Dr Cedric Leclercq

MB, Bchir, FRCPsych

Consultant Child And Adolescent Psychiatrist,
Consultant Psychiatrist
35 Great James Street, LONDON

I have twenty years’ experience treating the range of disorders encountered in child, adolescent and adult mental health. For the last telwe years, I have been focusing on ADHD and intellectual giftedness (High Potential). This is the specific clinical field I am actively working on in 35 Great James Street.

Working with ADHD and gifted children, young persons and adult is not only about treating a condition. It is helping them developing an evidence-based understanding of what they have to cope with on a daily base. Talking about family functioning, education, relationships, work, I think ADHD as well as giftedness make it an obligation to adjust the model. Practically, it means things should frequently be done in a slightly different manner. This allows helping parents finding their own way.
The patient I see may encounter a quite large range of difficulties in daily life. Amongst others, it could be that:   

  • They struggle at school/Work as they find it hard to concentrate, to focus, to maintain attention and to avoid being distracted.
  • They often (but not always) show difficulty controlling their body, their behaviour and their emotions. They frequently find it hard sitting still, or not being verbally or physically impulsive.
  • They frequently underachieve education, should they or not show learning difficulties as well.
  • They tend to have a low self-esteem, underestimate themselves and can be discouraged, sad or exhausted.
  • They are also anxious or look like not caring about what they go through. They could avoid engaging into education/work and show delay aversion.
  • They can also have sleeping issues (difficulties getting asleep or waking up frequently).
  • They could be intolerant to frustration, go from one mindset to the opposite one rapidly, or be oppositional, or be tempestuous. They could be fidgety or shift from one extreme to the other.
  • They could be flitting from thought to thought with great speed. In daily life conversation, they could jump from one topic to another which could make them look like not listening or not paying attention to others.
  • They are frequently sensitive, are angry with what would be unfair and can over-react in a way that doesn’t help them.
  • They often fail multitasking or achieving sequential activities.
  • Others could process very slowly or be quite rigid thinkers.
  • They could easily lose items or look like not organized or clumsy.
  • Some show difficulties with social interaction. 
  • Others seem sociable and easy with making friends. 
  • Some are spending lots of energy trying to fit in.

Once again, these are just examples amongst many others. ADHD and related neurodevelopment conditions as well as intellectual giftedness may express in very different ways depending on the person themself as well as on their history, environment, learning profile etc...

This is the reason why it is also essential to note that these people  frequently show some specificities. These are not necessarily issues, but they need to be addressed in order to precisely understand and help them and their family. These specificities could for example be:

  • Being sensitive.
  • Showing sensory particularities.
  • Being very mature in some circumstances, seeming not to be in others.
  • Paying strong attention to fairness.
  • Alternating kindness and rage or behaving like not being connected to others from time to time.
  • Or being over-connected to others, being considered idealistic, able of strong engagement, interested in many different subjects, being inquisitive and smart.
  • Showing deep empathy. 
  • Or on the contrary looking like not paying attention to others. 

Most importantly, having been working with them for many years now, I came to consider they always show some strengths or abilities which I like to enhance and nurture. Sometimes, these strengths and abilities are quite obvious (at least they are to parents, partners or to people who know them well). But it could be that they are hidden, or they could seem to have vanished into thin air after having been expressed in early age. Not underestimating how hard these people are struggling, knowing about their talent as well is more than helpful. It is just fairness. We could for instance talk about:

  • Empathy which as mentioned earlier could be exacerbated.
  • Showing interest into new activities, seeking for novelty.
  • Being very sensitive and/or showing peculiar sensory profile.
  • Being creative.
  • Showing originality while solving problems or using objects or words.
  • Thinking in a different way about people, situation and habits.
  • Being brave, strongly intending to do their best and to please others.
  • Being grateful when they are recognized for who they trully are. 
  • Being enthusiastic and shiny boys and girls.

It is my conviction that difficulties, specificities as well as abilities need to be considered when for instance deciding for a care plan. This care plan should be as adjusted as possible to one person. The more  a specific situation is  understood, the more efficient and helpful advice and tips are to be. Giving support, communicating with school, working with parents on routines and tools, helping the patient knowing about himself … are in my opinion essential in order to implement a sensible care plan.