Okay. I’ll admit it. Prior to having children, I didn’t really believe in ADHD.
I thought that ADHD was either grossly over-diagnosed or that it was simply children’s reactions to being placed in unnatural environments with unrealistic and developmentally inappropriate expectations. After all, many schools limit recess time to 20 minutes a day. Under the pressure of testing, public schools have largely pushed academic learning and a more sedentary lifestyle on children at younger and younger ages. At home, children spend less time playing outside and more time indoors watching television or playing video games. In my naïve view, children, deprived of an outlet for their energy, would naturally act out.
The news media often corroborates this notion that ADHD is either a product of our current society or a syndrome invented by the pharmaceutical industry rather than a true neurological difference. In a 2014 Guardian article, Dr. Bruce Perry claimed that ADHD was not a real disease. “Part of what happens,” he stated, “is if you have an anxious, overwhelmed parent, that is contagious. When a child is struggling, the adults around them are easily disregulated too. This negative feedback process between the frustrated teacher or parent and disregulated child can escalate out of control.” In the Psychological Today article, “Why French Kids Don’t Have ADHD,” Marilyn Wedge discusses how French psychiatrists, unlike their colleagues in the U.S., view ADHD as having social/emotional causes rather than neuro-biological ones. As a result, the French treat ADHD through psychotherapy rather than medicine. Other articles point to diet as a cause for hyperactive behavior. Many commenters on blogs or editorials view ADHD as the product of an undisciplined generation of children. They claim that if parents simply disciplined their children more or spanked them, then those children wouldn’t act so out of control. Finally, even psychologists, who believe in ADHD, question the dramatic increase in the number of children diagnosed with the syndrome after pharmaceutical companies began heavily advertising ADHD medications on television, radio or in magazines.
Thus, I too questioned the prevalence of ADHD. I viewed the syndrome as more of a behavioral problem than something stemming from neuro-biological differences. Then, I had my son, Sam. He was a happy, fat, wonderful baby (of course, all babies are wonderful). I breastfed him until he was over a year old. When he started eating solids, we limited sugar and fed him primarily whole foods. Except for plane or car trips, we didn’t allow him to watch television or play video games. Because we live in a moderate climate, he played outside almost every day. Yet, at 22 months, my son, like most toddlers, started having behavioral difficulties. Unlike most toddlers, my son didn’t grow out of many of the challenging behaviors, and those challenging behaviors seemed more extreme than those in other children. I attributed his behavior to the terrible twos and threes. Because I also blamed myself for Sam’s behavior, I read almost any kind of parenting book available about strong-willed and spirited children. However, none of the advice I read in therapists’ books really worked with my son. When Sam was four years old, I had an easier time parenting him, but he was still more challenging to raise than my younger son. Most people described him as having a lot of energy.
After a tumultuous first semester in a traditional kindergarten, which I documented in my first blog post, I decided to take Sam to a specialist. After two days of extensive testing, including brain scans, the neuropsychologist diagnosed Sam with ADHD. In our follow-up appointment, the neuropsychologist spent over an hour describing how ADHD affects a child’s executive functions and how the frontal lobe develops differently in children with ADHD. My husband, who also attended the meeting, said that the neuropsychologist could have been describing him as a child. However, because psychologists did not diagnose children as having ADHD at the time, my husband was simply called “stupid”, “bad”, or “un-teachable.” My husband, who completed a master’s degree in his second language, obviously does not have any cognitive deficits. However, he does have problems with following directions, planning activities, listening, sitting still and solving problems. He has many strengths, but he also probably has undiagnosed ADHD. In some instances, ADHD helps him to hyper-focus on things he likes to do, but it also hinders his abilities in other areas.
Listening to the neuropsychologist, I also began to think about my mother’s first cousin, who was always described as a “wild child.” I only knew him as an adult, but he had boundless energy, couldn’t sit still, talked very loudly and with a lot of profanity, and slept very little. He was also a very intelligent, sweet and caring man, who became a wonderful father, husband, entrepreneur, and outdoorsman. His path to adulthood was not easy, and he had a very strained relationship with his parents throughout his adolescence and early adulthood. I started thinking about all the children, who were deemed troublemakers as young children, and the effect that those labels had on them. Even though people sometimes claim ADHD didn’t exist when they were children, kids with ADHD-like behaviors and neurological differences have always existed. Parents and teachers just didn’t have the tools to deal with the behaviors. I don’t think any child wins when that child has been pigeon-holed as a bad child at an early age. That kind of labeling only exacerbates situations rather than ameliorates them.
Finally, ADHD affects so much more than a child’s ability to sit still in class. My own son, when interested in a topic, can sit still for hours or hyper-focus (also a symptom of his ADHD). He can listen to audio-books for hours, build elaborate lego creations, and draw. However, during hyper-focus, he cannot pay attention to anything else but the task at hand. Unless you touch him on the shoulder and look him in the eye, he won’t hear his name being called. He also won’t stop what he is doing to go to the bathroom. At school, he has difficulty sitting criss-cross applesauce in a group, walking silently in a line, concentrating in a normal-sized classroom of 22 children, and following multi-step instructions. His ADHD affects his visual tracking and focus. His optometrist told me that whereas only 5% of the population has problems with visual tracking and acuity, 80% of her patients with visual tracking problems also have ADHD. Other studies show that children with ADHD concentrate better when they move, as opposed to neuro-typical children who become distracted by movement. In short, children with ADHD are simply wired differently.
In many ways, I am grateful for the ADHD diagnosis, because there are a lot of research-based methods proven to help children with ADHD. I also realize how mistaken I was. All of the things that I thought might cause ADHD (schools with limited recess and emphasizing rote learning, poor diet, excessive screen time, lack of outdoor time, etc.) were not present in my son’s life. Yet, my son still had ADHD. When we moved my son to a wonderful school with an hour and a half recess, project-based education, small student-teacher ratios, and tactile learning, my son’s ADHD didn’t disappear. He still struggled. However, the teachers at this school were willing to implement accommodations to help him succeed.
As far as parenting, my husband and I have attended lectures and therapy sessions to learn how to parent our son better. Because psychologists have been studying ADHD for over 50 years, we have benefited from their research and findings. My son is a creative, sweet, thoughtful, passionate, energetic and smart little boy. Like my husband, ADHD both helps him in some areas and hinders his abilities in others. I would much rather live in a society that gave these kids the tools to succeed than a society that penalized these children for being different. After all, it wasn’t that long ago that scientists blamed autism on the autistic child’s “frigid” mother. As for the claim that French children don’t get ADHD, research reveals that approximately 3 to 5% of French children have ADHD just like the rest of the world. ADHD may still be over-diagnosed in the United States, but I think the next generation would benefit much more from a society that helps kids with learning differences succeed. No one wins in a society that refuses to accept the fact that some kids are wired differently and may need different tools and accommodations at home and in the classroom.