The Real ADD: ADD Often Goes Undetected in Bright Children
Bright children use higher levels of cognitive reserve or ability to compensate for ADD symptoms.
ADD symptoms remain hidden beneath the child’s ability to compensate. On testing scores tend to regress to the mean or average limits as higher level abilities are used to compensate for deficit areas. The result is that the whole picture remains depressed and deceiving. No one sees how smart the child is or how bad the deficits are. No one understands why he or she would be so frustrated with school. They are typically labeled as “lazy” seen as not caring about school and “not trying their hardest” to achieve. These are the children who tend to become so frustrated or so anxious or so depressed that they give up. The child assumes they are not smart, the parent or teacher assumes the child does not care.
It becomes easier for the child to avoid school, avoid conflict with parents or teachers by lying about their work and maintaining an outward appearance of not caring about school. Unfortunately despite their outward façade of ambivalence these children do care and are internally highly frustrated and angry with themselves, thus making intervention by a professional a rather difficult endeavor. By the time of adolescence, these children scoff at the professional who tells them they are smart because they have stopped believing in themselves. Social or sports activities take precedence. Former goals regarding school achievement are forgotten.
These are the children who in compensating for ADD symptoms over time tend to show the more significant gap or decline in their spatial functioning. The gap is representative of more extreme degrees of compensation given their abilities and higher levels of cognitive reserve. It is not uncommon to see a well below average vocabulary or reading problems (rate, speed or comprehension) in the bright population diagnosed with a genetic attention disorder. The bright population is what we refer to affectionately as “the sleepers”. Those individuals who do not come to the attention of their teachers due to their ability to compensate, to “get by” and to still attain average grades.
Intervention is more difficult when the above emotional cyclical issues are in place at the time of diagnosis. This is the population who could not be reached before we began our cognitive therapy intervention program at United Psychological Services. However, currently these are the children who make the most dramatic leap following completion of the IM program given the improvement in brain functioning (seen on post-evaluation) and the simultaneous benefit to their emotional state, decreased anxiety and depression symptoms.
Following completion of the training program these are the children that we target to develop good study habits so they begin to immediately use their newfound assets and lock in the upward spiral of success.
To summarize, in bright children:
The problem is more emotional, involving a disbelief in academic prowess, a pessimistic attitude about school, and the procrastination and avoidance that naturally follows these thoughts. Different temperament styles and personality traits, especially involving locus of control (internal versus external) will have an additional effect on the system described above, (whether the person easily gives up on reading or compensates by memorizing their words and continually working hard to read fluently). Finally, grade level, family stressors and developmental stages results in different symptom manifestations.
