Is ADHD real?

When I was a parochial vicar, I taught in the parish high school and frequently had students tell me variations of this line: "I have ADD; I can't pay attention very long."

"Rubbish," I said to them.  "I see you at basketball games and you do just fine there.  I know you go to the movies without problems, and I'm sure you don't mind sitting for several hours through a baseball game."

Naturally, they could not dispute any of this.  When it came to it, I said to them: "The issue is not that you have ADD, but that you have little self-discipline.  You can - and do - pay attention well, when you want to."

One day - this is my particular favorite - one my students protested, "I was diagnosed yesterday with ADHD; it's not my fault!"

I looked right at her and said, "You've been in this class for two months now and never once have you said a word.  Every day you come in, sit down, close your eyes and fold your arms.  You don't even move.  I've never seen any sign of activity in you, much less hyperactivity; I'd find a new doctor."

She did not protest and everyone in the class knew I was right.

When I was in high school I did not pay much attention in class, simply because I was bored (out of my mind).  Unlike most of my classmates, I did my homework at home and read the assignments before class and so already knew the material that was being covered in class.  So, in most classes, I simply read a book.  The teachers would call on me from time to time, I would give the correct answer, and then return to my book.

We had an understanding, they and I.  I knew they couldn't raise the standards of the classroom to teach more specifically to me and they knew that if they left me alone I would cause no disturbance or distraction.

When I was teaching, I had one student who really lacked the discipline to sit still for more than five minutes at a time (anywhere); he was a very active young man and many of the teachers had a difficult time with him.  I understood him, and told him he could pace back and forth at the back of the classroom, so long as he paid attention and participated in class.  He found it helpful and didn't disturb my class, as he did in those where he forced to remain in the chair at a desk (I don't like staying at a desk for more than 30 minutes at a time, either, and often take brief wander breaks to refocus, but I can stay in a comfortable chair with a good book for hours on end.

It's really a matter of preference.  Even when studying today, I tend to switch topics or books every 20-30 minutes.  I can sit still with the best with of them, but I still need to switch things around from time to time.  Even for leisure, I'm never reading only one book at a time, but I always have a small stack of books to choose from.  My classmates in the seminary were frequently frustrated with me because I would be curled up in a comfortable chair in my room reading a dense theological book for class, while watching The Lord of the Rings and visiting with those who walked by my room (the door was usually open), and I always knew what was going on in each of these.  Others can't do that; I can.  The notion of studying without music is appalling to me, though I know that others can't study with music.  It's a matter of preference.

Why am I writing about this today?  Because Matt Walsh, whose blog I am following with greater interest with each post, suggested yesterday that ADHD isn't really the problem - or perhaps even real - but that perhaps instead "people are all, like, different."  I couldn't agree more.

Before dismissing his suggestion, he asks:

Seriously, think about it. What if there ISN’T actually some preordained mold of behavior and thought in which we’re all supposed to fit? What if it’s OK for some people to be a certain way, while others are another way, and still others are an entirely different way? What if some people are active, and some people aren’t; some people are creative, and some people aren’t; some people have a lot of energy, and some people don’t; some people are daydreamers, and some people aren’t? What if — again, HUGE if — but what if we tried to find a place for the unique qualities of all men and women, rather than attempting to chemically eradicate entire personality types simply because they don’t gel with our artificial societal constructs?

Walsh points to claims from the Centers for Disease Control that 50% of Americans will develop a mental disorder - which seems rather high and unreasonable - and to an article concerning the difficulty drug companies have in selling ADHD drugs in Europe.

A few months ago, Psychology Today published an article with the title, "Why French Kids Don't Have ADHD."  That's curious; American kids have ADHD, but not French kids?  How can that be?

The answer is rather simple:

In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological--psycho stimulant medications such as Ritalin and Adderall.

French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational 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. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child's brain.

You should read the rest.  It seems a much more "human" approach to children - and realistic - than that now employed in the U.S.

Returning to Walsh, he asks the $10,000 question:

Could it be that our kids are distracted because they’re surrounded by distractions? Could they be overstimulated because they’re surrounded by stimulation? Could they have trouble paying attention in school because school is tedious and boring?

You cannot honestly raise children from the moment they're born (remember Baby Einstein?) with stimuli constantly around them and then put in a classroom with little stimuli and expect them to be content.  It simply isn't fair.

Some educators are seeking to remedy this today with the use of iPads and SmartBoards in the classroom, but I don't this will, in the end, be very helpful.  It simply continues the constant stimuli without every helping a person acquire self-disciple (but this could be the introvert in me talking).

 Walsh concludes:

There’s no question that some people — myself included — think and behave in a certain way; a way that currently falls under the “ADHD” umbrella. The question is this: are these people “disordered”? Do they need medicine? Is there something WRONG with how they are?

Or should we help them explore and harness their different, complicated, wonderful minds? In the end, this is more of a philosophical question than a medical one. I know my answer. I encourage you to come up with your own.

Many children diagnosed today with ADD or with ADHD are labeled as "special needs."  Yes, they have special needs, as has every student because they have unique personalities.  In my experience, these students often simply need to be challenged more.  Challenge them and they'll rise to the occasion, if you let them work in their preferred way.  But our cookie-cutter approach to education does not allow that.

Update: Over at Facebook, a friend has strongly disagreed with this post because, to him, it seems that I have "dismiss[d] the entire thing wholesale"and see ADHD as "completely bogus."  That certainly wasn't my intent.

His protest led to another person posting a follow up article in Psychology Today regarding the lack of ADHD in French children, titled, "Of Course French Kids have ADHD."  At the end of the article, the following is said:

Because ADHD is a disorder of performance rather than ability, we expect to find variability across settings and tasks.  That variability is instructive:  "What about this task or this setting is such a good match for this individual?  And how can we make other areas of his/her life more like that" [emphases original, both italics and bold]?

Those two questions were really the heart of what I was getting at, which our current educational model simply cannot address.  And because not every child simply fits into such a cookie-cutter approach, we do what's easiest and give them medication to fit in better.  That I find disturbing.

To be fair, the student I referenced above whom I allowed to pace back and forth was noticeably different when he did not take his prescribed ADHD medicine, but even without it he wasn't intolerable, just a bit more difficult.  He hated taking his medicine because he knew it changed his personality and, naturally, he was not comfortable with that.

Better to find the environment that works for an individual than to medicate.