Dr. Devon MacEachron\'s Blog


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When interviewing parents about their child’s strengths and weaknesses, I often hear statements like the following: “I don’t think my child has a problem with attention – he can focus really intensely on his cartoon-drawing (or video-gaming or Lego-building or reading) for hours at a time! In fact I can barely get him to stop. But his teachers complain he’s inattentive and distracted in the classroom. Maybe he’s just not stimulated by the material being taught?” Does this sound like your child – or one you know?

Some of the questions I need to help answer are: Is the child gifted? Does the child have ADHD? Is the child gifted and does he or she also have ADHD (i.e. is twice-exceptional)? Which of these factors are impacting the child’s ability to thrive in and outside of school? And what can be done to help.

My friends Xavier Castellanos, MD and Felice Kauffman, PhD wrote a monograph for the National Research Center for the Gifted and Talented on this very topic. It is reproduced here in short form on SENG’s website. They note that “Some people erroneously assume that a child who demonstrates sustained attention, such as a gifted child engaged in a high-interest activity, cannot have ADHD. It is understandable that an observer might discount the possibility of ADHD because from all appearances the child is so absorbed in a task that other stimuli fade into oblivion.”

While in fact: “This state of rapt attention can be described as “hyperfocus,” a condition that individuals with ADHD frequently experience.” Hyperfocus is the tendency for children and adults with ADHD to focus very intensely on things that interest them. At times, the focus is so strong that they become oblivious to the world around them. For more on hyperfocus see an article from Additude magazine here. Felice and Xavier point out that: “Activities that are continuously reinforcing and “automatic,” such as video or computer games or reading for pleasure, do not distinguish children who have ADHD from children who do not have ADHD, whereas effortful tasks do.” So it’s not whether the child can focus – it’s whether they can focus on effortful tasks.

They continue: “Evidence suggests that the gifted child with ADHD is particularly predisposed to exhibit this state of “hyperfocus.” While this can be a positive aspect of task commitment, it becomes a problem when the child is asked to shift from one task to another.”

Does this scenario sound familiar? You ask your child to stop doing what he is hyper focused on and come to dinner and he ignores you or objects strenuously?

Xavier and Felice write: “While cognitively this state (hyperfocus) can have positive aspects, behaviorally it can cause problems. It is important to understand that ADHD is not characterized by an inability to sustain attention, but rather by the inability to appropriately regulate the application of attention to tasks that are not intrinsically rewarding and/or that require effort. Such tasks are, sadly, characteristic of much of the work that is typically required in school, even in programs for gifted students.” So if school isn’t intrinsically rewarding, interesting, and/or requires effort, the gifted child with ADHD may tune-out and turn off.

To complicate matters, “By virtue of their giftedness, the range of tasks that are perceived as “effortless” is broader for gifted children, which is why their ADHD may be less apparent than in children who struggle more obviously and to lesser effect.” Something that would be effortful for a typical child (e.g. understanding a new math concept or comprehending sophisticated text) might not be effortful for the gifted child to whom such things come easily. So when a gifted child does have ADHD, their teachers may under-report symptoms because they appear to breeze through so much of the material. I see this most often when the child happens to be likable and internalizes rather than externalizes their frustrations.

It can take an assessment by a psychologist experienced in working with gifted and twice exceptional learners to tease out the subtleties.

It’s important to find out what’s going on because the student may be under-performing, or may be losing confidence and self-esteem. Their over-reliance on strengths to get by may “inadvertently obscure the disability.” They may get B+’s by answering questions based on superior reasoning skills, not necessarily having learned the actual material being tested. They may be frustrated and grow to distrust their abilities because they realize (consciously, or subconsciously) that they have to struggle to maintain them. They may feel they aren’t very smart after all. There may be negative impacts outside of academics: socially, emotionally, with friendships, and within the family dynamics.

When the student is accurately diagnosed, he or she can be given the opportunity to learn appropriate compensatory and coping skills. It’s especially helpful to address these issues at an early enough age before the student has turned off school, become a behavioral problem, become the class clown, or internalized frustrations in the form of anxiety or depression. While an adult can (if lucky) be happy and successful intensely pursuing their interests, few achieve success and satisfaction if they are unable to push through the less rewarding phases of an activity and keep working when something becomes effortful. These are skills and mind-sets we need to teach our twice exceptional children who are gifted and have ADHD.

If I can help you ascertain whether your child is gifted, has ADHD, or both, reach out to me at dm@drdevon.com. I do not charge for an initial 60 minute conversation.

I was asked to write an article for the December, 2017 issue of the 2e Twice Exceptional Newsletter, a bi-monthly subscription ($35/year) online newsletter for “those who raise, educate, and counsel high-ability (gifted) children who also have learning challenges.” It’s a wonderful publication and one I recommend for everyone who lives and breathes 2e. As the focus of the December issue was on relationships, they asked me to write about the importance of the student/teacher relationship, and what might be done to try to facilitate the development of positive ones. My article, in full, can be found here: 2E Newsletter Student Teacher Relationship Article.

But let me summarize a few key points as we head into a new semester.

Positive student-teacher relationships are important to virtually all students. But they are especially important for students who are “at risk.” And twice exceptional learners are at risk for underachievement, boredom, bullying, anxiety, depression, social disconnectedness, being misunderstood, and are prone to daily frustration. A good school year can be “made” by a relationship with a teacher who appears to like and bond with the student. A bad year can be “made” by a teacher who doesn’t. Strong student-teacher relationships can increase student motivation, grades, social outcomes, and emotional well-being at every stage in the student’s development, from early elementary school through college and graduate school. Clearly, they’re important.

Here are some things parents and students can each do to try to facilitate them.

Steps Parents can Take:

• Teach your child to be his or her own advocate. For obvious reasons (power differential, age difference) parents often need to take on the role of advocate for their child in school. However to the extent that the student can advocate for his or herself, it can be particularly effective. Teachers tend to be more open to requests and concerns expressed by students (and can be somewhat wary or skeptical of what they perceive as “helicopter” parenting).

• Teach your child social skills helpful in developing sound relationships with all people, including teachers (e.g., listening, turn-taking, conversational give-and-take, respect, complimenting others).

• Ask for a meeting to provide a “heads up” about your child. Explain their strengths and weaknesses, susceptibilities and personality. Ask for help addressing both exceptionalities – your child’s strengths and areas of weakness.

• Check in on a regular (but not excessive) basis to see how things are going and ask what you can do on your end to  help. Perhaps you can reinforce desired behaviors at home (e.g., waiting before blurting out an answer).

• Be a squeaky wheel – but a polite one. The squeaky wheel often does “get the grease.” Don’t hesitate to be direct about asking the teacher to meet your child’s needs. Stay on top of what’s going on in the classroom. But try to be polite and collaborative. A teacher may make more of an effort for a family they like.

• If things go wrong – your child comes home in tears or the teacher sends home behavioral warnings on a daily basis – it’s time to take action. Ask for a meeting with the teacher first. Go with an open mind. Listen, take notes. Patiently explain what you think may be happening from your child’s perspective. Try not to be too defensive. Suggest strategies that may be effective. If things don’t improve, then enlist the help of the principal, school psychologist, or an outside consultant.

Steps Students can Take:

• The more mature student can work deliberately on personal and advocacy skills conducive to developing good student-teacher relations, but even young children can learn helpful strategies.

• Make efforts to establish a personal relationship with your teacher. Ask if you can meet one-on-one so you can get to know each another. Talk about your needs. Stay after class to chat for a few minutes. Go to office hours. Share your interests and successes outside of school with your teacher. The better your teacher knows you and understands the person you are and the person you want to be, the more likely and better able he or she will be to help you toward your goals.

• Show appreciation by thanking your teacher for a lesson you enjoyed, for their feedback on a paper you wrote, or for the way they made a topic come alive for you. Positive feedback makes people feel warmly toward the person giving it.

• Show respect. Be polite. Try to listen and not talk to peers when the teacher is talking. Say “please” and “thank you.” If you feel that instruction is pointless or boring, explain this privately to the teacher rather than as an aside to your classmates.

• Ask for and accept help. Let your teacher know when you don’t understand something. Or when you already know the material and need something different or more advanced.

• Try to be patient, but also (politely) persistent in asking for the additional help, clarification or any accommodation you may need.

A good relationship with even one caring teacher can literally change a student’s life. We shouldn’t rely on chance and hope that such a relationship will develop spontaneously, but rather can try to set the stage and take proactive steps to try to help it happen.