The truth is, you can. In fact, minors are the only group of people in this country who you have the legal right to use physical force against. It’s barbaric, and primal, and ridiculous (But that’s a discussion for another time). My point is, you can beat the crap out of them. But anyone with even an elementary understanding of attention deficit hyperactivity (not hyperACTIVE) disorder (ADHD) should understand that beating them will do absolutely nothing to fix the problem.
Because ADHD isn’t bad behavior. It’s not day-dreaming. It’s not acting out. It’s not a display of immaturity.
It’s a lifelong, neurodevelopmental illness. And the reason we’re so supportive of the idea of taking our belt off anytime we spend more than five minutes around a child with ADHD is because we’re ignorant of what they’re going through – of the biological and psychological anomalies in the three pounds of tissue that determine their every characteristic.
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Defining ADHD
"ADHD is not a problem with knowing what to do;
it is a problem with doing what you know."
- Russell A. Barkley
ADHD is not characterized as a behavioral disorder. Nor is it factitious. It's neurodevelopmental, which means it flourishes during development, lasts for a lifetime and involves serious impairment to normal brain functioning (including differences in neuro-activity and neuro-anatomy).
ADHD is perhaps the most disputed mental disorder of our generation - driving debates on issues such as parental and school discipline for children with mental illness, medicating children with mental illness and the over-diagnosis of mental illness . While over-diagnosis is a problem concerning children with ADHD (and an under-diagnosed problem in minority children), the reality of ADHD cannot be ignored, nor understated.
Children with ADHD rarely show up in the offices of psychologists or pediatricians because of inattentiveness and hyperactivity; rather, their struggles are almost always first recognized as behavioral problems including aggressive attitudes, impulsive behavior and immaturity that has landed them into trouble either at school or at home. They are judged negatively by those with whom they share frequent contact and are often dealt with more harshly by teachers, peers and family members alike.
ADHD has a fairly high prevalence in the United States, affecting approximately 6 to 7 percent of children (and being much more common in boys (with a 2.5 to 1 ratio). The symptoms of ADHD are narrowed into two major classes including, inattention and hyperactivity/impulsivity.
Inattention refers to the inability for one to remain focused on a particular task.
Hyperactivity/impulsivity (often the symptom most associated with ADHD) refers to consistent and unintentional actions such as fidgeting, getting out of one's seat, being too loud, talking too much, climbing on things or taking part in behavior deemed risky/inappropriate.
Children suffering from ADHD are likely to experience either inattention, hyperactivity/impulsivity or both. These symptoms pave the way for a variety of relatable conditions, such as daydreaming, confusion, low alertness, physical hypoactivity (excessive movement), notoriously poor sleeping habits, poor school performance, aggressive attitude, forgetfulness and a lack of patience. In order to be considered ADHD, the child's symptoms must be present before the age of 12, interfere with or reduce the quality of regular functioning and exist in two or more settings (e.g. school, home, work, with friends or relatives).
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The Biology of ADHD
From the surface ADHD looks to be exactly as the world presents it: A behavioral problem. And for years, that's what it was accepted to be. In fact, it wasn't until the past couple of decades that even physicians began acknowledging it's existence. Today, however, we can move forward with the confidence that it is a very real disorder. The brain tells us as much.
ADHD correlates with biology more so even than it does to psychology or sociology. Twin studies indicate that ADHD is approximately 70 to 80 percent due to heritable factors, making this a "genetic mental disorder." In circumstances where heredity is not an accurate predictor, correlations have been seen between ADHD and difficulties during pregnancy, prenatal exposure to alcohol or tobacco, premature delivery, significantly low birth weight, excessively high body lead levels and postnatal injury to prefrontal regions of the brain - all of which are biological.
Neuro-chemistry gives ADHD a solid placement in physical science. Inherited traits in those with ADHD have been found to be related to impulsivity and reward-seeking behavior. Underlying these traits are genes specific to regulation of the neurotransmitter dopamine.
In addition, individuals with ADHD present with specific neurological deficits to the frontostriatal circuitry. This circuit involves the prefrontal cortex (involved in defining human characteristics) and the basil ganglia (involved in motor control). This circuitry is primarily responsible for executive functioning and will influence planning, organized response, attention span and the timing of responses. These areas are smaller in children with ADHD and also tend to receive less blood flow. Further, children often experience difficulties with coordination because of deficits in the cerebellum.
Finally, children with ADHD are notoriously poor sleepers, which envelopes a series of symptoms in and of itself (such as sluggishness, short tempers, mood swings, impaired immune response and difficulty concentrating along with a host of other complications. Sleep in children is primarily responsible for brain growth via the REM stage and because of this it has even been theorized that the causal pathway between ADHD and sleep is bidirectional (meaning poor sleep can cause ADHD just the same as ADHD can cause poor sleep) and others have suggested that sleep difficulty can account for most of the symptoms presented in people with ADHD.
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The Psychology of ADHD
In addition to presenting with a host of biological struggles, ADHD patients also, naturally, struggle psychologically. Specifically, there are three types of attention for which these children struggle: selective attention, sustained attention and freedom from distractibility.
Selective attention: Being able to focus on a specific task
Sustained attention: Ability to maintain focus on a task over time
Freedom from distractibility: Ability to ignore information that is irrelevant to the task
On the other hand, those with ADHD often excel in attentional capacity, which is the ability to hold information in short-term memory stores.
This is why children with ADHD tend to focus their attention on more stimulating activities through which they can receive frequent rewards, which explains why they can spend hours playing video games but sitting down to read a book, even for five minutes, is likely to be a struggle. It also explains why school is a challenge as well as other situations in which they are asked to remain seated for too long - there is no reward system at a wedding or religious service that a young inattentive child can identify.
Children with ADHD also perform poorly on tests that measure delay of gratification, which is the ability to delay satisfaction of a want or need temporarily in exchange for a larger payoff later. If you were to give a child with ADHD money, for example, they would spend it as quickly as possible, rather than save it to buy something more expensive at a later date.
As far as intelligence is concerned, children with ADHD are on average no more or less intelligent than other children. However, they tend to score lower on tests of intelligence and tests in general because of their inability to focus on the testing process for too long.
Finally, children with ADHD are more likely to develop other mental disorders. Specifically 50 percent develop oppositional defiant disorder (ODD), 30 to 50 percent develop conduct disorder, 20 percent develop tic disorder and (arguably, worst of all) 20 to 30 percent develop depression.
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The Sociology of ADHD
Social situations are often met with great difficulty by children with ADHD, both at home and in school. In the home, research has shown mothers are more likely to exhibit depressive symptoms and fathers are more likely to engage in problematic patterns of substance abuse when their kids have ADHD. At school, these children often face rejection by their peers and teachers because they demonstrate difficulty with very basic social skills like waiting turns, sharing and maintaining conversations. Children with ADHD often report that other kids do not like them.
The social issues surrounding those with ADHD is argued as a causal factor for the development of other mental disorders, especially depression.
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Okay, I'm convinced it's a real disease... So why is there a debate?
ADHD is primarily debated for two reasons.
The first reason is that it is overdiagnosed. Much like the reality of the disease can't be disputed, neither can the fact that it is all too often a go-to diagnosis for excessive, yet ordinary, childhood behavior. There are many dangers to overdiagnosis, such as the overuse of medication; draining funds from schools, parents and insurance companies; and labeling normal behaviors as pathological. However, psychologists have made great strides in recent decades to reduce the number of diagnoses to honest, clinical cases, giving much hope that this argument for the disease's nonexistence will soon be nonexistent itself.
The second reason people debate the reality of ADHD is that it often involves prescribing medication to children. Methylphenidate and amphetamine salts (trade-names Ritalin and Adderall) are both relatively safe and effective in targeting attention problems, but they're still medications that children with ADHD are often required to take every single day. And, simply put, people don't like medicating their children. In many countries, stimulant medications (such as the two mentioned above) are not legalized and in the U.S. they are not permitted for anyone under the age of six.
While I understand that people don't want the potential side-effects of stimulant medication to burden their children, they must understand that a disorder like ADHD is also burdening them. It's implications are expansive. The dangers of medication and overdiagnosis are certainly not ideal - but, I argue, they are superior to the certainties of physical hyperactivity and inattention, of psychological impairment and of social ostracization.
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Final Thoughts
The debate on ADHD is astounding to me because the reality of the disease is indisputable. It's an illness - one that influences its victims biologically, psychological and socially. Have you ever looked at someone with a broken bone and asked them to remove their cast? Asked them to stop taking their pain medication? Did you break another bone so that they would comply with your orders (refer to the "'original' ADHD medicine" nonsense at the beginning of the post)? No. Because we as a society accept that when someone breaks a bone, they are in pain. People who suffer with mental illness (and, notably, mental illnesses such as ADHD that we have chosen to dispute) don't have that luxury. Not only do they suffer, they suffer in silence. Because they live in a world full of people too blind to accept the reality that is right in front of them.
These children are sick. They're hurting. And they don't wish it on themselves. They don't want it. They don't want to get into trouble every day at school. They don't want to get picked on at the playground. They don't want to admit to their families that they have no friends because they're different from the other kids. They don't want to struggle to find happiness, or satisfaction, or purpose.
Do you think they want to be different? Looked down on? Yelled at? Ridiculed? Put in the corner? And yet, the world wants to tell them that there's nothing wrong with them. The world wants to tell their parents that all they need is a good beating. The world wants to share memes on social media indicating that it's all a farce - that they're not sick, they're just daydreaming.
Stop saying that there is nothing wrong with them. Stop saying that this isn't a real illness. Stop saying that all it takes is them growing up, paying attention, sitting still and facing front.
Because if you truly believe that's all it takes, if you truly believe that ADHD isn't real - that it's an invented disease - then you're not intelligent enough to say anything at all.
Further reading:
http://www.cdc.gov/ncbddd/adhd/conditions.html
