Ellen
PY251- Education Psychology
“Attention Deficit Disorder”
Disorder or Personality Type?
As parents and educators we hold the power to help form a child’s outlook on life, his[1] way of looking at his own abilities, and his willingness to accept and work with those abilities.
If we look at a “disorder” and call it “normal”, then we fail to support a child’s true need for support and assistance, if truly needed. However, if we look at behavior which is actually normal for a child and call it a “disorder”, then we instill in the child (many times from a very early age) a belief that there is something “wrong” with her; there is something wrong that cannot be “fixed”, or that must be fixed with drugs.
Is there an alternative to labeling a young child with a mental disorder? Is it possible that “Attention Deficit Disorder”[2] is not a “disorder”, but rather something more natural, a remnant of necessary skills that brings not only challenges, but a skills set that may be seen as helpful in certain circumstances?
Consider the following list of characteristics[3]. What condition does this list describe?
| Poor attention, boredom, daydreaming in specific situations. |
| Low tolerance for persistence on tasks that seem irrelevant. |
| Judgment lags behind development of intellect. |
| Intensity may lead to power struggles with authorities. |
| High activity level; may need less sleep. |
| Questions rules, customs and traditions. |
Is this “Attention Deficit Disorder”? No; the above list describes (in part) a child that is “gifted and talented”.
Below is a list of the same characteristics on the left, and a corresponding list of ADD/ADHD “symptoms” on the right.
| Poor attention, boredom, daydreaming in specific situations. | Poorly sustained attention is almost all situations. |
| Low tolerance for persistence on tasks that seem irrelevant. | Diminished persistence on tasks not having immediate consequences. |
| Judgment lags behind development of intellect. | Impulsivity, poor delay of gratification. |
| Intensity may lead to power struggles with authorities. | Impaired adherence to commands to regulate or inhibit behavior in social contexts. |
| High activity level; may need less sleep. | More active, restless than normal children. |
| Questions rules, customs and traditions. | Difficulty adhering to rules and regulations. |
If the wording involved is examined, we see differences in the way the same type of behavior is described. “Low tolerance” becomes “Diminished persistence” for tasks that seem “irrelevant” (which becomes “not having immediate consequences”). ”Power struggles” become “Impaired adherence to commands” and “Questions rules” becomes “Difficulty adhering” to those same rules[4].
If a high activity level is acceptable in a gifted and talented girl, and restlessness is medicated in the boy sitting next to her, what message are we sending?
Is there a different (and more positive way) off looking at the set of characteristics known as “ADD/ADHD”?
The Hunter/Gatherer vs Farmer View
Thom Hartmann says that there is, asking “Could it be that ADD is something that was once useful for the human race, but is now – particularly in schools – a liability?[5]
”The creatures that want to live a life of their own, we call wild. If wild, then no matter how harmless, we treat them as outlaws, and those of us who are ‘specially well brought up shoot them for fun.” (Clarence Day, This Simian World, 1920)
Hartmann reminds us of a time when the human race consisted of nomadic hunter-gatherers; these nomadic peoples around the world were gradually replaced as agriculture developed and the qualities that benefited farmers were developed. Over the years most humans became more adapted to farming; the “hunter-gatherer” gene remained. Those people who our society considers “normal” are those who adapted to an agrarian world. Those who retain some of the older hunter-gatherer characteristics may be labeled “ADD/ADHD.[6]
Hartmann writes, “At its core, ADD is generally acknowledged to have three components: distractibility, impulsivity, and risk-taking/restlessness.[7]” Hartmann hypothesizes that these things that we now see as impediments may have actually functioned as survival skills in ages past.
On distractability:
“A better way to characterize the distractibility of ADD is to describe it as scanning. In a classroom, the child with ADD/ADND is the one who notices the janitor mowing the lawn outside the window, when he should be focusing on the teacher’s lecture on long division. Likewise, the bug crawling across the ceiling, or the class bully preparing to throw a spitball, are infinitely more fascinating than the teacher’s analysis of
How would this sort of “scanning” have been useful in the past? Using Hartmanns’ “hunter/gatherer” scenario, we can imagine a primitive hunter constantly scanning his environment. The hunter that was unable to scan would have been at a huge disadvantage. That flash of motion that catches his attention might be dinner…or the animal that hoped to make dinner out of him. In today’s world we might think of a truck driver; would the ability to catch movement out of the corner of the eye help to prevent accidents?
The farmer, on the other hand, needs to be able to focus on the long term. Focusing on what is directly in front of him, his rows are straight and weeds are pulled.
On impulsivity:
“Thomas Edison eloquently described how his combined distractibility and impulsiveness helped him on his “hunt” for world-transforming inventions. He said, ‘Look, I start here with the intention of going there’ (drawing an imaginary line) ‘in an experiment, say, to increase the speed of the Atlantic cable; but when I have arrived part way in my straight line, I meet with a phenomenon and it leads me off in another direction, to something totally unexpected.”[9]
In times past this sort of impulsivity would have been an asset for our primitive hunter; if he were chasing a rabbit through the woods and a deer ran in front of him, he would have no time to stop and do a risk/benefits analysis. Impulsivity translates to the ability to make instant decisions and act on those decisions without a second thought. For a businessman such as a stock broker, this ability to see, make and act instantly on decisions could mean huge profits or losses.
Our farmer cannot make such snap decisions; to leave the field in the middle of harvest, to be distracted from the weed pulling would be a disaster for the field.
On restlessness:
“Risk-taking, or, as described in their book, “Driven to Distraction”, by Drs. Hallowell and Ratey, “a restive search for high stimulation,” is perhaps the most destructive of the behaviors associated with ADD in contemporary society…”[10]
Hartmann notes that this search for high stimulation may account for the high percentage of the prison population with ADD/ADHD and may play a role in a many social problems, from reckless driving to job-hopping.
Yet, looking again at the primitive hunter, we see that restlessness and risk-taking is an essential part of life for a hunter; if these hunters shied away from risks, they would go hungry. The adrenalin rush would be their “normal”. We see restlessness and risk taking in many situations today. We can look at young people who start a band in the garage and begin to seek out venues to play. We see the owner of an independent coffee shop who takes the risk of competing against the “big guys”. We see the ordained minister who seeks to become president.
Most farmers cannot take such risks. Over many, many years rotation crops have been developed. To vary from the rotation depletes the soil. To plant an entire farm of a new crop (rather than the low risk planting of one field) could risk an entire year of failure and starvation.
Hartmann’s view of ADD/ADHD (which is growing more popular) implies that it may not be a disorder at all; it may be a simple variation of human behavior. These characteristics may even be useful in some careers, rather than the characteristics of our primitive hunter’s
The Medical Community’s View
The counter-balance of the “hunter/gatherer” view of ADD/ADHD is that of the medical community. The education and medical communities shape our view of this “disorder”.
The
“Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood. ADHD is also among the most prevalent chronic health conditions affecting school-age children. The core symptoms of ADHD include inattention, hyperactivity, and impulsivity.”[11]
In these 35 words the AAP tells us that ADHD is not a natural variation of human behavior, let alone behavior that could be helpful at times. The AAP verifies that (according to their definition) ADD/ADHD is a neurobehavioral disorder and a chronic condition. Note that the three core “symptoms” are the same three hunter characteristics that Hartmann noted.
Global use of medications that treat ADD/ADHD nearly tripled from 1993 to 2003, and spending on the drugs rose nine-fold, according to a study co-funded by NIMH and published in the March/April 2007 issue of Health Affairs[12].
“Given ADHD’s prevalence and the increasing use of these medications, the disorder is poised to become the world’s leading childhood disorder treated with medication,” said Dr. Scheffler. “With this in mind, we should clearly identify the benefits and risks of these pharmacologic treatments, and promote careful prescribing and monitoring practices.”[13]
Is this condition that we know as ADD/ADHD truly this widespread and do we really have so many children in need of medication for a mental disorder?
Some doctors say no.
Dr. William B Carey of the
As stated in my presentation at the NIH conference and as published in the summary book edited by Jensen and Cooper, the problem resides primarily in the ADHD diagnosis itself and secondarily how it is applied:
1) The current ADHD symptoms are not clearly distinguishable from normal behavior. The DSM system fails to acknowledge the existence of temperament and how it differs.
2) The absence of clear evidence that the ADHD symptoms are related to brain malfunction. They may come from other causes, as mentioned above. Genetic studies do not prove that ADHD is a disorder any more than they do with normal temperamental variations…
3) The neglect of the environment and interactions with it as factors in etiology. The environment always matters for behavior. The problem is not all in the brain if the child.
4) Diagnostic questionnaires now in use are highly subjective and impressionistic. Items like "Often talks excessively" assess caregiver perceptions and discomforts, not the child.
5) The most important factors predisposing to dysfunction in school may be low adaptability and cognitive problems rather than high activity or inattention.
6) Lack of evolutionary perspective. The traits not fitting well in the artificial modern school setting may have had survival value and been highly adaptive in earlier times.
7) Small practical usefulness and possible harm from the label. The ADHD diagnosis does not define the specific problems. It may be a barrier to some occupations later.
8) Whether one agrees with the current diagnostic criteria or not, there can be no doubt about its widespread misapplication. Studies show criteria are usually not applied.
9) Nonspecific effects of methylphenidate. Many professional persons and members of the public do not realize that stimulants help most normal children too. [14]
Reading Dr. Carey, it appears that, despite the widespread and growing use of medication to manage ADD/ADHD symptoms in children, there is not a consensus that such widespread use is needed, especially given the fact that more children are being given more drugs at younger ages.
What is very clear is that ADD/ADHD does exist and that the
The truth is likely…both. Dr. Carey writes:
There is general agreement that 1-2% of children are readily identifiable by the ICD-10 criteria as "hyperkinetic" with pervasive high activity or inattention, which are the clinical problem itself, not just a predisposition or coincidence. However, that does not account for most of the up to 15% of children given the ADHD diagnosis in the
This means that, while ADD/ADHD dies exist as a valid disorder in 1-2% of the population, the remaining (up to) 13% of the population with the diagnosis of ADD/ADHD are most likely “victims” of a personality type that simply does not fit into today’s classroom.
What can we do? Deb Gilbertson (of
Let’s change the name! ADHD is about deficit and disorder. My reading of ADHD related articles had a ratio of over 500 articles on research into negative aspects of ADHD for every one article that had a positive focus. I suggest ADHD should instead be called Latent Entrepreneur Personality Type (LEPT) and for the rest of this article I will refer toADHD people as LEPTs. This name focuses on the qualities inherent in LEPTs, such as:
· Insatiable curiosity, bored by mundane tasks but enthusiastic to explore new ideas.
· Moderate risk taking, disregarding the obstacles that prevent others from starting.
· Adaptability, learning as they go to overcome difficulties.
· Strong intrinsic motivation
· Intense bursts of energy
· Impatient for early results, acutely aware of whether the goal is getting closer, now.
· Independent - needing autonomy and often preferring to be a leader or a loner than a cog in a large wheel.
· Action orientation
· Characterful
The name LEPT also conveys the idea that this is a normal personality type at one end of aspectrum rather than a brain disorder. The LEPT label will make it easier to celebrate the exceptional qualities of LEPTs, bring joy to those who are currently negatively labeled, and find constructive ways of helping them to express their best qualities.[15]
What would our classrooms look like if we accepted the differences in learning behavior that are exhibited by children who are now labeled “ADD”?
What would happen in our children (primarily boys) were actually celebrated for being adventurous, rather than medicated for being too active?
What would happen if the huge number of children who are told that they have a mental disorder were affirmed to themselves and to their peers as “normal”?
As parents and educators we hold the power to help form a child’s outlook on life, his[16] way of looking at his own abilities, and his willingness to accept and work with those abilities.
If we look at a “disorder” and call it “normal”, then we fail to support a child’s true need for support and assistance, if truly needed. However, if we look at behavior which is actually normal for a child and call it a “disorder”, then we instill in the child (many times from a very early age) a belief that there is something “wrong” with her; there is something wrong that cannot be “fixed”, or that must be fixed with drugs.
In closing I ask: “how many “normal” children are being needlessly medicated and labeled with a mental disorder – a label that may follow them for life”?
END NOTES
1. When my son was in kindergarten we were living in an inner city school district. Due to the attitude of the principal (long since moved on) we decided to homeschool until there was an opening in a different neighborhood school. Extremely bright, he also questioned the usefulness of such things as flash cards for reading sight words. He was enrolled in a public school at the beginning of first grade and (to my surprise) was put in a remedial reading room. I asked him what happened and he replied, “Flash cards. Duh!”
I followed up with the school and that was how they did things. He couldn’t (wouldn’t) read the flash cards so they chose not to test him another way. This earned him not only a placement in the remedial reading room, it also earned him a diagnosis of ADD/ADHD. It also turned him from an avid reader into a young man who has only recently started to truly enjoy reading again (at age 20).
[1] Personal pronouns (male and female) will be used alternately throughout this paper.
[2] “Attention Deficit Disorder” will be referred to as ADD/ADHD.
[3] http://www.kidsource.com/kidsource/content/ADHD_and_Gifted.html
[4] See endnote #1
[5] “Beyond ADD; Hunting for Reasons in the Past and Present”, Thom Hartmann; Underwood Books,
[6] Hunter vs. Farmer Theory, Wikipedia: http://en.wikipedia.org/wiki/Hunter_vs._farmer_theory
[7] “Beyond ADD; Hunting for Reasons in the Past and Present”, Thom Hartmann; Underwood Books,
[8] Ibid. p. 54
[9] “Beyond ADD; Hunting for Reasons in the Past and Present”, Thom Hartmann; Underwood Books,
[10] Ibid, p. 56
[11] AAP, Committee on Quality Improvement, Subcommittee on Attention-Deficit/Hyperactivity Disorder, http://aappolicy.aappublications.org/cgi/reprint/pediatrics;105/5/1158.pdf
[12] National
[13] Ibid.
[14] Carey, William B. MD, American
[15] Gilbertson, Deb, http://www.windeaters.co.nz/publications/innovation_entrepreneurship/Adhd2_web.pdf
[16] Personal pronouns (male and female) will be used alternately throughout this paper.
1 comment:
Good stuff. I have requested that I not be present at any teacher parent meetings where medication for ADHD be mentioned.
I also do not use flash cards - ever. Even the Down's syndrome kids read books and not flash cards.
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