency.
Korean Society for Creativity Education, 12,
45-63.
http://www.riss.kr/link?id=A60243750
Sang, B., Yu, J., Zhang, Z., & Yu, J. (2002). A Comparative Study of the Creative Thinking
and Academic Adaptivity of ADHD and Normal Children.
Psychological Science, 25,
31-33.
Shaw, G. A., & Brown, G. (1990). Laterality and Creativity Concomitants of Attention
Problems.
Developmental Neuropsychology, 6,
39-56.
https://doi.org/10.1080/87565649009540448
Shaw, G. A., & Brown, G. (1991). Laterality, Implicit Memory and Attention Disorder.
Educational Studies, 17,
15-23. https://doi.org/10.1080/0305569910170102
Shaw, G., & Brown, G. (1999). Arousal, Time Estimation, and Time Use in Atten-
tion-Disordered Children.
Developmental Neuropsychology, 16,
227-242.
https://doi.org/10.1207/S15326942DN1602_6
Shaw, P., Eckstrand, K., Sharp, W., Blumenthal, J., Lerch, J. P., Greenstein, D. E. E. A.,
Rapoport, J. L. et al. (2007). Attention-Deficit/Hyperactivity Disorder Is Characterized
by a Delay in Cortical Maturation.
Proceedings of the National Academy of Sciences,
G. Gonzalez-Carpio et al.
333
104,
19649-19654. https://doi.org/10.1073/pnas.0707741104
Simonton, D. K. (2004
). Creativity in Science: Chance, Logic, Genius, and Zeitgeist
.
Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9781139165358
Simonton, D. K. (2014). More Method in the Mad-Genius Controversy: A Historiometric
Study of 204 Historic Creators.
Psychology of Aesthetics, Creativity, and the Arts, 8,
53-61. https://doi.org/10.1037/a0035367
Sonuga-Barke, E. J., & Castellanos, F. X. (2007). Spontaneous Attentional Fluctuations in
Impaired States and Pathological Conditions: A Neurobiological Hypothesis.
Neuros-
cience & Biobehavioral Reviews, 31,
977-986.
https://doi.org/10.1016/j.neubiorev.2007.02.005
Sternberg, R. J., Kaufman, J. C., & Pretz, J. E. (2002).
The Creativity Conundrum
. New
York: Psychology Press.
Sternberg, R. J., & Kaufman, J. C. (2010). Constraints on Creativity: Obvious and Not So
Obvious. In J. C. Kaufman, & R. J. Sternberg (Eds.),
The Cambridge Handbook of
Creativity
(pp. 467-482). New York: Cambridge University Press.
https://doi.org/10.1017/CBO9780511763205.029
Sternberg, R. J., & Lubart, T. J. (1996). Investigating in Creativity.
American Psychologist
7,
677-688. https://doi.org/10.1037/0003-066X.51.7.677
Sternberg, R. J. & Lubart, T. J. (1999). The Concept of Creativity: Prospects and Para-
digms. In R. J. Sternberg (Ed.),
Handbook of Creativity
(pp. 3-15). New York: Cam-
bridge University Press.
Swanson, J. M. (2003) SNAP-IV Teacher and Parent Ratings Scale. In: F. Aykr (Ed.),
Therapist’s Guide to Learning and Attention Disorders
(pp. 487-500). New York: Aca-
demic Press. https://doi.org/10.1016/B978-012256430-7/50022-3
Swanson, J. M., Cantwell, D., Lerner, M., McBurnett, K., & Hanna, G. (1991). Effects of
Stimulant Medication on Learning in Children with ADHD.
Journal of Learning Dis-
abilities, 24,
219-230. https://doi.org/10.1177/002221949102400406
Tannock, R., & Schachar, R. (1992). Methylphenidate and Cognitive Perseveration in
Hyperactive Children.
Journal of Child Psychology and Psychiatry, 33,
1217-1228.
https://doi.org/10.1111/j.1469-7610.1992.tb00940.x
Taylor, J. L. (2006). Attention Deficit Hyperactivity Disorder and Creative Potential of
Children: A Multiple Case Study.
Dissertation Abstracts International B: The Sciences
and Engineering, 66,
4502.
Thomas, R., Sanders, S., Doust, J., Beller, E., & Glasziou, P. (2015). Prevalence of Atten-
tion-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis.
Pedia-
trics, 135,
e994-1001. https://doi.org/10.1542/peds.2014-3482
Thompson-Schill, S. L., Ramscar, M., & Chrysikou, E. G. (2009). Cognition without Con-
trol When a Little Frontal Lobe Goes a Long Way.
Current Directions in Psychological
Science, 18,
259-263. https://doi.org/10.1111/j.1467-8721.2009.01648.x
Torrance, E. P. (1974).
The Torrance Tests of Creative Thinking: Norms-Technical Ma-
nual
. Princeton, NJ: Personal Press.
Torrance, E. P. (1990).
Te Torrance Tests of Creative Thinking Norms—Technical Ma-
nual Figural (Streamlined) Forms A & B
. Bensenville, IL: Scholastic Testing Service.
Torrance, E. P. (1998).
The Torrance Tests of Creative Thinking Norms—Technical Ma-
nual Figural (Streamlined) Forms A & B
. Bensenville, IL: Scholastic Testing Service.
Torrance E. P. (2008).
Torrance Tests of Creative Thinking: Norms-Technical Manual,
Figural (Streamlined) Forms A & B
. Bensenville, IL: Scholastic Testing Services.
Torrance, E. P., & Safter, H. T. (1999).
Making the Creative Leap beyond
. Buffalo, NY:
G. Gonzalez-Carpio et al.
334
Creative Education Foundation Press.
Uddin, L. Q., Kelly, A. C., Biswal, B. B., Margulies, D. S., Shehzad, Z., Shaw, D., Milham,
M. P. et al. (2008). Network Homogeneity Reveals Decreased Integrity of Default-Mode
Network in ADHD.
Journal of Neuroscience Methods, 169,
249-254.
https://doi.org/10.1016/j.jneumeth.2007.11.031
White, H. A., & Shah, P. (2006). Uninhibited Imaginations: Creativity in Adults with At-
tention-Deficit/Hyperactivity Disorder.
Personality and Individual Differences, 40,
1121-1131. https://doi.org/10.1016/j.paid.2005.11.007
White, H. A., & Shah, P. (2011). Creative Style and Achievement in Adults with Atten-
tion-Deficit/Hyperactivity Disorder.
Personality and Individual Differences, 50,
673-
677. https://doi.org/10.1016/j.paid.2010.12.015
Submit or recommend next manuscript to SCIRP and we will provide best
service for you:
Accepting pre-submission inquiries through Email, Facebook, LinkedIn, Twitter, etc.
A wide selection of journals (inclusive of 9 subjects, more than 200 journals)
Providing 24-hour high-quality service
User-friendly online submission system
Fair and swift peer-review system
Efficient typesetting and proofreading procedure
Display of the result of downloads and visits, as well as the number of cited articles
Maximum dissemination of your research work
Submit your manuscript at: http://papersubmission.scirp.org/
Or contact psych@scirp.org
