Could being high-IQ and “gifted” really be a type of special need…and are we failing these children?

Our 40th episode of Against Medical Advice is a truly fascinating deep-dive into a topic that is often ignored, with the amazing Dr. Blair Duddy, pediatrician and friend of the show. Share, and make sure to check out his take on vaccines here.

Transcript Below:

Dr. Z: So, we have with us today, Dr. Blair Duddy. Local pediatrician extraordinaire, UCLA alumn  and pro science, pro children. So, one of your passions Blair is the idea that children who have certain intellectual abilities. Higher IQs. Gifted children. Talented children have a hard time in our current educational and social system actually surviving without a lot of suffering without a lot of downside, which is counterintuitive, you think, well, those are the guys that become the Silicon Valley nerds and make us all look bad and drive Porsches and have trophy wives. That’s not what actually happens. You have a kind of a vested interest in this with your own children. Tell us about your, you know, your thoughts around this and your work in this space.


Dr. Duddy: So, I was thinking about you when I was watching the show that you had with Mrs. Dr. ZDogg. And you were talking about parenting in general, and it was wonderful that you guys were vulnerable because we need people to do that. Like people like Chrissy Teigen, who talked about her postpartum depression, it’s super important. And it’s a challenge to parents. We all stress out even as a pediatrician, as a pseudo expert, you know, it’s a challenge. I’m always thinking, am I doing the right thing? But what I was thinking about was when you talked about what a handful you were as a kid to your parents. I was like, “Oh, that’s the giftedness.” Because.


Dr. Z: I knew it. See that mom and dad. Gifted AF, right here.


Dr. Duddy: No, it’s hard to talk about it because it’s like, you’re, you know, braggy. It’s, you know, you can brag about your kid being in the little league world series, but don’t talk about him being, you know, in the gifted program.


Dr. Z:  That’s kind of true.


Dr. Duddy: Right. But it’s really an attribute, just like any attribute, what you do with it is dependent on your work ethic and your heart and all that, just like.


Dr. Z:  Anything.


Dr. Duddy: You know, yeah. And so when I see young families, with kids that are gifted, I really try to help identify them early and let them know because one of the things is that the smarter they are, the more stubborn they tend to be when they’re young, I was thinking about your daughter too. And the more stuff they get into. High intellect goes with high anxiety. So, they tend to be high strung. They get this incredible sense of right and wrong that is kinda you too. Like when they see the news and they see injustice, it’s really hard for them. So, you have to like shelter them from that. It’s really a special need, you know? So, there’s several ways of finding gifted, you know, using IQ testing is one of them and it’s surprisingly effective. Meaning you think there’s some subjectivity to it. And I see kids that are tested several times and they’re usually within four or five points. This is just an attribute, just like height or BMI.


Dr. Z:  It’s like a vital sign almost.


Dr. Duddy: Yeah, and so, you know, gifted, some definitions would be two standard deviations above the normal. It could be the top, you know, two and a half percent of that tier, which would be 130. And the thing I talk about is that having a 130 IQ when 100 is mean is as far away from the mean as 100 is from 70. So, 70 is sort of the upper reaches of Down syndrome. Would anyone allow their 10 year old to be in a class, would it be appropriate of, you know, 20 kids with Down syndrome? And there’s no value judgment about that, of course. But it just wouldn’t be a good educational experience. So, putting these gifted kids in with neuro-typical kids is very problematic. It’s really a special need, and they get bored. If you look at dropout rates in high school, the two ends of those extremes and the gifted have a high dropout rate, they have a high substance abuse rate. They get bored.


Dr. Z:  So, you use the term. I mean, there’s so much to unpack in this. And of course it’s of acute interest to me because I’m a fricking genius. You don’t understand, like off the charts, I took an IQ test on United Airlines in their little sky mall brochure. And I broke, the thing it melted because the score was undefined because I got a lot of them wrong.


Dr. Duddy: Well, you’re of course joking. Cause you have to but it’s true. Like what you bring together is very unusual. And again, thinking about you as a kid would be very hard to raise the kid. I bet you were very difficult. You’ve talked about that. You’re a little oppositional.


Dr. Z:  Yeah, incredible, still oppositional. Still high anxiety. Still right and wrong. Cannot stand when I see things that I think are dumb and I can’t shut up about it. And I love the word you use “neuro-typical” to talk about more of the mean IQ, because that is now what I’m gonna call both Tom and Logan, even though it’s inaccurate.


Logan: Hey, I got a 120, Z, when I took that test.


Tom: How dare you?


Dr. Duddy: Well, you know, the other thing that’s common in the gifted is actually incarceration. If you look at incarcerated people, they tend to be.


Tom: I’m, yeah, I’ve been incarcerated, so I’m gifted. What’s up? What’s up?


Dr. Duddy: Now it is. We have to pay attention to these kids. And in the end, it’s kind of the rule of thirds, a third do wildly well. They are, you know, Supreme court justices, they become ZDogg. A third medium well, you know, professional types. And then a third of them very poorly. They, you know, the high anxiety, they can’t be functional society, you know, and we have to keep on track of this and their development to really help them out.


Dr. Z: So, I never hear anybody…you were the first person I’ve talked to in the medical space that has talked about high IQ individuals like this. It’s almost like, “Oh, there’s a component “of those assholes.” Right? And the idea that they could have a deep kind of suffering that they might not do well in the world, that they’re a square peg trying to fit in a round hole. These ideas aren’t really explored much.


Dr. Duddy: No, it’s absolutely true. They deal well…as children, they react well or interact well with older kids and younger kids, but typically not same age peers. I had one family with a gifted kid and he was in kindergarten. He came home and he told his mom, I think there’s something wrong with the other kids’ brains because they get bored. If a neuro-typical kid, I mean, if the neuro-typical kid needs, you know, 10 exposures, reps to learn a new concept, the gifted kids learned it really fast. And so from rep two to 10, they’re bored, right? If I remember that in school, and then sometimes if an unsophisticated teacher would be like, “Oh, you’re doing so well. We’ll give you more.” That’s kind of punitive. What they should do is if the kids have 20 homework problems in math, they’ll throw in the five or 10, the other kids are doing and then give them some advanced ones on top of that. You know, skipping, I would say most sources I’ve seen will actually recommend skipping in the right kids. I kind of don’t get it personally because I worry about you don’t want to be a 14 year old graduating high school. You know I have a patient that was an 18 year old. He graduated college and you know, he still had the maturity of an 18 year old. He was kind of unhireable in the way he was, you know, just the way he comported himself. But he was obviously very bright. I said, go to grad school, right?


Dr. Z: Right, well, you look at like Elizabeth Holmes from Theranos, who’s now the subject of a huge SEC investigation. Young dropout from Stanford. Always a Doogie Howser type ahead of the curve and turns out she had very low, you know, I’ve talked to people who know her, her emotional intelligence is not very high. There’s a lot of other issues with her that probably led to the downfall, you know? So, this idea that you can be intellectually gifted, but socially, or the way I see it, and you can correct me if I’m wrong. There are multiple lines of intelligence. And IQ is one, math is one, verbal reasoning is one, but there are emotional lines of intelligence, there are social lines of intelligence, there are physical lines of intelligence that the kids who get bragged about for the sports, which I thought is, it’s absolutely true. You can tell, “My kid he’s first pick in the draft for this, “yeah.” But, “Oh, my kid has a really high IQ “and is acing all his classes “but is socially awkward and yeah.”


Dr. Duddy: No, a lot of times giftedness is asynchronous. They’re very, you know, great in math and not the other, those kids have the hardest time. They really, they have a higher chance of depression as well. Although, certainly anxiety. I, again, I read the literature about depression and some people feel it’s higher. My clinical experience would be yes, especially the kid with asynchronous. They’re very great at math, but maybe not as strong in language arts, or they have their, what they call twice exceptional. They have, they’re gifted, but they have a learning disability like dyslexia or ADHD. Sometimes I’ll be referred a kid with possible ADHD. Poor focused attention. And the diagnosis actually gifted is what they don’t have to pay attention. They know they’re going to go over it five times. And really, if you’re a Ferrari hitting on four cylinders, you can still keep up with the Camrys, right? So, these kids just tune out.


Dr. Z:  Well, first of all, how dare you insult a Camry? Because that’s what I drive. Number next, I think you’re right. Especially on the multiple different lines of intelligence and the asynchronous development. So, just my own personal anecdote. And again, I’m not saying I’m in any way, particularly gifted, but I was pretty good at verbal stuff, history. Social stuff. I had some gift in that. Math had always been a kind of a secret Achilles heel because I was good enough that with the other kids in the class, I looked pretty smart, but compared to smart kids, I was developmentally delayed. And when thrust into the pre-med world in college, I had never had to study in my life until college calculus. And I delayed calculus, I stopped at trig in junior year because I was so terrified of math secretly. And I just said, “Oh, I want senior year “to do a bunch of APs.” Which I did. Which allowed me to graduate Berkeley in three years. But that first year taking calculus, it was the most humiliating experience of my life because I felt as just absolutely dumb and overwhelmed that everybody just got it. And I was reading that math textbook. Trying to learn how to do math and I’d never been that depressed and upset and anxious. And so do you see that as kind of…


Dr. Duddy: No, absolutely. A lot of times they’re also perfectionists. So, like you did terrible. You got a B instead of an A right.


Dr. Z: That’s kind of what it was .


Dr. Duddy: But again, it’s an inherent trait. What you do with it, you know, is who you are as a person, right? Someone say with Down syndrome, trisomy 21, who’s got the 70 IQ. They often have a very high social IQ. They’re lovely, loving people. And you know, one of the stores, one of them is a bagger and she’s the sweetest thing in the world. And she’s of more value to our society than that… Can I say d-bag on this show? That Shkreli guy, the pharma boy. He’s probably, yeah, gifted to get where he’s at, but the world is not a great place because he’s been in it really. I mean, it’s just, here’s your attributes that you’re gifted in. What you do with them and how we help them navigate those to be a good person in society. That’s what we want.


Tom: I have a question for you, Dr. Duddy. Is this an interesting point of fascination for you because you’re obviously a very smart guy, do you feel you were mishandled going through school?


Dr. Duddy: No, I mean, I made it, I was smart. You know, my kids are super smart. I’m at the end of the trail, my son’s a senior in high school and he’s made it through. We’ve been in every educational situation, public, private. He’s at a very good magnet school right now. And it’s been a great school with lots of smart kids and very supportive. I think early on, we did actually homeschool off and on my wife was a teacher and that was helpful. One of the families, I take care of, the dad’s actually an ENT in town and they have gifted kids and they were kind of frustrated when we were talking about it quite early. And you know, where do you put these kids? And the private schools and he’s an ENT so he can afford, you know, the more expensive tuition. They have generally bright kids, but it’s still different than the social emotional needs are not always met or identified, especially in boys who can act out. So, anyway, they started…


Dr. Z: I was never caught.


Dr. Duddy: They started at school. So, they started then it’s just here in town. It’s been a bit round about a year and a half. Called the Nasri Academy. And I’m actually one of their, like, I guess, volunteer boards. It’s a, board members. It’s, you know, it’s a nonprofit and they’re just trying to get it up, but it’s hard because you know, you have to get, you know, we’re starting with that end of the two standard deviations to 2% of the population gifted. 0.1% highly gifted, which is like 145 IQ. So, they’re, you know, getting up and running and they really focus a lot on these topics, the emotional needs of the gifted.


Dr. Z: So, you know, cause what I noticed, what I noticed with my oldest daughter and she’s does violin, and she obviously is decent at school is that she has trouble getting the good citizen award. That pretty much everybody gets. It’s kind of like a participation trophy. And it means that you’re not, you listen in class and you’re not fidgety and you’re respectful and all these things and she has trouble getting it. And it upsets her deeply that she can’t get it. And I think it’s a lot of that is the agitation. Because when you watch her practice violin, she’ll play something, it’ll be a mistake. She will drop to the floor and start crying and in a way that she’s inconsolable. And I think it’s this with high intelligence comes high anxiety, it’s a fact for many.


Dr. Duddy: You know, when I see straight A students, I asked the mom cause dads are idiots and don’t always know. You know, is she a perfectionist? And the mom will say yes or no. They know what I’m talking about. And that’s something to work on, right? Because when I talked to them about, so the kid is, if they’re old enough to understand that like your daughter’s age would be like, you know, we all make mistakes and people that accomplish a lot, all have a story, a failure story in there, right? So, sometimes I’ll tell the big fail story of the Lisa computer. Yeah, most people don’t know that.


Dr. Z: I wanted a Lisa when I was a kid that’s how much of a nerd I was.


Dr. Duddy: You know, if he found one at a swap meet now there was like 60 grand or something.


Dr. Z: Wanna hear a story? So, someone in elementary school handed me a Lisa keyboard that he said fell off the back of a truck. And I didn’t realize that was slang for, he stole it and he just gave it to me. He’s like, “You seem like the kind of guy who’d want this.” And it said Lisa on it and this and that. And I was like, wow. And I was so weirded out that I took it to the teacher and I was like, look what this guy gave me. And he’s like, that’s stolen. And I had to sit in front of the principal and explain how I got this, yeah.


Dr. Duddy: Well, most people don’t know the story, but of course it’s the big story of, you know, a failure of Steve Jobs and he didn’t give up and he, you know, learned from it. What was the problem with the Lisa computer? I don’t even know is it the hardware? Software, marketing?


Dr. Z: It’s a lot of stuff.


Dr. Duddy: Whatever. And then the next version next computer was the Mac, right? And so these kids that are perfectionists, they don’t try things. They might not be perfect at. They’re super anxious. So, it can be tortured. It turns out ignorance really is bliss.


Dr. Z: Ignorance can be bliss. You know, what’s the ironic twist on that story is Lisa was the name of his daughter and his daughter from another wife who was, I believe, I forget the story when I read it, his autobiography, but she was a little bit more ignored and only reconnected with him later in life. So, brother, like you’re fighting the forces of evil. You have the “Star Wars” gear, you’re pro science. You love patients. You love what you do. And you fight for people that nobody fights for, the gifted. Blair Duddy is the man.


Dr. Duddy: Aaw, thank you so much.


Dr. Z: The man. Thank you for coming on the show. And remember if you or someone you love is gifted. You’re a nerd and need to be stopped. Is that right? Is that the premise?


Dr. Duddy: Yeah, a little bit.


Dr. Z: Roughly? We out. ♪ Yeah ♪