Gifted Issues Discussion homepage Forums Twice Exceptional When are OE's really 2E?

So, I understand the whole theory behind OE's but I have to wonder at what point do OE's become more than just a 'quirk' and become something diagnosable? My DS6 has OE traits from all five domains but there are some in specific that have continued to be problematic and have seemingly gotten worse instead of better as of late.
His psychomotor excitabilities have always been noticeable but were problematic through the school year as well as at church, restaurants, etc... The biggest concern though is his anxiety and sensory issues. He is terrified of the noise of flushing toilets and is terrified that a toilet may overflow when flushing it. He is also frequently worried about thunderstorms, EAS warnings on the TV/radio, making mistakes in front of others, someone not following rules, etc... The reaction can range anywhere from just looking tense to hyperventilating and racing heartbeat, to an all out melt down.
Today he told me that his brain "feels funny" because it felt like one side of his brain was "saying that life is real" while the other side was "saying that life is fake". He said that it felt like the two sides were "fighting with each other to see which one if right". He also complained today of feeling funny in his chest, saying that "it feels like I'm not breathing even though I know I am." and that the fight in his brain was making his teeth "tingle".
I am a nurse and have listened to his checked hi vitals and haven't found anything concerning and he doesn't appear all that distressed most of the time so I am not too concerned that there is an acute medical condition to blame here. My thought is that some of what we have been seeing in him almost looks like a panic attack. There is a strong family history of anxiety disorder as well as some other mental health issues on both sides of the family. My concern is making sure that I am viewing the situation in a balanced manner. Knowing the family history as I do part of me is thinking maybe I'm just seeing things because I expect to find them and that maybe this is all within the realm of OE. The other part is worried however that I certainly don't want to cause my son to struggle more than necessary with something that may be out of his control and potentially limiting for him. I don't expect any medical advice here. I plan to talk with his pedi tomorrow while I'm at work but I was just wondering if anyone else here has BTDT or has any thoughts on where the line is drawn?

I am no expert, but this to me sounds like it would be useful for him to address the anxiety with someone familiar with gifted kids. It seems like there may be some tools they could give him (CBT?) to manage it, and like something perhaps worth addressing at this point.

I also think it would be helpful for you to seek advice from someone familiar with gifted kids and also with 2e issues. It seems like it can be very hard to sort out, even though I guess in some cases the methods of addressing the issues can be the same. We went to a non-specialist this year and ended up with a bunch of labels (ODD, ADHD, Aspergers) that we are now trying to work through and maybe get 'removed' or at least refined by another specialist (lest future teachers and schools be horrified by the number of labels)--a very long, time-consuming, and expensive process. The Davidson site has a number of helpful articles on this that maybe you're already familiar with; I found this one yesterday and it's like a checklist for our DD (about what if the 2nd e is emotional?)
http://www.davidsongifted.org/db/Articles_id_10438.aspx

Sorry I don't have anything useful to say about anxiety, but it sounds like you already are pretty well informed. Our DD has also gotten more sensitive over time, but mostly it's foods that she used to eat but now won't (whittling the total number down to about five) and clothes that she used to wear but now won't (muumuus only, please!). I hope you can find a solution for your son--it must be very frustrating for him to feel that way.

I am not an expert, but I think in most instances the diagnoses include the proviso that the behaviors interfere with normal life activity (which I guess is sometimes interpreted pretty broadly--such as annoying your teacher), and sometimes that that happens in more than one setting (e.g., school and home). It sounds like he's feeling this way all the time, but can he put it aside and focus on other tasks sometimes? I think that might be a line of thought to pursue.

Best of luck,
Dbat

And I would agree with this in my practice as a parent. If it's a real problem, why not work to solve it rather than shrugging it off by calling it an OE?

I have not seen evidence that OEs are "real." They are a theory about gifted people, but not a theory for which there's a great deal of evidence, as far as I know. IMO the idea of OEs keeps a lot of 2Es from being diagnosed and getting real, valuable help. (Our DS was diagnosed late with AS because people, including several doctors, assumed he was odd just because he's so smart. It lost us years of treatment.)

I'd say, if the behaviors and thoughts are interfering with life activities or causing suffering over some months or years, it's time to investigate.

DeeDee

This is my current thinking on this issue.

Although I'm never sure in psychology-land what exactly is going on.

Some things, like schizophrenia and real bipolar (with manias) are easy to see and figure out. Autism/AS seems to be pretty solid, too.

But with the OE/2e issue you are talking about a subset of an already small subset of the population where the problems are obviously not as clear cut as some of the more solid psychiatric problems.

My has all five OEs. The only one that was ever a problem was the hypersensitivity, but he almost always managed to control his behavior when he was around other people. He is sensitive to sounds and smells that cannot be avoided and he will not tell anyone about them because he knows that if any other kids knew he would be made fun of and possibly bullied. His acting skills have helped him hide some of this, but it doesn't stop what happens on the inside. His blood pressure goes up (I have the same problem) and he has anxiety but he can keep going if he has to. For example the sound of a fork against a plate or jangling keys will drive him up the wall and he will keep it together until he gets to a safe place to let it out. Insects buzzing around his head is the worst but again he is able to hide this most of the time.

When he was seven we were told to read "The Out of Sync Child Has Fun" but it didn't really help us that much except that I learned about the sensory diet. Since we homeschooled I let him take breaks often and move around the house and climb on furniture when he was younger and it helped. Then everything fell apart when he got the scoliosis brace and it limited his movement. The doctor and the orthotist told us that most kids can get used to the pain and learn to sleep in the brace. He had trouble sleeping before the brace and with pain there was no way. Every single day is a difficult balancing act trying to get enough brace time in while also getting enough sleep and exercise. It is really impossible to do it all but we get close sometimes and we are hoping it is enough and that we can continue for another year or so. When you add migraines any time the weather changes and it feels like life is totally out of control and then we don't have reliable internet where we live and that is another thing we work around. All of this does affect the amount of work he is able to do. Luckily he still learns very quickly when he is having a good day and he manages to make up for lost time. He would not be able to do this in our one size fits all, everyone must color in the lines public school. I don't know what would happen to him if he had to go back to school. I have anxiety about this.

This is a good question and one I'm asking too. We're in the process of seeing a 2e specialist so I don't have a definitive answer for you at the moment - except she briefly mentioned about the sensory issues too and the fact that my son has spent nearly all his life in therapy.

My 6.5 yr-old son was born with some physical issues. He was diagnosed early (under a yr) with severe sensory integration disorder/dysfunction (across all domains, if I remember correctly). He had a lot of delays and had over 5 years of pt/ot, including at a sensory gym. So I can definitely relate here. He also finished 2.5 years of vision therapy over the holidays. Visual processing deficits can often overlap with sensory/anxiety issues.

Until we placed our son in a private gifted school, we thought the sensory stuff and asynchronous development related to the special needs. We had no idea that they may be related to giftedness. We knew our son was bright, but had no clue how bright until he went through the curriculum so quickly at the private gifted school and the teacher told us that he might be eg/pg.

OT in a sensory gym can reduce the sensory overload or input. I can attest that it does work, over time, a lot of effort, and patience. The sensory diet can help; "The Out of Sync Child" is a classic in the field. Vision therapy, too, can make a world of difference too.

I've noticed that my son's OE's particularly flare up when he's going through a big development. He seems to be overstimulated and overwhelmed easily at times. I withdrew him from school a couple of weeks before it ended and plan on homeschooling him next year. I'm hoping this will reduce some of the OEs as well or at least we find a way to live with them more easily than we have been.

Here's a checklist on sensory processing disorder:
http://www.sensory-processing-disorder.com/sensory-processing-disorder-checklist.html

And other links on it:
http://www.sinetwork.org/about-sensory-processing-disorder.html

http://www.sengifted.org/archives/a...on-in-the-gifted-and-talented-population

Yes--this is what I see too. I don't really have an opinion on the larger theory of positive disintegration, but when I started reading about OEs I immediately recognized both of my children in different ways. This had a very positive impact on my ability to respond to them, because what used to seem much more worrisome to me, I now see as the difficult side of some of their more unique positive traits. While I think that there is cause for concern any time that a trait becomes overwhelming to a child in some kind of persistent way, I also think that we have a tendency to overpathologize differences.

The nice thing about gifted children is that some of them are able to read about these and contextualize their own "more" responses in a way that they might not otherwise be able to do. My son is still too uncomfortable holding a mirror up to his differences, but for my daughter it was a life changing sigh of relief to read about OEs and see them in relationship to her strengths.

I think this is key. I don't actually see what it would mean to answer the question in the subject line - we could draw a line and say that side is a sensory OE that side is SPD (for example) but I think such a line would always be arbitrary - we should draw in in a place that is pragmatically useful in getting the right things done. You don't want either to overreact to an unusualness (label something as 2e that's better treated as OE) or underreact (vice versa).

I'm sorry you lost years of treatment; sounds like the line didn't get drawn in the right place in that case. Here's a different anecdote:

When DS was 6 and struggling with what I labelled emotional OE, I found it useful to draw his teacher's attention to the notion, because this helped her to see his behaviour as a curiosity she could work with and around rather than as a disorder she should hand over to some other professional. Part of what I was concerned about, actually, was the risk that DS might get diagnosed with Asperger's, something I felt wouldn't be correct or helpful. (And in fact, reframing it for that teacher helped tremendously, and now that DS is 8, I don't think anyone would remotely consider that he might have an ASD; in that sense, I'm confident I made the right call.)

The behaviours and feelings that are labelled OEs certainly exist in some children; I suppose an interesting and answerable question would be, are they actually correlated with giftedness? You would need a careful study design to be sure, with good definitions of both what it is to have an OE and what it is to be gifted, avoiding being either more or less likely to count a child as gifted as a side effect of them having OEs, for example! But it should be doable. I'm not aware that such a thing has been carefully done? My hunch is that you might get different answers for different OEs, but that you'd find something interesting. Of course, it could still be a useful notion even if there turned out to be no correlation with giftedness.

I see both sides of this. I'm concerned about the tendency to see natural human varaiation as problematic/ a disorder. I want to exmiane the tendency to blame the child rather than the environment. However, if we have a child who is having problems in every environment, and if sensitive accommodation has already been tried, then it seems highly reaasonable to say--okay, we need to help this small person. Let's not get caught up in lalala, this is an overexcitability!