21 September 2014

Is the cause of ADHD simply spending too much time not moving?

Almost a year ago I posted some thoughts on the increasing diagnosis of children and young adults in which I asked, "Is ADHD real?" Naturally enough, the post was liked by many and disliked by many.

Within the post, I shared an experience I had with one of my former students:
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 [was] 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).
In the end, I suggested, "It's really a matter of preference."

It turns out I might have been correct all along. Writing in the Washington Post, Angela Hanscom, a pediatric occupational therapist, suggests a principle reason so many children are now being diagnosed with ADHD is simply because schools require to spend too much time sitting at their desks:
Over the past decade, more and more children are being coded as having attention issues and possibly ADHD. A local elementary teacher tells me that at least eight of her twenty-two students have trouble paying attention on a good day. At the same time, children are expected to sit for longer periods of time. In fact, even kindergarteners are being asked to sit for thirty minutes during circle time at some schools.

The problem: children are constantly in an upright position these days. It is rare to find children rolling down hills, climbing trees, and spinning in circles just for fun. Merry-go-rounds and teeter-totters are a thing of the past. Recess times have shortened due to increasing educational demands, and children rarely play outdoors due to parental fears, liability issues, and the hectic schedules of modern-day society. Lets face it: Children are not nearly moving enough, and it is really starting to become a problem.
What is more, spending so much time sitting is actually bad for the children's physical health because "many children are walking around with an underdeveloped vestibular (balance) system today–due to restricted movement."

The fix, she suggests, is really quite simple:
Fidgeting is a real problem. It is a strong indicator that children are not getting enough movement throughout the day. We need to fix the underlying issue. Recess times need to be extended and kids should be playing outside as soon as they get home from school. Twenty minutes of movement a day is not enough! They need hours of play outdoors in order to establish a healthy sensory system and to support higher-level attention and learning in the classroom.
As a fidgeter, and one who has always been a fidgeter, I know she's correct; I don't fidget as much after I've gone for a long walk or a good hike in Hawaii.

Maybe it's time to re-think our current educational model.


  1. Father, this is a well-considered post, and I concur that more active time in our educational model is necessary.

    However, I think it is important to be clear on this topic, that while all this time at desks increases the DIAGNOSIS RATE of ADHD, it doesn't per se cause it. One of the natural parts of the total ADHD treatment strategy (and one that I myself employ to treat my ADHD as an adult) is physical exercise, be it pacing back and forth for five minutes while thinking about a piece of writing or going on a run or to the gym before tackling a major project. Exercise causes the brain to produce the natural stimulants that the ADHD is deficient in, which makes it a complement or alternative to drugs.

    Now, as childhood has become less active in recent decades, that has removed some of the natural treatment options from children who otherwise would have worked it out organically. It doesn't cause the problem; it has merely overcovered it.

    But yes, on the broader point, school needs to be more fidget-friendly, not just for ADHD kids, but for boys in general, and when it comes to things like ADHD, be accomodating to a total range of treatment strategies, based on the needs of the child (medicine, exercise, organizational coaching, mentoring to help remain accountable, instruction on mental strategies for how to cope with anxiety over big tasks, etc).

    1. Thanks for your reply, Mike!

      Your comments about the benefits of exercise for mental activity are part of what makes me question the diagnosis of ADHD in general (though, certainly, there are some real cases of it, though I would contend those are very rare).

      I can't help but wonder if now we simply do not expect too much of people - both children and adults - by expecting us to basically sit at a desk for 8 hours a day doing much of the same thing. It wasn't that long ago that such a day would have been simply inconceivable.

      Is it possible that we - as a whole society - have shifted to a mode of living that we humans simply aren't suited for?

    2. "Is it possible that we - as a whole society - have shifted to a mode of living that we humans simply aren't suited for?"

      Absolutely, I think that is entirely possible, and well worth considering as we go forward with building communities and adopting certain ways of life in the future. That said, for the sake of argument, even if it was proved that the modern way of life causes or increases rates of ADHD, that doesn't make it any less "real" for the person who suffers from it. It just means that the cause is environmental. Important to clarify that, given how often people who suffer from mental health difficulties go through the crushing experience of other people write off their problem or illness as fictitious.

      Regarding your other speculation, I can only go off of my personal experience of having ADHD. I'm not a researcher or an expert in the field, so I claim no personal knowledge of its prevalence. All that I CAN say is that my exposure to experts in the field, like Dr. Edward Hallowell, has drastically improved my quality of life and ability to, not just cope with, but thrive with my ADHD. Given that the treatment strategies they teach have proven so effective and spot-on in my book, I am inclined to take them at their word when they say that ADHD is a real phenomenon and one that is much more common than "very rare."

      Also, I've yet to hear a satisfying explanation as to how giving amphetamines to a normal, healthy child who is just a little more energetic than usual will somehow calm that kid down! ;)

    3. In my original post, I mention that I do believe certain really do have ADHD, but, in my experience, the vast majority of those diagnosed with ADHD and medicated for it have simpler issues.

  2. Sitting is the new smoking.
    We homeschool in all manner of positions. And take frequent breaks for tumbling, stretching, and playing catch.