Intelligence and Medication: Treating the Gifted/ADHD Mind

This past Friday (October 7) I spent the day at a conference hosted by the Wisconsin Association for Talented & Gifted (WATG). I attended in particular because of the keynote speaker Dr. Nadia Webb, whose talk  entitled “Head, Heart and Hands: The Whole Gifted Child” touched on talented children who might also have ADD, ADHD, depression or a learning disability among other things (1). As she talked about the challenges and behaviors of these gifted children, I was struck by how eerily similar what she described was to what I experienced with my son.

I can imagine some of you rolling your eyes, because don’t all parents think their kids are smart? So let me say this, I don’t know if my son would qualify as “talented and gifted”, but he is smart. From the first grade, he has surprised his teachers with his “depth of knowledge” and his ability to recall verbatim things he has read or heard. He has also been diagnosed with ADHD. I have come to realize that this is how he was meant to be, but that ADHD doesn’t define him. He is still scary-smart; funny; a talented artist; has an amazing singing voice and a kind heart. Perhaps it is because his mind is going ten thousand miles-a-minute and he is trying to look at everything in every direction that he looks at things in ways I would never think of and notices little details that slip right past the rest of us.

“Nick” does take medication for his ADHD. This is part of the reason why I was so excited to go to the WATG conference. The first break out session I attended was “Everything You Wanted to Know About Meds (and Your Gifted Child) in One Hour” also given by Dr. Webb. It was fascinating how she talked about the different medications, how they work and why they work as well as why they might work differently for different kids. As a scientist, I found her discussion of drug metabolism and enzyme pathways fascinating. As a Mother of a child who has taken some of these drugs, I found the explanation for how and why these worked differently for different people incredibly valuable.  Best of all (for me, anyway) she provided a long list of resources where I could go to learn more.

It has been a long and rocky road for us, but we have finally found a medication that helps my son. It helps him keep his thoughts on track, stay focused when he needs to, and makes it much easier for him to follow through with tasks without help. Now he can focus on what HE wants to and let the rest of the world go by around him. What it hasn’t done is change

No, it isn't coffee. It is hot chocolate.

who he is. He is still the same silly, talkative, mischievous boy he always was.  ADHD is a piece of the complexity that makes up “Nick”, but it is not the sum total of who he is. 

Last year I read  two articles on Science Daily referencing the same journal article about ADHD, behavior modification and medication effectiveness (2,3).  This study found that the brain activity of children with ADHD seemed to normalise with methylphenidate medication (this is stimulant medication similar to Ritalin and Adderall). They also found that motivational incentives also helped normalise brain activity, although to a lesser degree than medication. When both medication and behavioral incentives were used together the effects were cumulative (4). These results were reiterated by Dr. Webb in her Keynote address.

This is not the first paper I have found that described “behavior modification” and the effectiveness it can have in treating moderate ADHD. Every time I see it I ask myself the same question: What kind of behavior modification? I mean if there is something I could be doing that would mean my son doesn’t need to take medication I would do it in a heart beat. We tried rewards for good behavior at school and didn’t see much effect. So it was with something that was almost relief that I found this quote in one of the Science Daily articles: “The incentives and rewards in our study were immediate and consistent, but we know that children with ADHD respond disproportionately less well to delayed rewards. This could mean that in the ‘real world’ of the classroom or home, the neural effects of behavioral approaches using reinforcement and rewards may be less effective.” (1) The speaker was the professor who led the study, Professor Chris Hollis.

Sometimes the best place to learn is not in the classroom.

I guess that explains why I can never find any concrete recommendations for behavioral therapy or rewards for kids my son’s age.

Believe me, ADHD medication will not make a child perfect; my son is as naughty as any other nine-year-old boy I know. The study by Dr. Hollis’ group showed that ADHD medication caused the brain activity of ADHD children to become more like their peers, that is to say “normal”. What I learned last Friday is that it isn’t all the unusual for kids who are smart (or gifted) to be “wired differently” in other ways as well. I am glad that we have found something helps “Nick” be less impulsive, but with all I am learning about intelligent kids and the challenges they face, I am becoming less concerned that he be considered “normal” and more concerned that he be happy. Sometimes that means letting him learn everything he wants about something outside of the classroom. And you know what? I am more than okay with that.

References (for those who want to do the reading themselves)

  1. Webb, J.T. et al. (2005) Misdiagnosis and Dual Diagnosis of Gifted Children and Adults: ADHD, Bipolar, OCD, Asperger’s, Depression and Other Disorders. Great Potential Press, Inc.Wellcome Trust (2010, April 4).
  2.  Behavioral incentives mimic effects of medication on brain systems in ADHD. ScienceDaily. Retrieved April 23, 2010.
  3. Elsevier (2010, April 6). Synergy between behavioral and pharmacologic interventions for ADHD. ScienceDaily. Retrieved April 23, 2010.
  4. Groom et al. (2010) Effects of Motivation and Medication on Electrophysiological Markers of Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder. Biological Psychiatry67 (7): 624
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Kelly Grooms

Scientific Communications Specialist at Promega Corporation
Kelly earned her B.S. in Genetics from Iowa State University in Ames, IA. Prior to coming to Promega, she worked for biotech companies in San Diego and Madison. Kelly lives just outside Madison with her husband, son and daughter. Kelly collects hobbies including jewelry artistry, reading, writing, photography and knitting. She would like to be an avid runner, as evidenced by her growing collection of running gear and her single half-marathon finishers t-shirt.

7 thoughts on “Intelligence and Medication: Treating the Gifted/ADHD Mind

  1. I enjoyed your article very much and it sounds very much like my son Logan. My son is also very bright and has been on meds since the second half of 2nd grade. My question for you is have you found any information on the effects of adhd meds on the out comes of gifted testing. I don’t know if I should give him his meds on the day of the test or not. I know the meds will make it easier to pay attention however I worry that since a lot of it is based on puzzles it will give him trouble being creative. He is in a gifted class this year( doing well) but was not identified as gifted two years ago in Va( with meds). However in his testing for ADHD years before he was found to have a FSIQ of Superior in Louisiana( with out meds). The only reason I care at all, is the fact that we are a military family and with the amount of moving we do, I feel it is the only way to make sure he is in a class that will challenge him. I would love any insight you have on this. Jackie

  2. Hi Jackie,
    I am so glad you enjoyed my article. Personally, I always find it encouraging to hear from other parent who face some of the same challenges we do. I imaging that moving around with the military adds a whole new lay of complexity to parenting, and I am glad that his current school has a gifted class for him.
    I am afraid I don’t know how to answer your question about medication and testing.

    I would suggest asking his doctor and/or the ones who will administer the test. It also might be helpful to talk to his teacher, since they are teaching a gifted class they might have a better idea which way would be better for your son.
    If you haven’t read it, I strongly recommend the book by James Webb (reference 1 above). Also, I am currently reading a book that was recommended to because my son can be super sensitive (also pretty typical for gifted kids) it is called “A Parent’s Guide to Gifted Children” also by James Webb. I am still feeling my way along, but I have found a lot of helpful information on the SENG website: http://www.sengifted.org/

    Good luck with the testing (and the moving). Please let me know which way you decided to go and how it turned out!
    Kelly

  3. The incidence of ADD/ADHD traits within the gifted population is indeed very high. In 2000, I outlined my theory, “The Gifted/ADHD Connection”, at a state gifted education conference in NC. The traits of the concept known a giftedness are *identical* to ADD/ADHD, although with a more positive spin.

    After surveying hundreds of families, I discovered that there are also many other interesting correlations and factors that create ADD/ADHD symptoms.
    Medication is often not needed, once you change what’s causing the symptoms. It is usually not just one factor, but several.

    Homeschooling and making adjustments to our kids’ diets and they way they learn helped tremendously. Music was also a huge help. They both graduated from college last May. Medication was never needed.

    • Hi Dori,
      Thank you for your comment and for sharing your experiences! Diet and teaching/learning style can make a huge difference in some children’s success. Music is one I have only heard occasionally; martial arts training is another that I have heard mentioned as helping some kids. My family is fortunate that we have had excellent teachers who have been willing to try different approaches in their classrooms. Diet adjustments have not helped us much, I am afraid, although I have read of many cases where it has made a world of difference.
      I am learning that a big thing is never to grow compliant, even when things are going well, but to keep learning, keep pushing and keep questioning. I hope that your kids continue to do as well!
      Kelly

  4. Hello,
    I read your article and felt like I was reading about my sweet boy. Do you mind me asking what medications you found the best to treat your son with for ADHD that did not affect his GT qualities! So nervous to start but know it is for the best!

  5. Hi Kristen,
    As a Mom I totally understand how nerve racking it can be to think about these medications. Non of the medications we have used seemed to adversely affect our son’s GT abilities. The biggest thing we learned is that finding a doctor who will listen and is willing to work with you is a really important. It is a never-ending process, and things that worked great when our son was eight didn’t work so well at ten. Also medications that were epic fails for us worked wonderfully for other families we know.
    We are our kid’s best advocate. The doctors know a lot, but they don’t know our kids the way we do. Don’t be afraid to speak up, to keep calling them if you have questions or if you aren’t comfortable with the effects of a medication.
    For us it was also important that we made sure our son felt involved in the process. And that we emphasized to him that just because his brain ran faster and in more directions that most people’s didn’t mean that there was anything wrong with him. One of the things that the speaker at the TAG conference I went to said was that we know these kids’ brains are different, so why are we so surprised to find out that their brains work differently?
    Good luck, and please let me know how things go!
    Kelly

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