The Story of Attention Deficit Hyperactivity Disorder
Based on my book: The Myth of the ADHD Child: 101 Ways to Improve Your Child’s Behavior and Attention Span without Drugs, Labels, or Coercion (Tarcher/Perigee)
Over the past forty years, attention deficit hyperactivity disorder (ADHD) has emerged from the relative obscurity of cognitive psychologists’ research laboratories to become the “disease du jour” of America’s schoolchildren. Accompanying this popularity has been a virtually complete acceptance of the validity of this disorder by scientists, physicians, psychologists, educators, parents, and others. Upon closer critical scrutiny, however, there is much to be troubled about concerning ADHD as a real medical diagnosis.
There is no definitive objective set of criteria to determine who has ADHD and who does not. Rather, instead, there are a loose set of behaviors (hyperactivity, distractibility, and impulsivity) that combine in different ways to give rise to the “disorder.” These behaviors are highly context-dependent. A child may be hyperactive while seated at a desk doing a boring worksheet, but not necessarily while singing in a school musical. These behaviors are also very general in nature and give no clue as to their real origins. A child can be hyperactive because he’s bored, depressed, anxious, allergic to milk, creative, a hands-on learner, has a difficult temperament, is stressed out, is driven by a media-mad culture, or any number of other possible causes.
The tests that have been used to determine if someone has ADHD are either artificially objective and remote from the lives of real children (in one test, a child is asked to press a button on a device every time he sees a 1 followed by a 9 on a computer screen) , or hopelessly subjective (many rating scales ask parents and teachers to score a child’s behavior on a scale from 1 to 5: these scores depend upon the subjective attitudes more than the actual behaviors of the children involved).
The treatments used for this disorder are also problematic. The drugs developed do not cure the problem, they only mask symptoms, and there are several disadvantages to their use: children don’t like taking them, children can use them as an “excuse” for their behavior (“I hit Ed because I forgot to take my pill.”), the side effects (insomnia, nausea, irritability) are unpleasant, and there are potential risks associated with bone density loss, cardiovascular problems, and psychotic experiences. While it is true that psychoactive medications properly prescribed and monitored by a physician can be an important tool to help some kids experience successes with teachers, parents, and peers, it still must be viewed as a last resort intervention and used with caution. Behavior modification programs used for kids diagnosed with ADHD work, but they don’t help kids become better learners. In fact, they may interfere with the development of a child’s intrinsic love of learning (kids behave simply to get more rewards), they may frustrate some kids (when they don’t get expected rewards), and they can also impair creativity and stifle cooperation.
ADHD is a popular diagnosis in today’s world because it serves as a neat way to explain away the complexities of 21st century life in America. Over the past few decades, families have broken up, the respect for authority has eroded, mass media has created a “short-attention-span culture,” and stress levels have skyrocketed. When our children start to break down and act up under the strain, it’s convenient to create a scientific-sounding term to label them with, drugs to stifle their symptoms, and a whole arsenal of ADHD workbooks, videos, and instructional materials to use to fit them in a box that relieves parents and teachers of any worry that it might be due to the failure of the broader culture to nurture or teach them effectively.
Mainly, the ADHD label is a tragic decoy that takes the focus off of where it’s needed most: the real life of each unique child. Instead of seeing each child for who he or she is (strengths, limitations, interests, aspirations, temperaments, etc.) and addressing his or her specific needs, the child is reduced to an “ADHD child,” where the potential to see the best in him or her is severely eroded (ADHD puts all the emphasis on the deficits, not the strengths), and where the number of potential solutions to help them is highly limited to a few child-controlling interventions.
Instead of this deficit-based ADHD paradigm, I’d like to suggest a wellness-based holistic paradigm that sees each child in terms of his or her ultimate worth, and addresses each child’s unique needs. To do this, we need to provide a wide range of strategies for parents and teachers. The following list of strategies covers behavioral, biological, developmental, cognitive, creative, cultural, ecological, educational, emotional, familial, physical, and social dimensions of the child with an ADHD diagnosis and is a step, I believe, in the right direction.
101 Non-Drug Strategies for ADHD
(For detailed information about each strategy, see The Myth of the ADHD Child: 101 Ways to Improve Your Child’s Behavior and Attention Span Without Drugs, Labels, or Coercion)
For detailed information about these strategies, plus a discussion of seven reasons for the ADHD epidemic, see my book The Myth of the A.D.H.D. Child: 101 Ways to Improve Your Child’s Behavior and Attention Span Without Drugs, Labels, or Coercion (Tarcher/Perigee)