Thursday, July 20, 2017

Is ADHD A Fraud?

According to the American Psychiatric Association, 11 percent of American kids (over 6 million of them) have ADHD (attention deficit hyperactive disorder). I'm not a psychiatrist, but I know the symptoms (inattention, hyperactivity, impulsivity) and I can honestly say that of the hundreds of children that have passed my way over the past couple decades, I've never met one upon whom I would hang that label.

Now, I admit to be completely unqualified to make that diagnosis, but you would think that by now I would have run across at least one child who set off my alarm bells. Or perhaps there is something about our school that attracts non-ADHD kids, or maybe I'm looking right at the symptoms and just see normal behavior, or it could be that the folks performing the diagnoses are wrong more often than they are right.

Well-regarded Harvard psychologist Jerome Kegan tends to think that ADHD is largely a fraud foisted upon us by pharmaceutical companies seeking to move their merchandise. I certainly can see that: the profit motive, when applied to things like healthcare and education, endeavors that simply can't be measured by dollars and cents, tends to warp things. For instance, there is an entire industry of for-profit "education corporations" (e.g., Pearson) that make their money by providing education-ish products like high stakes standardized tests and test prep materials and other nonsense that have little to do with learning and everything to do with returning dividends to their investors. It doesn't take a cynic to see that for-profit pharmaceutical companies don't the same thing, not always (or even rarely) placing health outcomes ahead of their bottom line.

That said, I know there are good, loving parents out there who insist that not only has their child "suffered" from ADHD, but that drugs have saved them. And, of course, folks like Dr. Kegan, no matter how well regarded, and there are those who consider him a modern day Carl Jung, are in a small minority. After all, ADHD has been included in the DSM (Diagnostic and Statistical Manual of Mental Disorders) since 1968. If it's a complete fraud then it runs broad and deep.

So, the odds are against it being a total fraud, but I still have my question: why have I never seen it? I've spotted autism. I've identified sensory issues. I've even seen bi-polarity (although I wasn't quite sure what it was) but I've not once thought to myself, "That kid has ADHD." It may be for any of the reasons I've listed above, but I think the most likely explanation is that the behaviors that define it simply don't show up as a "problem" in a play-based curriculum, while inattentive, hyperactive, and impulsive children are a problem in traditional schools where adults determine what, how, and when a child should do things, where teachers are responsible for herding large groups of children through material that may or may not be interesting to them. Traditional schools emphasize paying attention, sitting still, and concentrating on one thing at a time and children who struggle with that simply show up as a problem. I mean, that's tough for any kid, let alone one with a highly energetic brain and body. In contrast, when we don't place those artificial expectations on kids, like in a play-based curriculum, the "problem" disappears.

No, I suspect that for the most part, ADHD is mental health disorder that largely only exists under certain, unnatural circumstances, namely in traditional schools or when adults try to make a living at a temperamentally unsuitable careers. Indeed, I figure that the thing we call ADHD might well be, as author Thom Hartmann argues, an important aspect of human evolution. Like so many things we call "disorders" in children it's time we started considering that we aren't looking at a problem with the kids, but rather a problem with us and what we unfairly, and perhaps even cruelly, expect of them.

Hey friends! I'm currently in Australia where I'm appearing in venues around the country. I'd love to meet you! A few of the events are sold out, but there is still room in others. If you're interested, click here for details about my "tour."

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Allie said...

What about Sydney? I would love to come but all those places are far from Sydney and I have 2 small children. I can't travel that far. :(

Teacher Tom said...

I've just finished an ever in the western suburbs, but stay tuned. It looks like we will be adding a Sydney event in early August!

Brenda said...

Sorry, this is long...

Thanks for bringing up this topic. Like the issue of learning disabilities ADD/ADHD has had its share of difficulty convincing the public, and some of the diagnosticians, exactly where the line in the sand is drawn. I feel it all comes down to the struggle. When does it become something that gets in the way of functioning so that learning and living isn't overly compromised. Inattentive? We are all distracted at times. Impulsivity? Lots of people have a problem with being impulsive. Commercialism plays to that weakness. Hyperactive? Aren't all kids that way? True, but not always true. When being so distracted that it is hard to read an article through to the end without starting over several times then it is a problem. When someone has so much energy that they have to move around even in a setting where that isn't appreciated, that's a problem. Impulsivity, same thing. Does this mean we have to medicate our children into docility? No.

Speaking as a seasoned educator, what we do know is that outdoor nature-based education works better than medication for kids labeled with ADD/ADHD. Maybe they are hyper-sensory, or maybe it is related to environment, but we have to do something different for them. Few schools are equipped with ADD/ADHD science teachers that can pick up on what the children need and run with it. Not enough schools have outdoor classrooms and project based learning approaches. In other countries there are outdoor schools where the kids are outside year round - sun, rain, snow... outdoors. I am a proponent outdoor nature-based education.

I was diagnosed with ADHD and learning disabilities almost 2 years ago. I see it from the inside. It explained a lot to me about the way I think, I react, I behave. With this new insight I became more aware of my behaviors and I look for ways to have more control of myself without drugs. I like the way I am, with my creativity and quirks, and only want to change what doesn't work. I have always loved outdoors and see that as part of the solution. As a teacher I have a built in radar to recognize the struggle in my students. I don't want to label them but I do want to support them. Outdoor activities puts them in a place where they are deeply engaged. Its so full of all kinds of stimulus that they are rarely bored.

I don't know if diagnoses are as important as finding a better fit. We are not all designed for school in a box. Students need to be able to see themselves and their struggles in a better light... natural light. Time to throw open the doors and teach outside the box.

Anonymous said...

I've read some research connecting ADHD to possible early trauma. As in the signs of PTSD for very young children manifest as similar symptoms of ADHD. Interesting read. My mother always say she thought ADHD was a fraud and that is just how kids are...