Quite illuminating. A few reactions:
The diagnostic manual created by the American Psychiatric Association is the basis for the diagnosis. It divides ADHD into 3 different aspects. One is hyperactivity, another is impulsivity, and a third is inattention.
The key fallacy in the whole ADD/ADHD controversy is the assumption that a kid who is not paying attention to what the adult has selected for him is biologically incapable of paying attention to anything. In fact, our natures as human beings are curious; from our first hours on Earth, and probably before, we are using our senses to explore, to "pay attention to", what is around us.
They really ought to call this "uncontrollability disorder." It is the inability of authority figures to exert control over subjects, plain and simple. When this occurs, it seems to me that there could be several possible causes: (1) the authority figure is not properly or effectively commanding attention; (2) the subject has chosen to pay attention to something other than what the authority figure has selected for him to pay attention to; (3) the subject has initially paid attention to what has been selected for him, comprehends it, and is ready to move on; (4) the subject has lost respect for the authority figure and is expressing this lack of respect by refusing to pay attention (in biomedical terms, this is known as YOC disorder, or "Yanking One's Chain"); (5) the authority figure has chosen as the object of attention something which is not really worthy of attention; or (6) the subject is biologically incapable of paying attention. The whole debate is about why the educational and medical establishments are so eager to leap to conclusion (6)without pausing to consider the far more difficult issues posed by issues (1) through (5).
For example, under hyperactivity, the first criteria is "often fidgets with hands or feet or squirms in seat." Under impulsivity, the first criteria "often blurts out answers before questions have been completed," which to me means he could do well on Jeopardy. And the third, inattention, has for it's first criteria, "often fails to give close attention to details or makes careless mistakes." Clearly this is not a biological disorder, but a list of behaviors that put children in conflict with adults.
Even now, years later, I remember school well. My overriding image is of boredom. I didn't cause much trouble, but I would daydream, fidget, look out the window and focus on something going on across the street, bring my own books or draw pictures or write, regardless of the assignments. Did I need Ritalin? I wasn't paying attention, at recess I had so much pent up energy I would run around a lot, and I rarely waited for the question to be finished before answering and directing my attention elsewhere. Is this what we have come to, defining such behavior as a disease?
There are very few long-term studies. One good study from the University of California School of Education by Nadine Lambert followed children given Ritalin and other stimulants and found increased cocaine and nicotine abuse in young adulthood. Some children develop tics and on rare occasion they become permanent.
The anecdotal evidence is appalling but, on a scientific level, meaningless. It does, however, at least suggest that somebody ought to be trying to figure this out. In a perverse sense our children are being treated in a way fundamentally similar to that of the Nazi prisoners who were subjected to horrific and barbaric medical experiments in World War II. In both cases, no one really knew or seemed concerned about long term effects; in both cases, the subjects were not in a position to grant or withhold informed consent to their use as guinea pigs. Perhaps that seems like an overstatement, but if there's a difference please tell me what it is. I don't see it.
A recent study out of Duke University showed that more than 7% of children were receiving stimulants. Another study out of Virginia showed that 10% of children were receiving stimulants in school, and probably a greater number if you included children medicated before coming to school. In addition, a study in the Journal of the American Medical Association (JAMA) has shown a 3-fold increase in Ritalin subscriptions to toddlers, ages 2 to 4, and hardly anyone thinks that's justified.
We live in arguably the most mentally stimulating time and place in history. Why is it necessary to chemically stimulate? Is there something new about this time and place and generation that didn't exist before???
Let me suggest this as a possible explanation. We live in a time of great faith in medical interventionism. By and large, medical science made our lives dramatically better in the twentieth century. The average life span in the developed world has increased by more than a quarter century since modern medicine's era began around a century or so ago. That is a good thing. The quality of life for older people is dramatically better than it once was. That is a good thing, and much of it comes from the pharmaceutical industry.
But we must be careful not to let those good things beget a blind faith in medical intervention as a road to improvement of the species. Standards need to be developed and followed to ensure that such intervention, particularly in children, does not run amok.
However, in order to impose a Feingold Diet requires paying a great deal of attention to your child, including all of your child's daily activities inside and outside the home. It requires a rigorous program of discipline for you and your child. I believe this is why these fad solutions actually end up helping parents and children in regard to the child learning self-control.
Geez, eating right, exercising with your children, teaching them rigorous discipline in their habits, paying a great deal of attention to your child's daily activities inside and outside the home ...... why the hell should we do that when there is a pill that will make it seem as though everything is alright? It's a good thing the schools are there to stop us from doing all these things ..... it would take so much time, we might lose out in the workplace or the market or something. And self-control? What's that? That went out decades ago. Get with the program!
Schools can be very unresponsive to the needs of children. You should explain to the school that you do not favor medication, that there are many doctors who are against giving stimulants to children, and that you want to work with the school in engaging your child's interests and imagination. You should explain to the school that you will obtain any necessary psychological evaluation privately, and that you don't want the school evaluating your child except with tests given routinely to all children. Furthermore, a change of teachers or schools often completely solves a child's school problem. Do not accept blaming your child's brain; instead, insist that the school work with you to find ways to solve your child's education problems. And finally, if your child is out of control in class, you need to visit the classroom and spend time there, both to observe your child and to invest the classroom with your authority. Very likely your child is undisciplined at home, and if you get good advice on how to handle that problem, it will carry over into school.
I put this passage in bold because it ought to be taped to the inside of every parent's brain (even those whose brains are supposedly "abnormal", whatever that means).
Think of schools like a giant assembly line; after all, many of them think of themselves that way. Unlike the assembly line at the local Ford plant, though, this assembly line is a real challenge. Each car comes through with a different size chassis; different trim and chrome; different bumpers and taillights. Each has a different style interior. Some have powerful engines; others have engines barely powerful to move a tricycle. Some have hi-beam headlights; others have headlights that barely cast any light at all.
If that happened at the local Ford plant, the workers would not know what the hell to do. They would eventually have to address the problems and potential of each part individually. Each car would have to be assembled by hand, and polished and checked and coated by a unique process. Assembly, hampered by the need to tailor every detail to the individual characteristics of the car, would be painfully inefficient. The shareholders would revolt at the costs.
Ritalin aids the efficiency of our schools. It makes the assembly line, in the aggregate, run more smoothly, more efficiently.
The trouble is, we aren't cars. |
