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
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.
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.
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)
- 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).
- Behavioral incentives mimic effects of medication on brain systems in ADHD. ScienceDaily. Retrieved April 23, 2010.
- Elsevier (2010, April 6). Synergy between behavioral and pharmacologic interventions for ADHD. ScienceDaily. Retrieved April 23, 2010.
- Groom et al. (2010) Effects of Motivation and Medication on Electrophysiological Markers of Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder. Biological Psychiatry, 67 (7): 624
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