Monday, February 22, 2016

Why do smart girls develop eating disorders?

Parents of gifted girls might wonder how "smart" girls could develop an eating disorder. Doesn't their intelligence, insight and maturity somehow insulate them from developing these devastating problems?

And are they more or less likely than others to have a problem with their eating?

It's National Eating Disorders Awareness Week, a time to spread the word about identification and treatment. (See below for resources and an online screening tool)* The hallmark features of eating disorders, such as anorexia, bulimia and binge eating disorder include:

  • a preoccupation with food, weight and body image
  • an unhealthy change in eating patterns, such as restrictive eating, compulsive overeating, or a cycle of binge eating and compensatory attempts to prevent weight gain through the use of purging behaviors or excessive exercise
  • psychological effects, such as obsessive thinking, anxiety, low self-esteem, depression, a distorted body image, and shame and secrecy about the disorder
  • medical complications, including extreme weight loss (or gain), cessation of menstrual periods, gastrointestinal disturbances, electrolyte imbalance

Eating disorders tend to emerge during middle school and high school, but symptoms may start much earlier, or can develop later in life. It is estimated that the prevalence of anorexia is 1% and bulimia is 4%. Men also can be diagnosed with an eating disorder (approximately 5-10% of individuals with anorexia and 10-20% with bulimia are male). And although much more common among white middle-class society, where young women's self-esteem is battered by pop culture's images of unattainable thinness, most women do not develop eating disorders. Similarly, dieting often triggers the onset of eating disordered symptoms; however, cutting calories rarely progresses to a serious problem for the millions of women who diet (despite its known failure rate and the emotional toll of the weight loss/weight gain cycle - but that's another topic). In fact, one study noted that 91% of college women reported dieting at least once.

So then, why do smart girls develop eating disorders?


Because...
They cannot help it. They don't choose to have an eating disorder - just as no one chooses depression, alcoholism or diabetes. Recent research has linked eating disorders to genetic, heritable causes, and differences in brain chemistry. Responses to hunger and satiety are different for some girls with anorexia, and once malnutrition sets in, judgment and decision-making become impaired. And factors such as traumatic stress and developmental transitions are necessary triggers for symptoms to emerge. But intelligence and giftedness play no role in either preventing or warding off symptoms.
Because...
They may have had traumatic experiences that prime them to develop an eating disorder. While a genetic/biochemical predisposition may be necessary, many individuals with eating disorders have a history of sexual abuse or severe physical abuse, often accompanied by depression, anxiety and post-traumatic stress disorder. Although counterintuitive, gaining control over eating is often an attempt to manage memories of abuse and achieve mastery over feelings of helplessness.
Because...
They may have traits in common with individuals who also have eating disorders. Some gifted girls and those with eating disorders may be intensely sensitive and emotional; they also may be overthinkers, driven and perfectionistic. If there is a genetic/biochemical predisposition to develop an eating disorder, along with life event triggers, these "gifted" traits may get channeled into obsessive thoughts about food and a drive to achieve an unrealistic weight. Some may feel overwhelmed by their heightened sensitivity and reactivity, and eating disorder symptoms might seem to provide temporary relief.
Because...
They may have coexisting mental health problems, such as depression, anxiety, obsessive-compulsive disorder, drug or alcohol problems, or self-harming behaviors. They did not choose these either. But struggling with additional psychological distress, as well as possible family, peer or relationship crises, makes it more likely that an eating disorder might develop. Sometimes the obsessive focus on restrictive eating and weight loss, or the almost addictive-like feel of the binge-purge cycle, can be a relief, a distraction and an outlet from even more overwhelming life stressors and emotions.
Because...
They may feel like outliers and misfits, excluded and isolated from their peers, sometimes subject to teasing and bullying. In an effort to gain popularity and fit in, some gifted girls resort to dieting or restrictive eating to achieve an idealized appearance. For some, dieting transitions into more serious eating disordered behavior. 
One writer suggested that a high proportion of individuals with eating disorders also may be gifted. The author based this statement on her clinical impressions as a psychologist, but acknowledged that there was no research to back up her claim. Without additional research, it may be premature to speculate on the prevalence of women with eating disorders who are gifted. 

However, what seems more relevant is to question how eating disorders affect gifted people and how their giftedness affects their treatment and recovery.

  • How do social and emotional characteristics of giftedness, such as heightened sensitivity, asynchronous development, or perfectionism play a role?
  • How do childhood experiences, such as difficulty finding like-minded peers, feeling misunderstood, and possibly being bullied contribute to their symptoms? 
  • Are they using the eating disorder, for example, as a defense against fear of taking academic risks, underlying existential depression, or indecision over which career path to take? 
  • Are gifted individuals better able to "outsmart" treatment professionals so they can remain entrenched in their disorder?

Just as in every other area of their lives, their giftedness impacts who they are. And it will play a role in treatment and recovery. An understanding of giftedness is essential for family, friends, and treatment professionals in order to help any gifted individual struggling with an eating disorder.

How can you help your child (or friend, student or family member) if she has an eating disorder?


1. Insist that she get help. Don't take no for an answer. The sooner the eating disorder is treated, the less entrenched it will become, and the sooner she will be on her road to recovery. Outpatient treatment typically involves individual and family therapy, nutrition counseling, group support, and medical monitoring with a physician. If outpatient therapy is not enough, sometimes inpatient or day treatment programs are helpful for quickly intervening with symptoms and offering a jump start on recovery.

2. Find a comprehensive treatment team that includes a licensed therapist, registered dietitian and physician who specialize in eating disorders. Check with your pediatrician, school counselor, spiritual leader or other trusted sources for referrals. There are also some sites online, such as EDReferral, that may provide some direction. Your insurance company may be the worst referral source, since they frequently offer random recommendations without regard to your specific needs. Trust your child's and your own instincts about a therapist, even if the referral comes from someone you trust. This is an investment in your child's health, and all of you need to feel comfortable with whomever you choose.

3. Develop a plan if your child refuses therapy. If you have concerns about her health (e.g., weight loss, purging behaviors), take her to her pediatrician, who can evaluate her symptoms and inform her about the importance of treatment. If she still refuses, she might be more open to meeting with a registered dietitian, who can work with her collaboratively to develop a healthy meal plan. If she cannot follow the meal plan, then you have more authority in your claim that she needs treatment. See if other trusted adults in her life can speak with her about going to therapy. As a last resort, you could stage a form of intervention where you and other loved ones challenge her about your concerns and the need for treatment.

4. Get support for yourself.  While it is important to respect your child's privacy, ask her if you may speak with your closest family members and friends so that you can also receive support. When your child is struggling, you suffer as well.  If you need additional guidance, sometimes therapy, eating disorders support groups, or even online groups can be helpful. As difficult as it is, know that your involvement and concern sends a powerful message of support and encouragement to your child and aids in her eventual recovery.

*The National Eating Disorders Association (NEDA) is offering a free online screening tool that you can access here.

Websites filled with helpful information and resources about eating disorders:

Tuesday, February 16, 2016

What causes gifted underachievement?

Why does your gifted child struggle in school?

Your child, once curious, energetic, overjoyed to learn, now has little interest in academics. As a parent, you stand by helplessly, saddened as you watch the spark disappear.

Gifted underachievers vary in how they display their underachievement. They may exert just enough effort to coast through school, under the radar and ignored because of average or even above average grades. They may become "selective consumers" who choose to achieve only in classes they enjoy, Or they may give up completely, perform poorly, fail, or drop out.

Yet not every gifted child underachieves. All children, especially teens and middle schoolers, face peer pressure and heightened expectations; not all respond by losing their drive to succeed in school.

Then, why?


So, then why do some gifted students lose interest and underachieve when others stay focused?  Researchers and theorists have suggested various reasons for underachievement, some based on sound research, others based on clinical observation or theory (see several references below). Here are some findings:

1. Family dynamics - Family dysfunction, distress, conflict, inconsistent parenting, mixed messages about achievement, an absence of role models, excessive pressure to succeed, or either too much or not enough supervision - all may negatively impact a gifted child's drive to achieve. In families where parents are divided in their opinions about achievement, children may develop resentment about expectations, and may withdraw or rebel. If there is a high level of conflict at home, gifted children may become anxious, angry and preoccupied with the family struggle, and school may take a back seat. 
2. Individual traits - Various personal traits, behaviors and emotional reactions have been linked to gifted underachievers in research and observational studies. These include any of the following: insecurity, perfectionism and fear of making a mistake, conflict avoidance, passive-aggressive behavior, existential depression, and perceiving oneself as an "impostor." These traits limit students' willingness to push themselves, care about their school work, risk failure or endure the envy of peers.
3. Sociocultural Issues - Peer pressure, the desire to "fit in," and cultural issues that discourage achievement all take their toll. Many gifted youth "dumb themselves down" to remain popular; others do this just to survive and protect themselves from bullying. Gender role development plays a part, including boys' concerns about appearing strong, athletic and tough, and girls' self-doubt and desire to be popular and attractive - all quite different from the "gifted nerd" stereotypes. And some cultures discourage academic success, particularly for girls.
4. School Policy - Underidentification of giftedness, misconceptions about gifted students' abilities, and school policy that discourages universal screening or appropriate and meaningful education for gifted children all contribute to underachievement. Some gifted children become "involuntary underachievers," particularly those in impoverished school districts lacking financial resources for gifted education. School policies that discourage enrichment, acceleration, ability grouping or creative alternatives to the mainstream curriculum deprive these students of the education they desperately need. Without the necessary complexity, depth and pace of learning, without like-minded peers, and without teachers who are trained to understand and teach gifted children, they quickly lose interest in learning, and disrespect their teachers and the school culture.
5. Teaching mismatch - Even though most teachers genuinely try to provide the best possible education, gifted students are frequently left behind. Many teachers lack training in gifted education and some hold biases about giftedness. Teachers who do not understand asynchronous development or who think all gifted students are high achievers, may assume unrealistically high expectations and become frustrated when students perform poorly. Some teachers place gifted children in the role of "junior instructor," expecting them to teach fellow students. When gifted students are singled out, their differences are highlighted even further, resulting in increased isolation from peers and possible bullying. And in many classrooms, gifted students are just left alone - it is assumed that they "will do just fine" and don't warrant the time and attention the rest of the class requires. Without school work that challenges them, they become bored, inattentive and discouraged. They also may become apathetic, afraid to take academic risks, and may never learn study skills or the value of hard work.

A perfect storm: Middle school 


Although some gifted children lose interest in academics early on, most underachieving gifted students don't start to disengage from learning until middle school and high school. At that point in their development, there is a perfect storm combining the following:

  • An accumulation of apathy and disrespect for the system, built up after years of boredom, frustration and feeling that their intellectual needs were never understood, appreciated or challenged. School may seem boring and pointless, and they may refuse to consider any possible benefits it could offer; 
  • Increasingly independent thinking, as they forge their own identities, formulate their own views, and develop distinct beliefs, often quite different from those of their families (fueled even more by their sharp intellect and questioning approach to just about everything);
  • Developmental changes related to puberty, hormonal shifts, mood swings, and a heightened interest in sexual and dating relationships, which may take precedence over academics;
  • Social pressure to conform and achieve popularity, prompting decisions regarding the necessity of fitting in, and whether to embrace or discard their gifted identity. If it is seen as a liability, many will "dumb themselves down" to gain acceptance.  And for some, especially those in inner city schools, conformity can be a matter of survival;
  • Increased academic demands. Middle school provides an increasingly competitive, somewhat rigid environment, with higher expectations related to performance, less attention and support from teachers, fewer opportunities for creative expression, and less tolerance for quirks and divergence from the rules. Students also may encounter a difficult assignment for the first time - frequently a shock for those who had coasted through elementary school; 
  • Awareness of their inadequacies. If they have not had an opportunity to fail at something in elementary school, they surely will by middle school. In addition to the social scene, often filled with pain and drama, gifted students start to realize that they are not going to be successful in every area of their lives. They may not be the best in every subject, may not get the highest grade, and may never be the most talented. While some can brush this off and move on, others may believe their identity is threatened, feel devastated and retreat. Fearful of taking risks, they may give up easily or become highly anxious before every exam. Since they never had to work hard before, they lack the study skills and strategic planning abilities others learned years earlier. 

Understanding must inform intervention


In order to address the roadblocks that can derail gifted students' performance, a thorough understanding of the possible reasons for underachievement is essential. 

For each child.

Every child is different, so offering sweeping generalizations about reasons for gifted underachievement does not benefit any particular individual child. The list of causes above is a starting point, but parents, teachers, counselors, physicians, school psychologists, therapists, and the child all need to sort out the unique and specific factors that are creating problems. Typically, more than one causal factor is involved, and resolving the problem requires intervention at many levels. But it is critical that a thorough understanding of the cause(s) must inform and drive any intervention. Your child will benefit from your close and attentive focus on what is contributing to the problem, with the hope that you and the school can intervene to quickly resolve it.

This blog post is the second in a three-part series about gifted underachievement. The first post: Who is the gifted underachiever: Four types of underachievement in gifted children focused on forms of underachievement. Also, see Underachievers under-the-radar: How seemingly successful gifted students fall short of their potential. Stay tuned for the third post about interventions for underachievement in gifted children!

References:

Baker, J., Bridger, R., & Evans, K. (1998). Models of underachievement among gifted preadolescents: The role of personal, family, and school factors. Gifted Child Quarterly, 42, 5-15.
Clasen, D., & Clasen, R. (1995). Underachievement of highly able students and the peer society. Gifted and Talented International, 10, 67-76.
Delisle, J. & Galbraith, J. (2002). When gifted kids don't have all the answers: How to meet their social and emotional needs. Golden Valley, MN: Free Spirit Publishing.
Gurian, M. & Stevens, K. (2007). The minds of boys: Saving our sons from falling behind in school and life. San Francisco, CA: Jossey-Bass.
Hoover-Schultz, B. (2005). Gifted underachievement: Oxymoron or educational enigma? Gifted Child Today, 28, 46-49.
Kay, K. & Shipman, C. (2014, May). The Confidence Gap. The Atlantic. Retrieved from http://www.theatlantic.com/features/archive/2014/the-confidence-gap/359815/
McCall R., Evahn, C., & Kratzer, L. (1992). High school underachievers: What do they achieve as adults?  Newbury Park, CA: Sage.
McCoach, D. & Siegle, D. (2001). Why try? Factors that differentiate underachieving gifted students from high achieving gifted students. Office of Educational Research and Improvement: Washington, DC. Retrieved from  http://files.eric.ed.gov/fulltext/ED454678.pdf.
Peterson, J. (2000). A follow-up study of one group of achievers and underachievers four years after high school graduation. Roeper Review, 22, 217-224.
Reis, S. (2002). Social and emotional issues faced by gifted girls in elementary and secondary school. The SENG Newsletter, 2, 1-5. Retrieved from http://sengifted.org/archives/articles/social-and-emotional-issues-faced-by-gifted-girls-in-elementary-and-secondary-school.
Reis, S. & McCoach, D. (2000). The underachievement of gifted students: What do we know and where do we go? Gifted Child Quarterly, 44, 152-170. 
Siegle, D., & McCoach, D. B. (2005). Motivating gifted students. Waco, TX: Prufrock Press.
Smutney, J. (2004, Dec.). Meeting the needs of gifted underachievers - individually! 2e Newsletter. Retrieved from http://www.davidsongifted.org/db/Articles_id_10442.aspx.

Monday, February 1, 2016

Who is the gifted underachiever? Four types of underachievement in gifted children

There is a pervasive myth that all gifted people are high achievers.

But many are not.

Most young gifted children are a ball of energy, full of life, curious, intense, and driven. Then reality sets in. They confront the limitations of school, peer pressure, others' expectations and their own fears, and some scale back their drive. Their intrinsic love of learning seems to vanish overnight.

Underachievement may develop gradually, with less effort expended on homework, tests or projects. Or it can start abruptly. A gifted child, once actively engaged in school, might lose all interest and motivation. Examples of underachievement include risk-aversion, cutting corners on assignments, a refusal to study, or angry rejection of the school culture.

Gifted underachievers are a widely diverse group of children (and adults), whose behavior springs from multiple sources. Some underachievement reflects emotional distress, family problems, or the effects of peer pressure; other times, it develops primarily in response to boredom and an absence of challenging academics. Some underachievement is more easily recognized, such as when a child starts failing at school, but sometimes it is more subtle and is overlooked.

Why are gifted underachievers so hard to identify?


Although underachievement might seem obvious, gifted underachievers may remain hidden. Many students are not identified as gifted, their giftedness is masked by a learning disability or other twice exceptionality, or they may not fit the "gifted child stereotype," (i.e., the well-behaved, highly verbal, slightly nerdy student who always excels). As they get older, they may hide their giftedness to fit in, and as long as they are not disruptive, may be ignored. Their subpar achievement may not be recognized because they can often coast through school and receive adequate grades without exerting much effort.

Researchers also have struggled to agree upon a clear definition of gifted underachievement. Difficulties include the differences across studies in terms of definitions of both giftedness and achievement. The criteria and cut-offs used to identify giftedness or gifted programs have varied, with some studies using a wide range of test scores, and others settling for placement in a gifted class. And defining achievement is even more difficult. Questions arise regarding whether to use achievement tests, grades, teacher ratings, or some other measure of progress, along with whether to assess improvement based upon objective criteria over time, or on the difference between actual achievement and the child's potential. And how do you define potential, anyway?

Despite these theoretical and practical difficulties, researchers have settled upon the following criteria for defining underachievement:

1. A discrepancy between ability and achievement
2. Must have persisted for at least a year
3. Not due to a physical, mental or learning disability

This very basic criteria is only a start and does not convey the complexity and diversity of gifted underachievers. Researchers have offered more detailed information based on investigative studies, theories of gifted underachievement, and classroom or clinical observation (see references below as examples). Based on the literature, a picture of several types of gifted underachievers has emerged.

So, who is the gifted underachiever?


One way to understand different types of gifted underachievers is to consider four categories of underachievement:

1. Involuntary underachievers

These are students who would like to succeed, but are trapped in schools that are underfunded, poorly staffed or unable to meet their needs. Frequently a problem in minority and low-income communities, these gifted students are often bored, distracted, and may be completely unaware of what might be available through a more comprehensive, enriched education. Many are never even identified as gifted or offered gifted education. Some of these students may be hard-working, but never have an opportunity to excel. Others may coast through school, give up, or act out due to boredom. These students' underachievement results from an absence of available options and is not caused by personal, family or peer conflicts.

2. Classic underachiever

These gifted underachievers underperform in all areas of study. They have given up on school... and on themselves. Their underachievement typically starts in middle school, although there may be signs of boredom or depression that manifest in elementary school. They are often angry, apathetic, rebellious, or withdrawn. Given their intellect, they often espouse a host of "logical" reasons for refusing to exert themselves, and resist parents' or teachers' efforts to encourage, prod, or coerce. School faculty may give up in frustration, pointing out the "waste of potential," and worry that they have "lost" these children.

3. Selective Underperformers

These underachievers are active consumers - they choose to excel only in areas that interest them or within classes where they like and respect their teacher. Otherwise, they exert little effort. They view school like a Sunday buffet, where they can select what they want and ignore the rest. Gifted underachievers as "selective consumers" is a concept first identified by Jim Delisle, and describes the very independent path these students take. While involvement in what they enjoy still creates some challenge, their refusal to achieve in other classes limits their academic development and sets an unhealthy precedent for future learning. It also may affect their grades and opportunities for college or career.

4. Underachievers under-the-radar

Gifted "underachievers under-the-radar" are frequently overlooked, and sometimes even mistaken for high achievers. These are the exceptionally gifted students who coast through school, often receiving average to high average grades, but who fail to reach their potential. Given their performance, their lack of effort often goes unrecognized and they are rarely encouraged to challenge themselves. Consequently, they may never learn how to take on academic risks, experience and learn from failure, or develop resilience. These life lessons often occur much later - in college or at work - where they may feel blindsided because of lack of preparation.

Recognizing the different ways gifted underachievers may present their difficulties is a first step toward understanding them and finding an appropriate intervention. Certainly, prevention is ideal whenever possible. Although some situations may not be avoidable, such as a family crisis or an innate tendency toward depression, many precursors could be remedied, particularly when they involve changes within the schools. Early identification of giftedness, providing gifted services, and allowing these students to accelerate or study along with other gifted peers is a first step toward providing the stimulating, creative and engaging education they need.

This blog post is Part One of a three-part series on Gifted Underachievers. Part Two will focus on causes and Part Three will cover interventions. Stay tuned!

References:

Baker, J., Bridger, R., & Evans, K. (1998). Models of underachievement among   gifted preadolescents: The role of personal, family, and school factors. Gifted Child Quarterly, 42, 5-15.
Clasen, D., & Clasen, R. (1995). Underachievement of highly able students and   the peer society. Gifted and Talented International, 10, 67-76.
Delisle, J. & Galbraith, J. (2002). When gifted kids don't have all the answers: How to meet their social and emotional needs. Minneapolis, MN: Free Spirit Publishing.
Emerick, L. (1992). Academic underachievement among the gifted: Students’ perceptions of factors that reverse the pattern. Gifted Child Quarterly, 36,140-     146.
McCall R., Evahn, C., & Kratzer, L. (1992). High school underachievers: What do they achieve as adults?  Newbury Park, CA: Sage.
McCoach, D. & Siegle, D. (2001). Why try? Factors that differentiate underachieving gifted students from high achieving gifted students. Office of Educational Research and Improvement: Washington, DC. Retrieved from  http://files.eric.ed.gov/fulltext/ED454678.pdf.
Olszewski-Kubilius, P. & Clarenbach, J. (2012). Unlocking Emergent Talent: Supporting High Achievement of Low-Income, High-Ability Students. National Association for Gifted Children: Washington, DC.
Peterson, J. (2000). A follow-up study of one group of achievers and underachievers four years after high school graduation. Roeper Review, 22, 217-224.
Reis, S. & McCoach, D. (2000). The underachievement of gifted students: What do we know and where do we go? Gifted Child Quarterly, 44, 152-170. 

This blog is part of the Hoagie's Gifted Education Page Blog Hop on Other Achievement. To see more blogs in the hop, click on the following link:
http://www.hoagiesgifted.org/blog_hop_other_achievement.htm.