I spent 24 years as a high school teacher and a year teaching eighth grade. I’m SMH over the notion that parents are running their kids in droves to pediatricians who obligingly dash off an Rx so little River will settle down and get A’s. First, teachers are VERY aware that most kids who are very active are not ADD or ADHD, just as they’re aware, especially at the primary grades, who’s on the younger end of the age spectrum. Furthermore, kids mature at different rates, so kid A isn’t necessarily better-behaved than six-months-younger classmate, kid B
An inability to focus and “settle down” are NOT sufficient for an ADD/ADHD diagnosis, which must be made by an MD. And as Chronos said, ADHD meds make kids WITHOUT ADHD very “hyper.” Those kids would have MORE trouble focusing and behaving, not less. The meds aren’t magic smart pills. Furthermore, pediatricians are loathe to put kids on ADHD meds who don’t need them.
ADD/ADHD is hell for the kids who have it. One boy described ADD as trying to watch a movie that was interrupted by static every 20 seconds. Imagine trying to learn that way.
The operative word is “support”. we didn’t write kids off in the school I went to. It was a collaborative effort between teachers, parents and schoolmates.
The number of kids you’re your looking for is all of them.
Sure, blame the anti-vaxers; after all, they just ignore the science that doesn’t confirm their bias. I bet you get along w/ them swimmingly!
But seriously, since you’re 60 I have to think that age is a factor in your argument and lack of desire to understand where you’re wrong. It happens to all of us as we get older, mis-remembering and filling in what we’ve forgotten. You may as well be claiming that no one had home phones when you were a child, or that women didn’t go to college.
Ambi* That article is based on a study from 1990. I’d rebut that several ways. It’s 30 years old. No one is saying that ADHD might not be overly diagnosed, just that it is a real, physical condition, which can be validated with physical criteria. Further, that beating children will not cure them (Note - you did NOT say this). We generally agree that teams of parents, teachers, counselors, and medical professionals working together to help children with the diagnosis result in the best outcome. Finally, medical, pharmaceutical, and psychiatric thinking and options have come a long way in 30 years.
To emphasize that last point, which gets at the heart of the criticism raised in the article, pharmaceutical treatments alone do not provide the most successful long term outcome. Further, pharmaceutical options are widely different now. No one wants to hurt children while trying to help them. I think it is irresponsible of the author to suggest it, particularly using 30 year old research to do so.
(*I would like to thank you for bringing actual research to this discussion.)
In the modern world, it is usually recommended that kids combine medication with therapy that will help them (and you) figure out how to work around there processing disorders. MAYBE you can get so far with the therapy that eventually you won’t need the medication. At the very least, kids need to learn self sufficiency - medication doesn’t do any good if you forget to take it because mommy doesn’t remind you - so set an alarm to take it. That’s a coping mechanism.
And that’s the part of this that pisses me off. IMHO, too often kids get diagnosed and then it becomes and excuse. Accommodations are made around them, and no effort is made to help them develop the coping skills they need to live with a disability (and it is a disability) and wean them off the accommodation they won’t get once they are adults.
And this hits a button for me right now because my daughter just went off to college - and it was fairly obvious in the accessibility services orientation that a lot of parents didn’t bother with this part. I could see the Dean of Students staff want to scream at the parents “this is college - your kid’s professor is not going to remind them to turn in their essay or study for the midterm - they needed to be developing those skills before they got here!” And they did - but they were much nicer and more patient than I would have been.
Most grade schools have a 100% graduation rate even now. I come from a generation before the diagnosis of ADHD as well - and a lot more has changed than just more diagnosis. For one thing, I never had 38 kids in a third grade class like my kids did. For another, no one in my graduating class had to pass Algebra II in order to get a diploma like in my kids class, or pass any standardized test to graduate - if you did your time, they gave you a piece of paper at the end - didn’t turn in your homework and failed your tests, you could still come through with a gentleman’s D - since graduating high school was more important than actually developing skills. Heck, I graduated with a kid who was only in school every 2 out of 5 days and i doubt could read. Plus, I never had mainstreamed kids with significant disabilities - sure there was the odd kid, and the fidgety one - but there wasn’t anyone severely autistic in my grade school or high school classrooms, no one deaf, no one who didn’t speak English, no one with Down Syndrome. The teacher had time with eighteen kids none of whom had any truly severe challenges to overcome. That wasn’t my kids’ experience in school at all. Sure 1/3 of the class is on IEPs, but of those IEPs, two of them were kids would would never have been mainstreamed when I was in elementary school - back then - why educate a kid with Down Syndrome? Now, they graduate along with the neurotypical kids (but they do get waived graduation requirements to their ability.)
You want fewer diagnosis? Make it possible for kids who have some minor challenges to excel without requiring an IEP to do it. Right now, 2/3s of the kids in the classroom need to follow the rules set by the classroom - take your test in the allotted time, turn in your homework on time, stay in your seat during class. The others get to operate with a set of rules determined by their IEP, which the teacher, in the interest of privacy, can’t explain to the rest of the class. Maggie, get back in your seat…yes, Avery is up and roaming around the room right now, but he gets to do that." And that’s great for Avery with his ADHD-Hyperactivity diagnosis, but Maggie also has ADHD, she just hasn’t gotten diagnosed, and doesn’t have an IEP, and therefore has to stay seated.
One of the examples from my own life - before my daughter was diagnosed, she had a principal who LOVED Cornell notes. So any class where it was applicable, it was mandated that the students keep notes, that they keep them in Cornell format, and that they were graded, and that the notebook was worth 10% of the grade. Well, one form the the processing disorder for my daughter is that she can’t write and listen at the same time. She has great memory - give her five minutes at the end of the class to write things down and she’d do fine. The other thing is when she does think things through - it isn’t linear - so she does better with a mindmap than Cornell notes…better still with just a few words to trigger her memory written on a piece of paper. So here was a kid getting 90-100% on the tests, and at best a B in the course, because 10% of the grade was something that was simply not realistic for her to accomplish. Now, I can’t imagine my principal in the early 1980s (who had been there as principal since the 1960s) micromanaging a classroom to the extent of Cornell notes. (Her college accommodation is the ability to record lectures)
About the time I graduated from high school there was a rash of attention on students graduating who couldn’t read. And that resulted in a demand for graduation standards that old people like us simply didn’t have to live up to. So you could have a much higher graduation rate - and no need for IEPs - because schools weren’t metric focused. At the same time, we decided as a nation that public education wasn’t important enough to fund adequately, while mandating that schools provide services that were not part of their remit when we went to school - a school psychiatrist, a social worker, and on site physical therapist, a wealth of educational specialist to deal with kids who couldn’t meet the new graduation standards without help - and would have simply graduated with a sixth grade reading level and basic math skills when I went to school.
Over-diagnosing; not never diagnosing, which seems to be what you are suggesting. I think there are probably a lot of people who would agree that the diagnosis went through a fad, and may have been over-diagnosed* for a while, and that there may have been some kids who were put on medication without exploring other solutions, from therapy, to holding the kid back a year, to CBT. But some kids definitely have the disorder, and some of the children with the disorder absolutely need to be medicated.
What you have suggested, that people with a brain disorder are simply the product of inattentive parents who didn’t spank them enough, is offensive.
*I personally know one person who was diagnosed with ADD, and put on medication, reacted very badly to it, was taken off of it, then held back a year, improved in school for a while, but was struggling again about four grades later, and was put on a very low dose of an anti-anxiety medication: he improved again. A few years later, he got a diagnosis of Asperger’s Syndrome, the year that it was proposed as a new item for the DSM-IV-- well before it was faddish. I hesitated to tell that story, because I don’t want anyone saying that “See? if one person was misdiagnosed, they all must be!” No; one misdiagnosis means one person was misdiagnosed. I also know someone who got a false positive test for HIV. He eventually learned that he was HIV-negative, but HIV definitely exists.
Magiver, Boomers can’t be compared to young people today. A Boomer who didn’t have the aptitude (for whatever reason) to get into college wasn’t doomed. A college degree was not necessary to get a “good” job. Hell, even if you did wind up with a minimum wage job, you could still earning a livable wage.
But nowadays, college graduates and high school graduates are vying for the same minimum wage jobs. Nowadays, a person cannot support themselves on minimum wage.
It’s all fine and dandy to play the “back in my day” card, but the reality is we living in a different economy. Young people are under different pressures.
These two statements are in direct conflict with each other. We could read in the 1st grade and had math tables memorized by the 3rd grade. I don’t understand how a high school student got a diploma without the earliest of grade skills.
I am old enough that I never heard of ADHD until I was an adult – and I even went through a period of heavy skepticism that it existed. I thought it was an excuse for poor behavior and laziness. (I also had a stay-at-home mom, got spankings, and even went to schools that had corporal punishment.)
Eventually, I got a doctorate level degree, and was working in a high-level position in my field, doing what was regarded as excellent work. I was getting feedback that I was taking too long to accomplish projects, though. I was working very hard, but I knew I sometimes got distracted by extraneous matters, or had trouble concentrating, particularly on dense or “boring” reading. I was dedicated to figuring out how to work faster and more efficiently, both as a matter of personal commitment to excellence and because I did not want to lose my job or get branded as “slow.”
I was receiving treatment for some anxiety issues I was having at that time. At one point, I heard a description of the “inattentive” type of ADD. (Non-hyperactive. Before that, I had always thought ADD meant hyperactive.) I was struck by how familiar some of it sounded. I was referred to someone qualified to diagnose it, and I was diagnosed as an adult.
I will mention that, as others have pointed out, stimulant medications affect people with ADHD very differently from non-ADHD people. There may not be a formal confirmatory test in common use, but from what I understand, a trial of a stimulant medication is often viewed as fairly confirmatory. Neurotypical people tend to respond to amphetamines by getting amped up, and might display behaviors similar to hyperactivity. People with ADD/ADHD tend to become calmer and more focused. So, as others have said, if wrongly diagnosed kids (or adults) get medicated, it is likely to be apparent. Response to medication may rely on observations, but those are not necessarily subjective. You can quantify how many times Jane got out of her seat, and how much of the worksheet she completed.
I was consistently called lazy in school, and I believed it. I’ve wound up being pretty successful, but it’s been hard. I can explain in more detail how it affected me during childhood-- quite apparent in hindsight – if anyone is interested. And I was lucky that I had other skills and advantages that helped me to succeed as much as I did. I can only imagine how things might have gone for me if, instead of being called lazy, I had been told that my brain worked a little differently, and been given useful techniques and, perhaps, effective medications.
Right. I’m sure things were great in the awesome school you went to. Meanwhile I’ve heard stories from friends and family of your generation that were, shall we say, different. This may not have occurred to you, but your experiences as a child may not be universal.
too bad I didn’t say that. In a world of ever increasing use of drugs for ADHD I pointed out we weren’t a part of that when I was young and we were able to get through this by a combined effort of teachers, parents, and schoolmates.
This thread is about the premise that ADHD is over-diagnosed.
In the 1970s, AD(H)D was known as “minimal brain dysfunction” and was believed to occur only in boys.
To me, an indication whether it’s “real” or not is how aggressively the parents pursue a diagnosis even though experts say their child doesn’t have it, and whether they brag about it if they do. Really.
There was nothing awesome about my school beyond the obvious. I’d say it was similar to what my parents went through.
It’s no surprise that school successes are not universal. If there isn’t solid involvement between teacher, parent and classmates it will be less successful.
Again, you don’t (and cannot) speak for everyone. Many people were not able to get through it. I understand that you believe that at your school, everyone was able to achieve success and no one had any learning disabilities that required more intervention than simply “the combined effort of teachers, parents, and schoolmates.” Unlikely as that may be, I concede that it could have happened at a particular school at a particular place at a particular time. That experience is far from universal, and the conclusions you are drawing from it are unfounded as a result.
I’m confused. Here, you seem to acknowledge that it existed, but suggest it was effectively dealt with by a combined effort of teachers, parents, and schoolmates. You’ve previously identified punitive measures by teachers and parents. Not sure about schoolmates’ roles.
But earlier, you said that there was no ADHD when you were a kid because it wasn’t “allowed” and was shut down by kindergarten. That sounds like a denial that it exists at all, and that it was just bad behavior that could be eliminated.
Can you clarify? Do you think it’s over diagnosed, or that there is no such thing? Besides thinking back to your own experience of school, have you done any investigation into what it is, and what the evidence for it is?
They’ll be alive for their whole lives, though. Who does better, those who have learned to redirect and control the inappropriate impulses, or to burn the excess energy, in productive ways, or those who have learned to take pills and do their work while Mom watches closely? I had a coworker who was clearly capable and smart, but who would only do any externally-mandated work if and while a second person was staring at the back of his head. He was worth a lot; he wasn’t worth two salaries. My hyper-hyperactive classmate is now our HS Phys Ed teacher - and one of the things that make him a good Phys Ed teacher is that he knows most people don’t have his energy levels. My family is full of people who “bore easily”: we’re engineers, international consultants, sales managers for half a country, successful business owners… none with pills, because we found fields that attracted us and we learned how to push ourselves through the bits that we don’t really like but which we know to be necessary. Replacing teaching life skills with pills worries me. Going to the pillbox as the first option, specially, worries me. We’ve decided that it’s better to spend your whole life taking drugs than to see if you can learn how to deal with “just I had to be me”, and that worries me.
I think medications can be a great short-term or “as needed” solution. Learning strategies are a great long-term solution.
But the success of this dual-pronged approach hinges on the context someone finds themselves in, which includes things like their personality, cognitive ability, and self-awareness. Not to mention all the other neurological atypicalness they may have got going on. I have a sister with bipolar disorder and ADHD. She is functional even when she is “extra”, but she is highly resistent to therapy because she loves being manic. Most professionals find her mania to be problematic and try to steer her towards meds. But that is a no go for her. But weirdly enough, she has no problem taking her Concerta. Is she taking an easy way out? Sure. But she isn’t the type of person who is willing to learn adaptive techniques. So we take what we can get without “shoulding” on her. Perhaps she could be the CEO of her own Fortune 500 corporation if she would only learn how to manage her impulsiveness and hyperactivity without chemical intervention. But her life up to this point has been pretty good with the Concerta. She has no motivation to swap this solution for something that may leave a lot of damage in its wake before it works.