The problems with over diagnosis and excessive use of medication in children with “attention” problems have become so commonplace that they no longer have the capacity to shock.
This is a problem in itself as these recent figures are shocking. In normal circumstances these latest figures would be grounds for a fundamental reassessment of diagnosis and treatment. They would be a clarion call for a reassessment of what we expect of children. They would be a sign, that parts of the medical and education system, as well as parts of government have lost the plot.
Instead they have been treated with a shrug of the collective shoulders.
Some 11% of school age American children and some 20% of teenage boys have been diagnosed with ADHD (or its variants). That is one in five teenage boys being labeled with a ‘disorder” and in most instances being given “treatment” in the form of amphetamine like medication.
When one considers the ease with which ADHD can be diagnosed it is a wonder anyone is normal anymore. Included in the criteria are such gems as:
1) “Often fidgets or is restless”
2) Is often “on the go”
3) Is often “excessively loud” during play
4) Dislikes homework
5) Finds it difficult to resist temptations
So a kid who screams and won’t say no to an ice cream has a disorder!
The advent of the DSM V will relax the criteria for diagnosis further. This means even more young people will be medicated.
We also know that older teenagers fake symptoms so that they can get diagnosed and prescribed medication. Why? Because there is a belief that using these amphetamine like drugs improves focus and concentration. To be fair in some people it does do this. Mind altering substances will alter the mind.
Some teens pop the pills on an as needs basis. Others do a tidy business in, on selling what they do not need. Colleges are awash in ADHD drugs.
Unfortunately this fact is often used as justification for diagnosis and treatment. “ Johnny is doing better now on medication so the diagnosis was right.” In reality a change or even improvement is due to the effects of the drugs regardless of whether the person has a “disorder” or not.
Some American doctors have even admitted to diagnosing kids so that they can have medication so they can do better in school. This is because the doctors feel that the other problems (family, social or educational) cannot or will not be addressed.
In simplest terms these drugs are being used as performance enhancers. In sports this would be illegal and those caught doing it would be sanctioned. In education it is seen as OK.
The other component of this is parental and societal pressure to “do well” at school. Not everyone is a scholar just like not everyone is a great runner or footballer. Yet we try to make all children and teenagers conform to a system of education designed to produce factory employees in the 19th century.
We need to reframe how we look at education. The aim needs to be to do your best as against “do well”. We also need to (re) acknowledge that different people have different strengths and talents. Not everyone needs a university degree. Indeed some of the most successful people in the world do not have one or where they do it has had little impact on their success. This is not to argue against a good education. It is to say that the definition of what this means needs to be widened, as does our definition of normal.
A good childhood and adolescence is the best preparation for life. This means helping a child be the best they can be. It means providing them a strong grounding on the basic three “R’s”. It also means helping them to find their strengths and helping them harness them.
Telling children they have a disorder and to pop pills with significant side effects so that they can get better grades is not and should not be seen as acceptable.
Currently it is. That is the real problem we face.