Autism

I think a big divide for those that were listed as academically gifted were how their parents treated them.

I was basically "tier 2" gifted in that I was in the gifted programs, AP classes, honors, etc. I was a pretty solid B student and couldn't just cruise through class and get As, that took some effort.

I have what most people would see as a prestigious career in STEM, I know people that I went to HS with that doctors, researchers, etc. The key difference is that there was way less parental pressure. My parents (and the others I know that are successful) didn't get rewarded or punished for good grades. It was a more of a what you make of it situation. "You know you can do better than this B if you applied yourself, but we won't punish you for it". My parents gave me more freedom as I demonstrated responsibility. I never had video games taken away as a punishment. Never given money for good grades either.

In contrast, all those kids who had their parents up their ass (often out performing me) mostly went nowhere. Burnt out before hitting college, selecting "middle of the road" careers.

I think it boils down to motivation. All those parents suffocating those kids. The kids never build any intrinsic motivation. It's always driven by fear and reward for them. You need your own motivation to push through the "more challenging" career choices.