One of the few things I remember agreeing with when I heard Ken Robinson talking about changing educational paradigms was his observation that diagnoses of ADHD (Attention Deficit Hyperactivity Disorder) fall as you travel across America from West to East.
He calls this modern epidemic the “plague of ADHD” and claims it is “fictitious”. He clarifies this by saying,
Don’t mistake me, I don’t mean to say there is no such thing as Attention Deficit Disorder. I’m not qualified to say if there is such a thing. I know that a great majority of psychologists and
paediatricians think there is such a thing, but it’s still a matter of debate. What I do know for a fact is it’s not an epidemic. These kids are being medicated as routinely as we had our tonsils taken out. And on the same whimsical basis and for the same reason – medical fashion.
I’ve written about some of my own experiences of teaching children with ADHD before. There are certainly some children who seem to choose when and where their ADHD will kick in. One of the first children diagnosed with ADHD I taught was Ricky. He was a delightful, hardworking boy and I had no idea of his condition (This was in the days before schools had SEN registers.) One day Ricky turned into a chair-flinging monster. He screamed and raged and stormed out. I was flabbergasted; what on earth had happened? What had I done to this normally mild-mannered lad? . “Don’t worry sir,” one Ricky’s friends told me, “He just forgot to take his pills today.” This was my first encounter with the extraordinary effects of Ritalin.
Clearly Ken is right to say that denying the existence of ADHD – or indeed the dramatic effects of medication – is foolish. But in an article published in Psychology Today, Dr Marylin Wedge asks why French children don’t suffer with ADHD. She says,
In the United States, at least 9% of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5%. How come the epidemic of ADHD—which has become firmly established in the United States—has almost completely passed over children in France?
Why indeed. Ken blames computer games, boring schools and standardised testing. I don’t know about you, but this sounds suspiciously simplistic and convenient. Dr Wedge says that US physicians see ADHD as a biological condition best treated with biological interventions. This could be an example of the Fundamental Attribution Error. French physicians tend to view ADHD as having contextual causes.
Instead of treating children’s focusing and behavioral problems with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling.
Of course it’s a little bit more complicated than that as Dr Wedge outlines. Her book, A Disease Called Childhood: Why ADHD Became an American Epidemic is fascinating and well worth a read.
I read Dr Richard Saul’s ADHD Does Not Exist last year and in it he makes a compelling case for doubting the diagnosis and treatment of very many who have been labelled as having ADHD. Saul makes clear that the symptoms are all too real but the medicalisation of the condition has had severely negative consequences. He presents cases of children and adults who suffer with disorders which contain elements of attention deficit or hyperactivity and are then misdiagnosed. Sometimes the symptoms are normal. Sometimes they’re not. Sometimes they respond well to medical intervention. In the case of my student Ricky, the effects of medication seemed wholly positive, but generalising from a sample of one would clearly be foolish. Saul’s thesis is that, on average, medication is overwhelmingly unnecessary or counter-productive.
Maybe ADHD isn’t as straightforward as some would like to have us believe. The Centre for Disease Control (the boffins in the US who track the likes of Ebola and SARS) have monitored a 60% increase in the diagnosis of ADHD over the last decade. This is startling. Either the human genome is failing, leading to a bizarre increase in the number of prefrontal lobe related problems or some other factor is at play. My money is on the ‘other factor’. It might be worth considering who has a vested interest in the status quo, specifically pharmaceutical companies that make a lot of money out of ‘medicating’ kids with drugs such as Ritalin, but also self-professed ‘experts’ who give advice to the education sector, and wondering whether their advice is really in children’s best interests.