John Whitehead's point of view in the Huffington Post's The Psycho-Therapeutic School System: Pathologizing Childhood suggests that we have told millions of normal kids that there is something wrong with them mentally. He assesses that the medical community, driven by the money and power of "big pharmaceutical", or in their desperate attempt to answer why little Tommy can't sit nicely through eight hours of school (a perfectly normal thing), are too quick to diagnose ADHD for behavior - inattention, hyperactivity, and impulsivity - that falls well within the spectrum of normal childish action. He rails against the lack of a clinical test for ADHD, meaning
this so-called mental illness falls into the "I'll know it if I see it" category, where doctors are left to make highly subjective determinations based on their own observation.
Judith Warner's piece in Time entitled ADHD Isn’t A Metaphor begs us to look deeper into why the number of children diagnosed continues to rise. She doesn't argue that we are near alarming levels in the U.S., but suggests the rise can be attributed to inclusion of certain groups (girls, Latinos, and African-Americans) previously ignored in the assessment of ADHD. She downplays the need for a specific test, because that development supports the idea that ADHD somehow isn't a real issue. She elaborates:
It’s a developmental disorder — and while it’s true that its precise definition is linked to all sorts of values and understandings unique to our time, it is not a symptom of social pathology. It is a medical condition, not a metaphor.
If we truly care about kids — all kids — we’d do well to keep our stories straight.
Both articles, however, neglect to discuss the important role of parents. If parents, the most consistent influence in a child's life, are involved and active in their child's ADHD diagnosis and treatment, the fact alone that the overall numbers are rising is a societal inquiry. It's one thing to wonder why the numbers are going up, but if what is being put forth (by Whitehead and the original NY Times piece) or insinuated (by Warner and the fact that she needs to defend that the disorder is real) is that misdiagnosis is on the rise, parents can address this head on.
When I talk about parental role in diagnosis of ADHD, I'm not talking about "blaming" them or calling it "bad parenting" when kids act up. In fact, the opposite. Parents know their children better than anyone else. It's unfortunate on the rare occasion my 4-year-old has a massive meltdown in the diner when his grilled cheese comes with the crust still on it. Is that an appropriate response for an adult? Definitely not. For a preschooler who is learning how to read and write and overloaded with new experiences every moment? It's probably in the range of normal. I calmly explain that I can fix the sandwich and he settles down in a few minutes, rather than rushing out in horror that we might have disturbed other diners. He's not a bad kid unable to ever eat in a restaurant and he's definitely not in need of medication - he's four.
It took me a long time to trust myself as a parent. When that same son was an infant, I worried so much every time he coughed or his temperature went above 100.3 (the current standard for a "real fever"). What if I am missing something I thought constantly. I read and re-read my baby books, looking for the silent killer that was coming to harm my baby. Feeling overwhelmed and ill-equipped to handle the situation, I called the doctor. Together we worked out whether this was something serious or not. I learned a lot from the questions they asked.
By my second child I learned to trust my instincts far more. I wasn't so quick to pour over guides turning me into a hypochondriac by proxy. Even though she was very different from my first-born, I learned to spot was was abnormal or alarming in her. I called the pediatrician with informed analysis and smart questions, not blind panic. I've recently heard doctors saying "don't worry about every little thing" but that's a vague instruction. Doctors should be asking parents, "what do you think? You know your child far better than I do. Is this normal?"
I want to stress that I'm not saying doctors and members of the medical community aren't necessary - they are invaluable resources. I also strongly believe that ADHD is a real disorder and that many children have reaped the benefits of the prescriptions created to address the problem. But in an age where we are drugging our kids just so we don't bother other passengers on a plane, maybe we need to stress what is normal behavior for the child rather than having society-at-large think our children are perfect angels and we are parents of superhuman abilities. It is a challenge - not only in the assessment of ADHD or other mental disorders, but in all of parenting - especially when everyone else seems to have an opinion and a blog. And since I have both I'll share mine: trust your gut.
Parents need to be the first resource in teaching their children appropriate behavior and coping skills, for defending them when they are just being kids, for getting them (and you) help when it is needed, and for assessing how well treatment is working. That also means refusing to allow a diagnosis to continue when you believe your child is exhibiting something in the range of normal, as well as refusing to feel guilty or defensive when pharmaceutical treatment is best. Working with teachers, doctors, and other professionals, it's up to parents to be the strongest advocate for their child's mental health.
(photo: Lisa F. Young/Shutterstock)