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Agreed. The trade-off is difficult. We're having to consider it for my (almost) 10yo daughter. Her teachers consistently tell us that she's exceptionally smart, but she can't stay focused long enough to complete her work. (She has been formally diagnosed as ADHD.) ADHD kids are prone to self-esteem issues arising from not meeting their own expectations for achievement: "Darn it, I know I'm smarter than a C." We don't want her getting to that point, so medications are on the table as a possibility. But, we want to explore other options as well.

I would refer to Barkley's latest book on "Executive functions what they are and how they evolved" to take a very high level approach of the problem. He puts forward a thesis at the end of the book that it's possible to diagnose someone on the evolutionary level of their exec function deficits. It's unbelievable. It's well worth a read, for more immediate and hands on I would check his other books.

If you figure out what part of the extended phenotype your daughter has the deficits you can probably move forward, however I've never seen this explained anywhere else other than his book. I wish more people had read it.


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