Logo for kidsinthehouse.com, a parenting site with 9,000 videosI wrote an article, ”Why I Believe Attention Deficit Disorder is a Myth,” for the website The Kids in the House:  The Ultimate Parenting Resource, on August 29, 2017.   The Kids in the House is a site that offers 9,000 videos from experts and parents (who are the real experts!) on a wide range of parenting topics.  You can also watch a video on ADHD on this site, ”How to Thrive with ADD and ADHD” where I am one of the panelists.

The title of my new book is The Myth of the ADHD Child, and some people might get upset and think that I am saying that their disorder or their kids’ disorder simply doesn’t exist.  I say no such thing!  As a former special education teacher, I know that the symptoms associated with a diagnosis of ADHD—hyperactivity, distractibility, and/or impulsivity–are very real indeed!  So let me clarify what I mean when I say that ADHD is a myth.  I’m using the word ‘’myth’’ in its original sense of the term in Greek, which is mythos, meaning ‘’story.’’ So I’m talking about ADHD as if it were a story.  It’s a story that has been developed over the past three decades about why certain people are inattentive, fidgety, spacey, disorganized, impulsive and/or hyperactive.  The plain truth is that I don’t think it’s a very good story.  There are plenty of inconsistencies.  The main one, in my view, is the fact that professionals can’t seem to agree on how many kids have the disorder.  The DSM-5, which is the official manual of the American Psychiatric Association, says 5% of kids have ADHD.  The International Classification of Diseases, which is used instead of the DSM-5 in many parts of the world, uses an entirely different term – hyperkinetic disorder or HKD—and concludes that the prevalence is 1-3% of all kids.  The Centers for Disease Control in Atlanta, says 11%.  The prevalence also differs by state.  In Nevada 5.6% of all children are diagnosed with ADHD, while in Kentucky that number jumps to 18.7%.  That’s a lot of variation!

I think one of the reasons for the huge differences has to do with the fact that there is no objective diagnostic tool that can definitely say whether someone has ADHD or not.  Instead, the decision about who is ADHD relies mostly on subjective judgements.  The most commonly used tool—behavior rating scales—which are used in 90% of the diagnoses of ADHD, ask simple questions about behaviors, whether a child has sleep problems, whether he forgets his homework, and so forth.  The answers to these questions depend heavily on context.  A child might forget homework whenever he dislikes the assignment, or because the teacher gives the assignment at the start of the day instead of at the end, or because the dog ate his homework (sorry, just joking about this last one!).  The point is, that ADHD is a psychiatric diagnosis—that’s serious stuff—and to make this diagnosis hinge upon the subjective judgements of teachers and parents is very iffy to me.

Advocates of the ADHD story usually emphasize the gravity of the disorder by pointing out that there are thousands of studies indicating that ADHD is a brain-based disorder, probably of genetic origin.  I agree that there are brain differences between many kids diagnosed with ADHD and typically developing children, but the key word here is ‘’difference’’ not ‘’disorder.’’ Recent studies, for example, indicate that the brains of kids’ identified as having ADHD develop normally, but lag behind typically developing kids by two to three years.  This finding has huge implications for many of the other brain studies that have been done over the past twenty years especially those which have discovered problems in the executive functioning areas of the brain that govern planning, organization, inhibition, and goal-setting.  In kids diagnosed with ADHD, these areas of the brain (in the prefrontal cortex behind the forehead) are developmentally delayed and thus are apt to be less functional than so-called normal children.

Another issue related to brain studies is that these brain differences can be due to environmental effects such as early childhood trauma, adversity in the family, and even growing up in poverty (in fact several studies have suggested just that).  Advocates of the ADHD story also emphasize the genetic nature of ADHD, with the implication that this disorder is heritable and thus hard-wired into the DNA of ADHD-identified children.  Such arguments, however, ignore the fact that recent trends in genetics have focused increasing attention on how the environment can affect which genes are turned on and which are turned off (a phenomenon known as ‘’epigenesis’’).  In one study, a gene-environment interaction was noted where a child with a specific genetic mutation would develop behavior disorders under conditions of parental criticism.  That means if the child is in a family where the parents are supportive and helpful, this particular gene will not be expressed and the behaviors will not manifest themselves.

One final problem that I have with the ADHD story is that many kids with the diagnosis also have diagnoses with other mental disorders such as depression, autism, anxiety, and bipolar disorder—a situation referred to as ‘’co-morbidity.’’  In fact, one study in Denmark noted that 52% of all kids with an ADHD diagnosis had at least one other disorder.  The raises the following question in my mind:  if a child is both depressed and ADHD, where does the one disorder stop and the other one start?  How do we know for sure whether it’s not the depression alone which causes the inattention, impulsivity, and/or hyperactivity? These are also symptoms of depression in children.

All of these issues, to my mind, suggest that we should be critical in thinking about the validity of ADHD, and not rush to judgment in placing a label on a child and medicating him with a potentially hazardous medication (although medications can be helpful for some kids).  Yes, the symptoms are real, but is there really a ‘’thing’’ called ADHD that is responsible?  I have my doubts. (Note: all decisions regarding diagnoses and medications should be made in conjunction with your physician).

To order a copy of The Myth of the ADHD Child:  101 Ways to Improve Your Child’s Behavior and Attention Span Without Drugs, Labels, or Coercion, click here.

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About the author

I am the author of 16 books including my latest: The Myth of the ADHD Child: 101 Ways to Improve Your Child's Behavior and Attention Span Without Drugs, Labels, or Coercion (Tarcher-Perigee). http://amzn.to/2ewwfbp.
19 Responses
  1. Ian Ford

    Just a thought. ADHD has a herediatry component. ADHD is more prevalent in USA and Australia than in Europe. Maybe the reason is that the settlers who made the journey to the colonies a few hundred years ago either went out in chains because they had upset the ruling classes by refusing to conform to the social or religious norms, or else they needed to be a special personality type to face the risk of a long sea journey to an unknown future. In other word, the risk-takers and adventurers said farewell to family and friends for ever and started a new life. The risk-averse conformists stayed put in Europe, prayed in the esablished church each Sunday for the King and the lord of the manor, and watched the turnips grow.

  2. Kathy collins


  3. Navya Malik

    I think it is also important to consider the purpose of diagnoses in the first place. One of the biggest reasons diagnoses exist is so that patients can get the right treatment. If the symptoms of ADHD exist, and a patient is diagnosed with ADHD and their symptoms are targeted, I don’t quite see the point of discussing whether ADHD is a “thing”. Patients are diagnosed with ADHD when they display symptoms, and then those symptoms are treated. If the treatment works and improves the patient’s quality of life, then what is point of discussing whether ADHD is a “real” diagnosis? What constitutes as “reality” for you, if it is not the presence of symptoms that affect one’s daily functioning?

    PS – With all due respect, I believe that by calling ADHD a “myth”, you are spreading the wrong idea, since, as you noted in the first couple of sentences, you are not using the word its colloquial sense. This can be damaging since in today’s world, a lot of misinformation is spread and beliefs are formed due to articles and books titled such as yours, since many people do not take the time to actually read what the article says, which can negatively affect the lives of patients with “real” ADHD.

  4. Father

    “In one study, a gene-environment interaction was noted where a child with a specific genetic mutation would develop behavior disorders under conditions of parental criticism. That means if the child is in a family where the parents are supportive and helpful, this particular gene will not be expressed and the behaviors will not manifest themselves.”

    This is very interesting. Can the expressed gene be “turned off”. I.e. if the family becomes more supportive, could the symptoms disappear/improve drastically?

  5. (1=”kid with adhd” , 2=” kid without adhd” ) 100 % agree just think if 1 was messing about and 2 saw , but 1 got toys becuz 1 has adhd, but 2 has been good ,but 2 don’t get toys
    so he thinks that if 1 get toys by messing about then 2 will do the exact same as 1 ,so 2 will get toys , then comes the medication if you don’t need it it could cause death or serious brain damage then it carries on and on and a big circle of shit literal bullshit but that my apion ,adhd is purley apion there is no fact but on our side there is slight fact so no one is right but on apion im on the side of it doesn’t exist and i want to know


  6. Jaskiran

    I have ADHD and Panic Disorder, the argument that ADHD symptoms could be symptoms of the second disorder isn’t true because :
    1. I developed a panic disorder when I was 14 and I had symptoms of ADHD since I was 7
    2. my panic disorder meds don’t alleviate any of my ADHD symptoms

    It isn’t just that I cant focus even when I pay attention I still can’t retain information. the diagnosis was much more complicated than just a few questions I was visiting my psychologist for 3 months and she would run various tests and gave surveys for my teachers and parents to fill out.

  7. Randy Norton

    Correct me if I’m wrong. Wasn’t most of the research done on this disorder funded by pharmaceutical companies, the ones that supplies the drugs for it? And the authors of the books published were affiliated with these companies. If so that should say it all…

  8. Samantha

    That is exactly the point Randy Norton. If you have big pharma companies doing the “research”, that’s almost like the cops investigating themselves and find they did no wrong doing… Don’t get me wrong, I am not knocking cops, just making a comment.

  9. Bianca

    My son was struggling in reading comprehension. Teachers and the principal made suggestions that he may have ADHD. I did not think that was the case. I started to focus more on him and started to really look into what was going on in the classroom, which was over crowded. I started to request updates from the teacher. Needless to say his grade improved tremendously and no one is talking to me about him having ADHD anymore. If I would’ve listened to the principal my son would be taking medication that is not needed. Changing his diet also made a big difference.

  10. Yes, ADHD seems to be the ”default” response when a problem in school is identified. You did the right thing to work directly with the teacher – in my book The Myth of the ADHD Child: 101 Ways to Improve Your Child’s Attention and Behavior without Drugs, Labels, or Coercion, forging an alliance with the teacher was one of my 101 ways, and diet was a part of two or three other ways. Good going!

  11. K709rs

    Great article! There should be more talks and education about it. There is no need to overmedicating young kids with drugs that alter their brain development forever and Not giving it a chance to correct itself. Many of the “troubled” children just need more love, understanding, attention, and one on one work with caregivers. And really does every single child need to earn PhD? Can’t they be happy with the normal life instead turning them into zombies on meds?

  12. Logan

    I am a teenager with adhd. I have serious issues when it comes to focusing on things that are not interesting or challenging to me. I move around more frequently than my peers. I present all the symptoms of adhd. My parents are wonderful and are not controlling, and I’ve been this way since I was a very young child. I have a genetic link, that being my maternal uncle, to the disorder. Adhd is a very real disorder that is NOT a product of poor parenting, but is simply a different brain. It is a disorder because it interferes with the patients every day life. Kids who present symptoms of adhd are not treated correctly, however. I am on medication and it helps, however my desire is not to rid myself of this disorder. Despite it being a debilitating disorder, there are some definite positives to it. We are passion and challenge driven, which makes me an excellent math student. We crave adrenaline, making us good at sports such as skateboarding. We need to learn to accept the disorder and embrace its effects, as doing otherwise is an attempt to change the character of the patient, which is counterproductive and an awful idea. Trying to make a kid sit still is frustrating and makes the child resent the situation. Helping them accommodate and helping them based on their kinematic nature is the best option for helping adhd children. My point is it’s a very real disorder with genetic links that effects a vast number of people, where medication is helpful and treatment should consist of accommodation rather than getting rid of the symptoms all together. It is not a factor of parenting.

  13. Thanks so much for your comments. I don’t think I said anywhere that ADHD is due to poor parenting (this accusation is typically used by proponents of the deficit model of ADHD as a ”straw man” argument that can be easily knocked down by them). We’re actually not so far apart in our views. I believe ADHD is a difference or a form of diversity that can be disabling in certain environments (e.g. a teacher lecturing in a classroom) but as you note, can also be empowering in environments where creativity and high energy are required (e.g. skateboarding, composing music etc.). That’s pretty much what you said. And I believe that medications can be useful for some people but should also be accompanied by as you call them ”accommodations” or what I call ”niche construction” (building an environment where you maximize your assets and minimize your difficulties). So, here again we seem to agree. I appreciate your taking the time out to articulate your views in such a clear way. Thanks!

  14. Alex

    Hi Thomas,

    I believe that some of the comorbidities that you mentioned arise from the treatment of an individual with ADHD within society.

    A lifetime of being told that you are lazy and just need to try harder really fuels the old depression and anxiety.



  15. Jake

    There is some interesting new research about ADHD and prenatal nicotine exposure. The widespread adopt of smoking in the mid 1900s could have had a significant impact on the number of ADHD cases we are seeing today.

    Secondly, I would definitely agree that current diagnostics leave something to be desired. The symptoms have significant overlap with other conditions. Additionally, the diagnostic criteria have to be evaluated with a patient’s age in mind. A 10 year old that can’t read a book for 5 hours straight isn’t displaying an “Inability to focus”. A 10 year old that consistently can’t remember the content of lessons they just attended would indicate an “inability to focus”

    As for this statement regarding medicine: “potentially hazardous medication”, I would disagree. At initial, clinical doses, stimulants are typically very well tolerated and have minimal long term side effects. Obviously patients shouldn’t be on unnecessary medication but adhd medication is extremely safe, especially compared to other psychiatric medications (neuroleptics and benzodiazepines for example). Given studies have found untreated adhd leads to a significant reduction in lifespan, the hazards of not medicating could be significantly greater than medicating.

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