Updated: Nov 21, 2022
My friend followed advice as best she could for her son.
Did she get the best advice?
We are chatting at the kitchen table while Jeanette* makes dinner. I’ve offered to do some veg prep and she hands me the cutting board and encourages me to push the significant pile of medicine boxes aside.
Willem, her 18 year old son, has been on meds since he was four, she explains. He is on the autism spectrum and has ADHD.
Jeanette tells of the journey of finding the right meds, of consulting and arguing with medical doctors along the way.
“It took months to adjust the meds to not have a usually stoic Willem constantly tearful and overemotional.” She speaks of managing meds to an exact science on an exact schedule: 10mg of Ritalin on waking and again a couple of hours later as the attention wavers…
Her dedication and investment as a parent is glaringly evident.
Our conversation moves to my work and my understanding of and enthusiasm about brain differences. I comment that I have noticed many signs of giftedness in Willem …
She’s coy as she confesses that Willem recently qualified to be on the Mensa database, the high IQ society. It strikes me that she is more careful to tell me this than the aspects of her son that she clearly believes needs treatment.
Did any of the clinicians that worked with your boy over the years bring his giftedness into their diagnosis and their suggested treatment? I ask.
“They acknowledged it”, she shrugs.
Jeanette goes right back to talking about how a recent shift to a new clinician and new medication has meant the world to Willem’s focus. She shakes her head at the sudden increase in his performance at school. “I get mad if anyone suggests he comes off the medication” she says.
I don’t blame her.
Her deeply committed parenting is providing for her boy what is offering relief: a break from the busyness and distraction and ensuring performance.
What could be wrong with that?
She mentions then that the latest clinician did suggest that Willem writes his exams in a private space. The lack of interruption accommodation came at the same time as the new medication, and I wonder which intervention was responsible for the better grades.
But mostly I wonder if this boy knows himself at all.
I wonder if he understands that his extraordinary brain comes with intensities that flow from that strength.
I’m sure he sees the gift, but what is the effect of not understanding both sides of the coin? Is the message unwittingly given by doctors “you are unhealthy and need fixing?”
After dinner Jeanette and her husband, Andries, tell me about Willem as a kid.
They talk of teachers complaining about his lack of sitting still and challenging him to repeat what they just said: At which point he would repeat and understand and supplement their teaching.
I can’t help thinking that hyperactivity was there but wasn’t interfering with his ability to learn.
It was however inconvenient for teachers and distracting for other students.
Behaviour alone does not indicate ADHD, there must be an impairment also for the child.
Could these have simply been psychomotor intensities often seen in gifted kids?
I check myself.
The people in Willem’s life were deeply committed to him, they weren’t trying to just get him to sit still.
Did clinicians speak with knowledge of giftedness?
Jeanette tells me again of how concerned she has been over the years of Willem’s lack of close friendship and general disinterest in the children around him.
Does that not constitute as a social impairment?
Possibility number one
Willem could be twice exceptional - A boy with extraordinary intellectual gifting and learning and behavioural challenges that need a careful response combining therapy and coaching alongside medication.
Possibility number two
The challenges Willem experiencing could be entirely explained by his giftedness and needs not be medicated but still coached and supported.
Ok so let me just get all my questions out:
Did Willem’s parents have any other choice for him to survive school but to medicate and hope for the best?
If Willem was made aware of the intensity that comes as a package deal with his giftedness, would he think differently about himself?
How would clinicians with training in giftedness and specifically twice exceptionality have responded differently to Willem?
As Willem goes off to university, does he know how to live well with is unique wiring?
How can Willem be made aware of his gifts and given permission to celebrate and lean into them?
What would change for Willem if he understood his difference with advantages and disadvantage? (and see that Difference isn’t deficit!)
I ask these questions because research shows that many gifted kids are being misdiagnosed. Have a look at these and make sure you address them with your child’s healthcare provider.
21 Gifted Traits often misdiagnosed
Sensitivity to loud sounds
Sensitivity to textures
Refusal to do schoolwork
Failure to complete tasks
Difficulty with transitions
Tendency to interrupt
Frequent mood swings
Not paying attention
(Source: James T. Webb of the US national Association for Gifted Children)
*Names have been changed to protect identities