Monday, January 19, 2009

Gifted with a Learning Disability - A Brain-Based Framework for Understanding Twice Exceptional People

Since the 2004 re-authorization of the IDEA, twice exceptional students (students with gifted abilities or talents and LDs) have qualified for individualized educational support in the form of 504 accommodations or an IEP. That said, twice exceptional students are often overlooked in conventional school settings because their gifts may compensate enough to avoid identification for help, but not enough to avoid emotional problems and often gross academic achievement.

From Successful Strategies for Twice Exceptional Students above, it's easy to see how students' gifted abilities might be missed; often it is only parents or teachers who develop a close relationship with a student who notice advanced conceptual ability, abstract reasoning, self-initiated creative activities in the presence of otherwise lackluster academic performances. It's also worthwhile noting how often secondary social, emotional, or behavioral problems erupt making the sources of school underachievement difficult to identify.

Advances in our understanding of brain biology provide helpful insights into how twice exceptional abilities arise; also they raise important issues about how they should best be identified, accommodated, and taught.

1. Twice Exceptionality Often Runs in Families - Structural Brain Differences

Although parents don't always think about their extended family tree when they are thinking about why their son or daughter is having trouble in school, it's important that they should. It's a rare teacher or doctor who will think to ask about whether a child's learning problems or "underachievement" runs in the family, and if parents or grandparents don't think about it, it may be highly likely that no one will. In addition to individual inherited factors contributing to giftedness and learning disability, assortative mating (tendency of like to marry like) can dramatically increase the likelihood of adults' learning differences being inherited by children (6-40x higher chance of a person with a reading disability marrying another with a reading disability! - see Hynd).

With advanced imaging and morphometric methods, its becoming easier to identify familial differences in brain organization (see Asymmetry and Dyslexia). Looking at Einstein's brain at left, is it any wonder that he found his most successful life's work using visual and spatial problem solving methods, and that he had an undistinguished start to his schooling and was a late talking child?

2. Dynamic Reorganization Ability in the Brain - Alternate Brain Pathways Can Compensate for Weakness

In the past 30 years, there have been dramatic advances in our understanding of how dynamic pathway remodeling exists in the brain. Partially redundant systems help us to accurately sense our environments, learn and remember, and plan and act.

Gifts Secondary to Disabilities

Partial redundancy provides a buffer system in the event of injury; if one system is injured, another increases its activity to take its place. At right, Shibata and colleagues found that the part of the brain that normal hears in congenitally deaf subjects was reorganized to 'see' - so although the deaf were unable to hear, their visual sensitivity was greater than normal hearing subjects because more brain resources were now devoted to seeing.

It is likely, then, that some twice exceptional abilities many occur as the result of the brain's compensatory drive from a deficit or injury. One practical implication for this idea is that a thorough search for strengths and gifts should be made in the setting of any disability.

Disabilities Secondary to Gifts

But in some cases, there is a suggestion that some disabilities or delays in development are secondary to gifts. In a study from Port Townsend (Sweetland), researchers found that the higher the IQ, the greater the likelihood of high VIQ/PIQ discrepancies (17% of a control sample had IQ subtest discrepancies of 18 points or more vs. 55% of a gifted sample). And there's that data from Giedd and colleagues showing that the higher the IQ in young children, the slower the development of prefrontal cortical thickness. Extreme ability or talent may result in slower time courses of development or stunting of other systems or pathways if resources are limited.

Different developmental time courses should also (in the best of all worlds) warrant appropriate curricular and other educational accommodations. For instance, if young gifted children were found to present as mixed dominant "late-bloomers", shouldn't demands for heavy bihemispheric activities be individualized (e.g. note-taking, writing to open-ended prompts) and instruction optimized for what we know to be well-developed?

Twice Exceptional Guidebook, Montgomery County
Eides Presentation: Twice Exceptional - Life at the Extremes pdf
Hynd: Neurobiological Reseach in Reading Disabilities and Implications for Autism Spectrum pdf
Superior nonverbal abilities in families with dyslexia - ppt
Eide Neurolearning Blog: Blessings and Burdens of High IQ


  1. Anonymous1:56 PM

    Fernette and Brock, what a fascinating blog entry. Thanks so much! Luiza Moreira

  2. Anonymous7:17 AM

    The same group who wrote the letter in Nature about Intellectual ability and cortical development wrote another paper (PNAS, Dec 4, 2007, 104(49)19649-19654): "ADHD is characterized by a delay in cortical maturation". The later (ADHD) paper does not refer to the earlier (IQ) paper despite the fact that both describe a shift in peak cortical thickness. It's difficult to compare the findings in the two papers because the methods used to analyze and summarize the results are quite different (linear mixed model vs Kaplan-Meier curves modeling time to peak thickness), but both seem to describe a later age (in superior IQ group and in ADHD group) for peak thickness. The choice of words to describe this difference is interesting: when referring to the superior IQ group (prefrontal cortex, left middle prefrontal and inferior temporal gyri ???), they refer to "a developmental shift" and "a particularly plastic cortex". For the ADHD group (prefrontal cortex, temporal cortex ???), they describe it as a "marked delay". Can you comment on the difference in choice of words and the similarities and differences between the findings, as wells as reasons why the authors might have failed to refer to their own earlier paper?

  3. Great point, Annie.

    There is the data - and there is the interpretation. It is a complex business looking at motive for an interpretative framework. One could easily argue that the delay in superior IQ is purposiveful and ultimately beneficial for brain development, but to argue the same for ADHD would trigger an outcry of protest from many corners.

    What matters is - what is the truth?

    Surprisingly little is known about the heterogeneity of normal brain development and the points at which experts make their determinations of normal variation vs. disease are murky, but not without significant implications.

    Yesterday we got a call from a Washington Post reporter about the issue of "mission creep" in diagnoses such as autism and ADHD. We also got into a discussion of the problems of heavy industry-based funding for psychotropic medications and recent problems that high profile psychiatrists have gotten into because of conflict of interest (Nemeroff at Emory and child psychiatrist Joseph Biederman at Harvard). Biederman has been a driving force for antipsychotic use in autism and stimulants for ADHD.

    There is no way that grant funding for normal development or developmental variation can match the funding resources of the pharmaceutical industry.

  4. I think that reading really is a tool that should be utilized to our very best ability. I mean it does nothing but enhance our reading skills. But then again, most people think that by reading you are gaining knowledge, which they are correct! But what kind of knowledge are they gaining? Is it True? Is it False? Now a days, people conceive the notion of believing everything that is on paper or screen simply because it is "written"
    If we all take a look outside the box, we can see that what we read is just a compiled amount of researched data, but then again, it does not necessarily mean it is all true most of the time. Especially if children read the mass amounts of data that is available on the internet now a days, it could be beneficial on the reading part of it, but the knowledge should be double checked on the content itself sometimes. But then again, it is a choice to believe what they read or not, and that is part of the maturing process. Whether what they read is true or not, it is still something that can be expanded into ones own pre-conceived imagination.

  5. Hi, I'm Catherine from Indonesia. I've ever read in a journal that the autism have the volume of brain structure early growth. Wheras we know that some of them hav the low IQ. Can you explain this fact? Why do the autism have the same condition as the superior? Why do their brains growth earlier than the normal one?
    Thank you. I like your article..

  6. Christy5:15 PM

    Hi, I am a graduate student and have been researching brain based learning. Thank you for posting this article. I find it very interesting. It gives another view and more insight on other articles I have been reading.