Why Everything You Think You Know About ADHD May Be Wrong

A 1,000-word summary of 'A Disease Called Childhood,' Marilyn Wedge's polemic that eviscerates conventional thinking on ADHD and charts a new way forward for parents.

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Child therapist Marilyn Wedge, PhD., just published the latest shot across the bow of the medical diagnosis known as Attention Deficit Hyperactivity (ADHD), and A Disease Called Childhood pulls no punches. In Wedge’s (convincing) estimation, ADHD is largely bullshit and propped up by a pharmaceutical industry medicating “symptoms” that fall within the spectrum of normal childhood behavior. The good news is that she offers plenty of alternatives that, while more labor intensive than doling out pills to kids, can help parents get a handle on rambunctious offspring.

The latest in our Crib Notes on influential parenting books summarizes the main takeaway from Wedge’s book:

1. ADHD Is Overdiagnosed And Overmedicated In The U.S.

The Bar For Diagnosis Is Ridiculously Low

In the latest version of the Diagnostic and Statistical Manual of Mental Disorders, a child (or teen, or adult) need only present 6 out of 9 “symptoms” in order to be labeled ADHD. These symptoms include “Often talks excessively,” and “often fidgets with hands or feet or squirms in seat,” and many other annoying, but totally normal, behaviors. A diagnosis can be made by a child psychiatrist, doctor, nurse practitioner, or licensed counselor.

Drugs Often Follow Diagnosis (And Guess Who Funds The Research?)

There are no genetic mutations or discernible biological markers for ADHD; rather, it’s a constellation of behaviors with one thing in common: they can be curtailed by stimulants. Virtually every major study that indicates the existence of ADHD — and the effectiveness of stimulants in treating it — has been funded by the companies that make those stimulants.

ADHD is a constellation of behaviors with one thing in common: they can be curtailed by stimulants.

The Rest Of The World Doesn’t Medicate Their Kids Like The U.S. Does

In the U.S., 13.2 percent of boys and 5.6 percent of girls are diagnosed with ADHD. The U.S represents only 4 percent of the world’s population, but we consume 70 percent of the world’s stimulants. According to Wedge, “A child in the United States is six times more likely to be medicated for ADHD than a child in France and sixty times more likely than a child in Finland.”

What You Can Do With This

  • Don’t accept the first diagnosis you receive and don’t assume that medication is necessary to treat any behavioral issues your kid might be having.
  • Ask yourself, “If ADHD were an actual ‘disease,’ wouldn’t its geographic distribution be pretty much equal?”

2. Behavior Attributed To ADHD Can Be Explained By Myriad Factors

Immaturity Causes Kids To Fall Behind Or Act Out In School

Studies have shown that being born just before the eligibility date for entering kindergarten increases the chance of receiving an ADHD diagnosis.

Environmental Factors Play A Huge Part In A Child’s Behavior

Adverse Childhood Experiences like emotional, sexual or physical abuse, neglect, proximity to domestic violence, substance abuse, or divorce can all contribute to the development of impulsivity, hyperactivity, and inattentiveness.

What You Can Do With This

  • If your kid will be a young kindergartner, consider holding them until the following year.
  • Work with counselors or therapists who are interested in finding the cause of behavioral problems, as opposed to simply treating symptoms.
  • Remember that “adverse childhood experiences” can be as common as hearing parents fight or getting consistently yelled at.

3. Drugs Aren’t The Only Treatment For ADHD Symptoms

American Schools Don’t Let Kids Be Kids

In the 70s, Finland overhauled their school system by raising the age when kids start to 6 or even 7. Today, Finnish kids get very little, if any, homework and have a 15-minute recess every hour. Early elementary education is play-based, so being squirrelly isn’t considered a medical condition. Oh – they also consistently score at the top of world-wide education rankings and 0.1 percent of them are on ADHD meds.

Americans Eat Garbage

The landmark 2007 “Southampton Study” concluded that “artificial colours or a sodium benzoate preservative (or both) in the diet result in increased hyperactivity in 3-year-old and 8- and 9- year-old children in the general population.” In Europe, food manufacturers reacted by finding alternatives to these chemicals. In the U.S., the FDA said “Meh,”, and manufacturers kept churning out lurid, everlasting food-like products.

Not All Screen Time Is Created Equal

A 2004 University Of Washington study showed a correlation between the amount of screen time toddlers were allowed and attention problems at age 7. A 2011 University Of Virginia study showed that kids who watched frenetic Sponge Bob cartoons experienced declining executive function while kids who watched comparatively soothing Caillou cartoons showed no difference (as did the kids who just colored instead of watching anything at all).

One of the reasons ADHD has become such a common diagnosis is that it lets parents off the hook.

What You Can Do With This

  • Become an advocate for change in your kid’s schools.
  • Vote with your grocery money — recent consumer pressure has resulted in companies as large as Kraft and Nestle removing artificial flavors and colors from their products.
  • Be judicious with how much and what kind of screen time your kid gets. Common Sense Media has comprehensive movie and app guides, with selections vetted for educational value and inappropriate content by level-headed experts.
  • Move to Finland.

4. Parents Have A Larger Role To Play Than Drugs Or Doctors

One of the reasons ADHD has become such a common diagnosis is that it lets parents off the hook to a large extent. By dismissing environmental factors and claiming a biological source of the “disorder,” medical providers give parents a pass on doing the work that would “put the authority of the children’s emotional and behavioral well-being back where it has traditionally belonged: into the hands of the parents,” Wedge writes.

What You Can Do With This

  • Don’t stress your kid out. Keep grownup problems and arguments between grownups.
  • Keep things positive with you kids; take time to identify at least one positive thing about your day, every day.
  • Practice mindfulness and meditation. Seriously — try it — and, while you’re at it, have your kid try it, too.
  • Make sure you and your partner are on the same page, so a tyrannical child doesn’t have a power vacuum to try and fill.
  • Take a lesson from the French and maintain a framework within which your kid can be autonomous. Clear rules with consistent and appropriate discipline encourage self control and self-sufficiency — 2 things that, when present in a child, drastically reduce the chance of anyone diagnosing them as ADHD.

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