ADHD is one of the most diagnosed and widespread mental illness going today, and this reality should be met with curiosity as it is also the most widely used excuse for when a person falls short in life.
“He struggles with (school, sports, listening to parents, staying out of trouble, etc.) because of his ADHD.”
There is no argument that many kids are challenged with tasks that include paying attention and remaining focused, but is this “mental illness,” or instead quite normal behavior seen in kids still learning how to direct focus and control behaviors? And if we simply write off every failure our kids experience to “ADHD,” are we really being honest with ourselves? And our kids? Quickly assuming the unwanted behavior is “ADHD” leads to self-fulfilling prophecies, creates a victim-status, and often prevents parents and kids from even trying to improve.
Unlike nearly every physical illness and disease that can be observed and measured by means of blood, EKG readings, and other objective measures, ADHD is diagnosed through a collection of self-reported symptoms. Put another way, you should put far less confidence in an ADHD diagnosis than you should one for high blood pressure, cancer, or a torn ACL — all things that can be far more accurately measured. In fact, below are a few of the exact criteria we use when diagnosing for ADHD inattention, with my concerns and criticisms following each in bold:
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities. What is “often?” What is “close attention?” What is a “careless mistake?” If you do not know precisely how these features are observed and measured, what do you really know? Words like “often” mean different things to different people, and the same is true with “careless mistakes” and other general words used in ADHD diagnostics. Furthermore, to what extent should we expect and accept that these qualities are relatively normal, especially for kids?
- Often has trouble holding attention on tasks or play activities. Could this be that he’s simply not interested?
- Often does not seem to listen when spoken to directly. Maybe he is listening, how do you know he’s not?
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked). Isn’t this nearly EVERY kid??
- Often has trouble organizing tasks and activities. Time management and organizational skills are executive functioning challenges for many people, including adults!
- Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework). Again, I can find many more kids like this compared to kids who excitedly race to do their homework.
- Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones). There’s that word “often” again! If I regularly misplace my reading glasses does that mean I’m ADHD?
- Is often easily distracted and forgetful in daily activities. I think you get the point.
In addition to all the vague and subjective questions above, there are even more issues to be concerned about when it comes to ADHD:
- The diagnosis of ADHD seemingly provides an answer. When parents see their child struggling with school, learning that he is ADHD provides an immediate reason why, and the diagnosis will hopefully lead to a solution. Isn’t it better to leave the doctor’s office knowing what is going on, versus leaving just as confused as when you walked in to the office?
- The diagnosis will almost certainly lead to a prescription psycho-stimulant drug. These days, getting a prescription to drugs like Vyvance and Adderall is easy, as many doctors will quickly try these drugs with kids self-reporting ADHD symptoms. You might be surprised to learn this but many kids enjoy taking psycho-stimulant drugs recreationally, and some feign ADHD symptoms (as you have already learned this is remarkably easy to do) simply to attain these drugs. Additionally, many parents simply go with what the doctor says, and wanting the problem to be fixed often embrace the idea that a pill will fix the problem.
If it seems weird to you that you regularly hear people talk about how they are hamstrung by their ADHD, your intuition is telling you something. If most kids are ADHD today, is this really a valid diagnosis? The point in today’s column is not to prevent kids from getting the help they need when dealing with focus and attention challenges, but to instead point out the growing number of concerns about how ADHD is both diagnosed and treated. If we stop using vague, subjective criteria, and begin examining the number of kids who normally display executive function focus and attention struggles, we might come away with a different, more accurate, and healthier view of the normal challenges all kids have when it comes to being disciplined, focused, and attentive in school. More compassion, empathy, and understanding is needed, not more pseudo-diagnoses and faster distribution of potentially dangerous drugs.