Monday, December 03, 2007

Elementary Angst: Early Problems with Attention and School Behavior May Still Mean Success

"Themistocles was an unruly boy, and carried on his mad pranks without much restraint. When taken to task for them he said, "The wildest colts make the best horses when they come to be properly trained." - Plutarch (46-120 AD)

There's a lot of buzz about two new studies this month that suggest that children with attentional and behavioral problems in the early elementary grades are not doomed to failure as they grow up. In fact most of them seem to do just as well as their "easier" fellow students in the early grades.

From the NY Times:

"Kindergartners who interrupted the teacher, defied instructions and even picked fights were performing as well in reading and math as well-behaved children of the same abilities when they both reached fifth grade, the study found."

and from the NIMH, Dr. Philip Shaw:"'The basic sequence of development in the brains of these kids with A.D.H.D. was intact, absolutely normal,' Dr. Shaw said. “I think this is pretty strong evidence we’re talking about a delay, and not an abnormal brain.”

About three in four children do grow out of the problem by early adulthood..."

The kids diagnosed with ADD in this group had been on stimulant medication. It will important to the non-medicated kids too, of course. The articles are just released; the PNAS article is free abstract only now. The NIMH group is the same that found young superior IQ kids had delayed frontal cortical development compared to mildly elevated IQ and normal IQ groups.

All of this should be encouraging to parents and teachers of bright children with challenging behaviors in the early grades, but don't think all these kids will grow out of it. Too many people who like the wildest colts saying forget the "properly trained" part at the end.

In our clinic see some remarkably bright children who really present with very challenging behaviors in their early years. An metaphor we like is Ben Hur and his three-horse chariot. If you've got three horses running together in the same direction - that's good. If you don't have the control of the three horses, you've got a wreck.

So the bottom line for many of these "ODD-ADHD-but-smart-kids" in school is that the eventual prognosis is good; it is not a disease, but it can still mean a lot of work, wisdom, and guidance from Mom and Dad.

(BTW: What happened to Themistocles? Wealth and achievement as an adult, but lousy leader because of his moral weakness)

NYT: Bad Behavior Does Not Doom Pupils
PNAS:Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation
School Readiness and Achievement pdf
Eide Neurolearning Blog: The Biology of Late Bloomers
Eide Neurolearning Blog: The Blessings and Burdens of High IQ
Smarty Brains: High-IQ kids navigate notable neural shifts: Science News Online
Themistocles in Plutarch's Lives

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