First, let me begin by saying I am not an idiot.  I clearly recognize that ADHD is a certified medical condition as defined by the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM 5).  In addition, I recognize that the symptoms described in the DSM-5 are very real:  things like ‘’fidgets’’ ‘’blurts out answers’’ ‘’is forgetful’’ ‘’has difficulty waiting their turn’’ and ‘’fails to follow through on tasks and instructions.’’ I’m not denying that these behaviors exist. But my question is:  why do certain children (and teens and adults) act in these ways?  Is it because of something called ADHD, or are there other, more complex and subtle reasons for these and other ADHD-related behaviors?  I’m going to share 17 reasons why I think we should deeply question the legitimacy of the ADHD diagnosis.

  1. Our culture has changed radically over the past 50 years, with greater fragmentation of the family, different expectations for kids, a faster pace, and a more complex society, and ADHD symptoms are a global systemic response to these changes. This is basically a sociological explanation for ADHD symptoms.  The problem is not in our kids but in the crazy society that has sprung up around them.  By locating ADHD within an individual, it fails to account for the fact that we’re social beings and respond to changes in systems, in this case to contemporary Western culture. Children are the most vulnerable members of a society and are the ones that are most likely to respond negatively when the culture itself becomes problematic.  In this case, don’t blame ADHD, blame our confusing, fragmented, complex, stressful society.  The ADHD diagnosis in this context, represents a way of blaming the victim.


  1. Children and teens diagnosed with ADHD have normal brain development, but it lags behind typically developing individuals by two to three years. This is a developmental explanation for ADHD symptoms. Several research studies have confirmed the fact that this delay exists, and the last part of the brain to mature is the frontal lobes, the very area of the brain which most ADHD experts see as the main region implicated in ADHD.  Simply maturing later than other kids is not a reason to give someone a medical diagnosis.  Other research suggests that kids who enter kindergarten or first grade as the youngest in their class, are more likely to be diagnosed with ADHD and medicated. Again, we’re talking about a developmental delay here, not a medical disorder, and we should be using a developmental perspective rather than a medical one to help these kids (e.g. developmentally appropriate enrichment such as free play).


  1. Kids diagnosed with ADHD are responding to an increase in the pressure on kids to succeed in school. Over the past thirty years, our schools have increasingly focused on accountability using standardized testing and more ‘’rigorous’’ expectations for achievement. Not every kid can shrug off this increasing stress, and if you’re lagging behind developmentally by two or three years, it’s even more difficult.  Teachers are often the de facto diagnosers of ADHD (even though it’s regarded as a medical disorder), and are more apt to see ADHD symptoms when the curriculum consists primarily of lecture and seat work. It shouldn’t be a medical disorder simply to have difficulty with what is an inappropriate way of teaching kids in the first place (education experts say kids need project-based learning, and active, experiential hands-on ways of learning new material).  In fact, it’s makes a good deal of sense that many of these kids ARE becoming more restless, forgetful, disorganized and so forth in a classroom that stifles their vitality and inhibits their natural ways of learning.


  1. Boys are diagnosed with ADHD more than four times as often as females, and the main reason for this situation has to do with normal gender differences. It shouldn’t be a medical disorder to behave like a boy.  In times past, people would regard ‘’all boy behavior’’ as a natural part of being a male: being rowdy, enjoying lots of action-packed moments, engaging in horseplay, and the like.  In research studies, preschool boys are found to engage in more physical activity than girls, they prefer object play to interpersonal interaction, and they pay attention more to non-verbal sounds while girls respond better to verbal stimuli like the teacher’s voice.  Thus, in the average elementary school classroom, the deck is stacked against boys, particularly since eighty-one percent of elementary and middle school teachers are women, who judge appropriate behavior in terms of their own gender bias.


  1. ADHD symptoms have increased in our culture due to the high consumption by youth of fast-paced multi-media stimulation. Our kids are now spending seven-and-a-half hours a day consuming media, compared with just a few minutes a day playing outside.  Research studies are finding correlations between high media consumption in kids and attention and behavior difficulties.  Consumption of mass media, including television, movies, video games, the Internet, and social media, has a direct impact upon the dopaminergic areas of the brain (dopamine being a neurotransmitter important in novelty-seeking, rewards, and motivation).  These are the same regions that are regarded as dysfunctional in ADHD.  The big question is:  are they dysfunctional because of a medical disorder called ADHD, or because the brain is bombarded with seven-and-a-half hours of daily media stimulation?


  1. ADHD symptoms have arisen in our culture due to the decline in the amount of time children spend playing outdoors in free unstructured settings. Neuroscientists have seen direct links between frontal lobe damage in laboratory mice and an inability to play.  Play stimulates the production of important brain chemicals and even assists in the building of new brain connections.  Some thinkers believe that the frontal lobes themselves evolved over time due to playful behaviors and that playful behavior is an important factor driving human evolution.  Yet our children have been playing less and less over the past thirty years .  During this same time span, kindergartens have become increasingly academic with less time devoted to play-based activities.  Recent research has indicates that when children diagnosed with ADHD play in outdoor settings, their symptoms decrease, and the wilder the environment, the more the symptoms go down.  Let’s allow children more time to play, and then see how many of them are diagnosed with this purported medical disorder.


  1. Children diagnosed with ADHD are ‘’hunters in a farmers world.’’ This metaphor, derived from ADHD expert and political commentator Thom Hartmann, helps us understand why the genes for ADHD are still in the gene pool.  During the hunting and gathering era of prehistoric times, there were advantages to being able to move constantly in a nomadic tribe (hyperactivity), being able to pay attention to any sudden stimulus (distractibility), and being able to respond quickly with immediate action in response to that stimulus (impulsivity).  Thus, the three main signals of ADHD were advantageous in hunting and gathering cultures.  Transplated into the modern day classroom, these traits become disadvantageous, but that isn’t due to any kind of medical disorder, but rather by being in the wrong place at the wrong time (e.g. in a restricted classroom setting rather than roaming in the great outdoors).


  1. Children diagnosed with ADHD are ‘’novelty-seekers’’ who crave dynamic, creative, and exciting new experiences. One factor that unites many kids identified as having ADHD is that they absolutely have a hard time with boredom.  But is it a medical disorder to be intolerant of being bored?  Our greatest creative artists have traits that are virtually identical with the warning signs of ADHD, only we use more positive words to describe them:  spontaneous instead of impulsive, divergent rather than distractible, vital rather than hyperactive.  Research studies have indicated that individuals diagnosed with ADHD score higher on creativity tests and also in brain scan studies respond more intensely to novel experiences.  Our culture needs creative people to fuel new discoveries and innovations.  But if we regard creativity as a medical disorder (and medicate it), then what does this portend to the continued development of a vital civilization?


  1. Some kids diagnosed with ADHD are simply responding normally to what are in fact adverse living conditions in the home. If a child doesn’t feel safe at home due to parental conflict, violence in the neighborhood, or other adverse circumstances, they are certainly going to have trouble paying attention, and their frontal lobe function will shut down as they descend into fight or flight mode or into a state of chronic stress.  Research studies have linked greater levels of adversity in the home with an increased risk of being diagnosed with ADHD and medicated. Many stress symptoms are identical, in fact, to those of ADHD, and researchers have seen a significant amount of cross-over (called ‘’co-morbidity’’) between ADHD and depression, anxiety, and other emotional disorders.  But is it ADHD or is it instead depression, anxiety, or another emotional disorder that needs to be recognized and treated?


  1. Kids diagnosed with ADHD are different from so-called normal kids, but their differences are better accounted for as ‘’neurodiverse’’ than as ‘’medically disordered.’’   Over the past twenty years, a new paradigm has emerged to account for individual differences in human beings: neurodiversity.  Rather than regarding certain individuals as mentally disordered, we are increasingly seeing them as reflections of human diversity.  Just as we honor and celebrate biodiversity and cultural diversity, so too should we validate diversity in brains.  We don’t say that a calla lily has ‘’petal deficit disorder’’ but instead value its uniqueness as a flower. We should do the same with kids displaying symptoms associated with ADHD.  Research is increasingly revealing that the so-called disorder of ADHD has distinct strengths associated with it as well as challenges (including creativity and novelty-seeking).  Rather than counseling kids to accept their disorder, we should be helping them learn strategic ways of maximizing their strengths and minimizing their difficulties.


  1. Many of the symptoms regarded as part of the ADHD diagnosis are in fact healthy behaviors which simply need a proper channel in order to be constructive. One of the diagnostic criteria for ADHD in the psychiatrist’s bible, the DSM-5, is ‘’Fidgets with or taps hands or feet, squirms in seat.’’ Remember that this is regarded as a ‘’warning sign’’ of a medical disorder.  The problem is that experts are now beginning to understand that fidgeting is actually a positive behavior; that kids diagnosed with ADHD concentrate better if they’re allowed to fidget! The provision of ‘’wiggle furniture’’ ‘’bouncy bands’’ and other flexible seating that permits quiet fidgety behavior are examples of how this behavior can be constructively employed in the classroom and the home.


  1. The DSM-5 criteria used to diagnose ADHD are too highly subjective and general to be used in identifying something as serious as a medical disorder. I mentioned fidgeting above.  Another criterion is ‘’talks excessively.’’ First of all, how do you define ‘’excessively’’ and secondly, what’s wrong with excessive talking?  For some kids that’s their nature, and we should have a tolerance for those who like to share their thinking with others.  Another criterion is ‘’Avoids/dislikes tasks requiring sustained mental effort.’’ Yet many of these kids put considerable effort into activities that interest them (e.g. lego structures, video games, a hobby).  The key word here is interest.  If a child isn’t interested in a topic, isn’t it understable that they wouldn’t want to put much mental effort into it?  When is the last time you put considerable mental effort into a lecture you found boring or irrelevant?


  1. An underlying theme in many of the criteria used to diagnose ADHD is the need to be ‘’compliant,’’ which is an expectation from ADHD authorities who themselves have been overly compliant during their lives. Bruce E. Levine, a clinical psychologist, points out that the people who create psychiatric categories such as ADHD have had to go through years and years of training, wherein they were required to be compliant toward supervisors, professors, trainers, and other authorities. Thus, they approach life from the standpoint that compliance is a good and necessary attitude to have toward life (since it worked for them).  But non-compliance has its good sides as well. The United States would have never become an independent country had it not been for a lot of non-compliant individuals (we call them Founding Fathers).  Advances in science would never have occurred if not for the non-compliance of scientists who refused to accept the status quo.


  1. Many kids who are diagnosed as having ADHD simply have a different temperament than other kids. The ancients had a theory of personality which believed that human nature consisted of four basic temperaments: choleric, sanguine, melancholic, and phlegmatic.  Many kids identified as ADHD tend to have the sanguine temperament (enthusiastic, active, social).  Modern temperament theorists Stella Chess and Alexander Thomas had another way of categorizing individuals:  as easy, difficult, and slow-to-warm-up.  Many (if not most) kids diagnosed with ADHD would fall into the ‘’difficult’’ temperament, but the important point here is that it is not superior or inferior to the other temperaments; it’s simply different.


  1. ADHD does not reside ‘’within’’ the child, but rather emerges as a result of the interaction between the child and his or her parents, caregivers, and teachers. Temperament experts suggest that behavior problems arise not due to the temperament of a child but to the ‘’goodness’’ or ‘’poorness of fit’’ that the child has with his caregivers. Some parents and teachers have a way of being with a difficult child in a way that results in a harmonious relationship and an active healthy child.  But many kids diagnosed with ADHD are regarded by parents or teachers as ‘’trouble-makers’’ or as possessing other negative characteristics, and this bias affects how caregivers or teachers interact with them.  This exacerbates the child’s difficult behaviors, and may lead to an ADHD diagnosis.  But the ‘’disorder’’ is in the relationship, not in the child.


  1. The rise in the power of the ‘’medical model’’ and multi-national drug companies has fueled the increase in ADHD diagnoses in the U.S. and increasingly elsewhere in the world. Over the past fifty years, there has been an increasing tendency to regard life problems as due to medical ailments.  The concomitant rise in the scope and reach of powerful pharmaceutical companies, which actively promote through advertising the sales of ADHD drugs, creates a self-perpetuating system that seeks an ever-widening market for its products.  Medical doctors often spend as little as fifteen minutes diagnosing ADHD (often using a simple checklist of behaviors) and are susceptible to pressure from parents to have their kids diagnosed as ADHD, sometimes to qualify for benefits such as extra time in which to complete standardized tests.


  1. The symptoms of ADHD can be caused by a number of other conditions. Neurologist Richard Saul has argued that what is regarded as ADHD could be any of a number of other factors, including vision problems, sleep disorders, mood disorders, hearing problems, giftedness, seizure disorders, learning disabilities, sensory processing disorder, Tourette’s syndrome, fetal alcohol syndrome, and several other conditions.  The rush to diagnose ADHD runs the risk of failing to recognize these other issues, thus leaving them untreated.


As you can see, each one of the 17 points discussed above raises doubt about the legitimacy  of the ADHD diagnosis in children and teens.  But it’s the cumulative power of these arguments that really drives home the idea that ADHD is a highly flawed diagnosis.  Let’s imagine that we start out with 100 kids – all of them diagnosed by medical doctors with ADHD.  Then, let’s eliminate the kids whose problem is mainly a ‘’difficult temperament.’’ Let’s say that eliminates 20 kids and leaves us with 80 ADHD labeled children. Then let’s eliminate those kids who are ‘’latebloomers’’ (whose brains develop normally, but 2 or 3 years later than other kids).  Now we’ve eliminated another 20 kids, leaving us with 60 ADHD-identified children. Then, let’s consider those kids who have developed symptoms because of their overconsumption of mass media.  Take out another 20 kids, leaving us with 40 ADHD cases.  Next, let’s eliminate 10 boys in the remainder of the group who are simply demonstrating ‘’all boy behavior’’.  This leaves 30 kids diagnosed with ADHD.  Now, let’s consider those remaining kids who aren’t getting enough outdoor play in their lives.  Another 10 leave the group, and we’re left with 20 kids diagnosed with ADHD.  Let’s say that of that group, 15 of them are responding to adverse living conditions at home.  That leaves us with 5 kids.  Of these 5 kids, three show signs of depression and anxiety that mimic the symptoms of ADHD.  We’re left with two kids.  And the symptoms of these two kids turn out to be an allergic reaction to their consumption of wheat and milk (bad reactions to certain foods can also trigger ADHD symptoms).  That leaves us with . . . what?  Zero kids with ADHD.  And that’s why I do not believe ADHD is a legitimate medical disorder.

To see a video version of this post, click here.  For more information on why I believe ADHD is not a legitimate medical disorder, plus 101 strategies to help kids who’ve been diagnosed as ADHD, see my book:  Thomas Armstrong, TThe Myth of the ADHD Child, Revised Edition: 101 Ways to Improve Your Child’s Behavior and Attention Span Without Drugs, Labels, or Coercion (Tarcher/Perigee).

This article was brought to you by Thomas Armstrong, Ph.D. and


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22 Responses
  1. Kathy Isaacs

    Well, it’s clear that *you’ve* never experienced living with ADHD. What a lot of superficial twaddle you’ve written here, based on half-arsed observations and your personal belief system.

    If ADHD was delayed development, then we’d grow out of it. If you think we grow out of it, you’re more confused than this article makes you sound.

    BTW, If there’s no difference in the physical neurology, then it’s not “better accounted for as ‘’neurodiverse’’”. If there *is*, which you contradict yourself by saying at a later point, then it’s a physical condition, not something caused by people not living like you think they should.

  2. I’m sorry if I offended you with my essay. I’d like to take up the points you raised. Firstly, in point of fact, many people with ADHD DO grow out of it. One study concluded that the rate of ADHD in a given age group declined by 50% every 5 years, such that an ADHD prevalence figure of 4% of all children (this study was done in 1996 when rates were much lower) decreases to .8% of all 20-year olds, and .05% of all 40-year-olds. J.C. Hill and E.P. Schoener, ‘’Age-dependent decline of attention deficit hyperactivity disorder,’’ American Journal of Psychiatry, 1996, vol. 3, no. 9, pp.1143-6. Secondly, the brains of kids diagnosed with ADHD develop differently from typically developing kids and that’s what makes them neurodiverse – the diversity inheres in the rate of development.

  3. The Don

    Hi Thomas, I am an adult male approaching 30 years of age who has been diagnosed with ADHD-PI. What do you suggest for adults who haven’t “grown out of it” that are floundering in society? I feel stuck in a lot of areas in life and feel that I’m constantly on the verge of my life collapsing, but I do have a safety net of supportive friends and family. Others in my cohort are not so fortunate.

    Undiagnosed and under-treated ADHD in adult life can lead to:

    -chronic anxiety and depression
    -stress and substance abuse
    -relationship failure
    -chronic underemployment and self-esteem issues
    -very high risk of suicide

  4. There are a lot of things you can do. Exercise. Meditation. Yoga. A Mediterranean Diet. Cognitive-Behavioral Therapy. And of course, medications under the supervision of an MD. That’s just a start. See my book The Myth of the ADHD Child: 101 Ways to Improve Your Child’s Behavior and Attention Span Without Drugs, Labels, or Coercion (most of the 101 ways are appropriate for adults as well). Good luck and hang in there!

  5. Jamie

    As I was reading this article , I was thinking of all the people that will have negative responses! No one wants to take blame in parenting choices. However, I loved your article and absolutely agree with everything you wrote and have wondered why there are not more articles like this or more research done.

  6. Anne

    You stated :Kids diagnosed with ADHD are responding to an increase in the pressure on kids to succeed in school.

    I am also anti medication and my child has severe ADHD. Have you considered genetics could be the reason?

    I found your article to be pretty misleading and not correct. I couldnt finish it. Just providing feedback as a fierce advocate for my child.

  7. Yes, certainly genetics has a role to play. But the genetics will play out in different ways depending upon the environment. I’m sorry you didn’t agree with the article. I appreciate your being a fierce advocate for your child! That’s a very good thing!

  8. Yes, people sometimes don’t understand what I’m driving at. They take it personally, even though I’m not saying at all that poor parenting causes ADHD. I appreciate your kind feedback!

  9. Linda

    very interesting article. Do you have any thoughts on children and parents who use ADHD as an excuse for rude behavior? I have been in these environments where the parents do not address their ADHD child’s bad behavior, actually expecting everyone around them to excuse it too. The child eventually grew up not taking responsibility for their actions that hurt others. And the result is an adult with ADHD that is rude, entitled and disrespectful. People don’t want to be around that.
    What are people around ADHD people to do?

  10. Angela

    This article is very interesting and I agree with every single point you have made.
    I can bring my own personal experience as an adult with suspected ADHD as a further example that ADHD is not a disease in itself but it only becomes such when society decides to see it that way. I’m an Italian national who is currently leaving in the UK and I can say that many of the symptoms normally associated with ADHD are considered completely acceptable in the Italian society, such as fidgeting, hyperactivity, or even “talking excessively” (in school for example teachers tend to single out the students that don’t speak enough, as being too quiet is considered a concearn) It’s only when I moved to the UK that I learned that that these traits can be considered negative. I have always used to fidget when I was at school for example, or drawing doodles, or even just starting outside the window, and none of my teachers ever complained. Many students were doing like this, it wasn’t just me. Even in office environments everybody is very relaxed in Italy, they move around, they swing their chair, they talk loudly while moving their hands, and nobody expect you to stand still sitting in a chair for 8 hours. In the UK however it’s a completely different world. I have once been told off by my manager for “looking outside of the window” during working hours, and most office environments where i have worked in were so unnaturally silent that it felt as if people were afraid to even move. These are the type of environment were I struggle to work. I can’t sit completely still on a chair for more than an hour. I don’t know how people can do it (i normally end up getting up every hour and go to the toilet to do press ups). I have never had any problem when I was living in Italy, neither in school nor in a personal environment. I have always been considered “weird”, absentminded and “lost in my thoughts” but it has never really been treated as a problem, rather just as a personality trait. And as long as I was allowed to be my self I have never had significant problems focusing either (fidgeting or staring outside of a window, for example, just help me focus more). It’s only when I can’t do any of these things that I tend to lose focus and I become extremely restless. So when I was in Italy I never had ADHD problems, I only started to have them when I moved to a different country So that’s why I believe that ADHD doesn’t exist, the real problem is our society. And another example I can bring is my eldest brother. He used to be very hyperactive when he was a child (even for Italian standards). We will never know if he had the sympthoms of what we now consider ADHD because that was a long time ago and “thankfully” ADHD wasn’t a thing yet in those days, but I my mother didn’t want to accept that he had a problem, she was convinced that what he had was “excess energy” so she made him take karate classes and all his problems have disappeared.

  11. Thank you for your comments which I found fascinating. The proponents of ADHD as a diagnosis have no grounding in cultural understanding – they prefer to see ADHD as this neutral condition that applies equally across cultures, which is nonsense considering the fact that ADHD is nothing but a set of behaviors. One thing I found especially telling in your account was the fact that teachers in Italy are concerned about the kids who don’t speak, whereas in the U.S. teachers are concerned with the ones who talk too much! If the ADHD world was run by anthropologists, we would see the number of kids diagnosed with ADHD decrease considerably. Thanks again for your sharing!

  12. I love how you said that issue is not with our kids but with the crazy society they are born into. Too many parents blame their kids for having issues. It is not the child’s fault a majority of the time. ADHD can still be managed if the child has loving, caring parents who actually do something about it.

  13. Jonathan

    This is the type of message that perpetuates the Stigma surrounding ADHD. Parents of ADHD children won’t get them the help they need, and they will end up another 30 year old getting diagnosed and wondering what life would have been like had they known sooner. Are your statements backed up with data from studies?

  14. The blog post you read has several links in it that will take you to studies that back up my statements. I’m not saying parents shouldn’t help their kids, even get them diagnosed with ADHD so they can get medication if necessary But there are other points of view that deserve to be considered, some of which I’ve presented. Moreover, there are many non-drug alternatives out there that ought to be better known by parents so they can use these strategies with medication or instead of medication.

  15. Angel

    As someone who is in the middle of obtaining a dual M.D./PHD in hopes of becoming a neurologist one day, I find your “research” ( social commentary really) and focus on proven facts for this article lacking, to say the least. As some who suffers from ADHD and was not diagnosed until late in life due to ignorance such as this, I find it typical for your age and demographic. This article pointedly leaves out many of the processes that go into research, diagnosing, and treating ADHD and clear the objective of it to demonize everything in regards to It. I promise that after I do complete my studies to spend my life disproving ignorance like this. I will make it a mission to make sure this particular article, along with your Ph.D., is heavily scrutinized.

  16. Thank you for sharing your views. Note that there were over 20 links in the article to research studies, so refuting those should be a big part of your debunking project.

  17. Thank you for talking about how ADHD is a result of nature. My son has been having trouble concentrating. I will find a reputable add testing center locally.

  18. martin wright

    Hello Thomas and thank you for sharing your thoughts.
    Firstly, can I mention the cessation of physical chastisement of children written into law. This societal change occurred (certainly in the UK) shortly before the discovery/invention of ADHD. Masson, Szasz and others have suggested the role of psychiatry in providing timely ‘solutions’ to societal problems, in this case what to do when parents and teachers are deprived of a major source of control. I’m no advocate of such control but nor am I blind to the idea that when one form of control is removed, new ones invariably replace them.
    Secondly, if space allows, is the development of belief systems and how they often masquerade as ‘science’. Karl Popper developed a theory of falsification, that scientists of whatever kidney might welcome the falsification of their ideas to enable the refinement or rejection of them. Anger towards challenge, as manifested in responses to your article and others in a similar vein, seem to me to have a religious flavour, as if, like Galilleo, your observations can be refuted by threat.
    Lastly, as it would appear that space is allowing, I would wish for the citing of other, past, groundbreakers who were castigated for their observations. I’ll cite just one as an example – R D Laing was branded ‘anti-psychiatry’ after obseving the importance of the family ‘nexus’ and how it seemed to be disregarded, or at least minimised, by those who wished to either pedal older ideas as facts (for example scizophrenia) or introduce new ones. I’m sure that, had he lived to witness its inception, Ronnie would have had some suitably acerbic comments to make.

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