Wednesday, May 01, 2013

Is ADHD Actually Underreported?


A recent study has suggested that we may actually UNDERestimate ADHD in children, given the backlash against the diagnosis and the resultant use of speed (as I mentioned in a previous post): Salon. This may very well be true, but it raises more questions about the proliferation of this near pandemic condition. Is it something in the environment that is causing increased ADHD? Few think so; that research is more aimed at the dramatic increase in Autism. Is it just our increased ability to diagnose the problem? This is possible, but we just used to call it hyperactivity. Or is it a result of changes in the ways kids live their lives? This seems the most likely answer and a reason for great concern.

What could be the cultural factors leading to ADHD in children? Well, the answer seems obvious. 1. Increased watching of television and movies, together with increased use of video games. This is coupled with children getting cellphones, and smart phones, at a much younger age and the almost universal use of iPads inside and outside schools (see this Kaiser Family Foundation report for the alarming details: http://www.kff.org/entmedia/entmedia030905pkg.cfm). 2. The amount of sugar and high fructose corn syrup found in many foods kids eat and particularly the amount of sugar they get from soda. The amount of sugar in the diet would obviously lend itself to hyperactive behavior and the ups and downs that go with sugar addiction. 3. The regimenting of school life and decline in gym and physical activity. In trying to address lagging test scores, schools are returning to tried and true traditional approaches to schooling. The problem is they are tried and truly show they don't work for all students -- particularly the increasingly diverse student body in American public schools today.

In other words, ADHD is arguably a cultural/social disease rather than a medical condition. As Ivan Illich argued in Tools of Conviviality way back in 1973, the medical field had moved, within the 20th century, from a source for improving and prolonging life to a legitimator for the ill effects of industrialization, urbanization and now globalization (and the mechanism that essentially fixes the symptoms of these problems, rather than providing a cure). He did not see the full realization of his vision, with corporate power at unprecedented levels and more people living in urban areas than ever before (I believe over 6 billion). But his critique might be even more relevant today than it was then, even as medical science continues to prolong our lives and cure diseases. The problem is the profit motivate still at the center of healthcare in America and the deleterious effects of pharmaceutical companies moving from curatives to palliatives (and making up more and more conditions to treat the symptoms of). 

So should more kids be on FDA-approved speed, or should we consider cultural changes that could actually address the situation in less invasive ways? I am obviously a proponent of the latter. It seems rather simple, though simple solutions to complex problems are usually wrong: 1. Cut the amount of sugar in children's diets. 2. Provide physical activity for students in school every day. 3. Find ways to focus children on specific tasks for longer periods of time. Parents should arguably not allow kids to be on their computers, in front of tvs or videogames or on their phones for periods of time, allowing them to learn to focus on one thing at a time -- particularly given that multitasking makes us worse at every one of those tasks (according to multiple studies). 4. Find ways to stem the media intake of children in general. iPads might be sexier and cheaper for schools, but research has found we retain less than reading on a screen and the opportunities for children to get on the web in class only undermines instruction and their ability to concentrate. 5. I believe we should also bring art and music back into schools (particularly for younger children). These are both avenues where kids can concentrate on one thing and learn the skills necessary to combat constant disruption and switching of tasks/activities. 

If we are to combat this constantly growing problem, it appears schools and parents must band together to face it head on. Media companies will never abide reducing the amount of media children consume, so this effort must come from outside their purview -- and one knows the government is unlikely to get involved in much of anything that benefits the common good (they stopped regulating children's programming and advertising way back in the 80s and seem unlikely to start now). 

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