Boyhood is a disorder that must be cured
But yes, ADHD is real, too.

So says Dean Esmay’s analysis of the disturbing trend among parents and teachers. He quotes Glenn Sacks,

Educational Consultants Bret Burkholder and Ed Leitner....[discuss] the fake "Attention Deficit Hyperactivity Disorder" epidemic, and [note] that we in fact do have an "Attention" problem--teachers and administrators are not paying attention to boys' educational needs, and are instead pushing Ritalin as a way to get boys to "behave" in a system which is not suited to them.

More about ADD/ADHD in a moment. Business Week pointed out last May that in our public schools, "boys are becoming the second sex" (sorry no link, see May 26 edition, following quotes are from the Oct. 2003 Readers Digest version of the article, and RD’s online presence is pathetic, so no links to it, either).

When the leaders of [Lawrence High School] class of 2003 assemble … there are few boys among them. The senior class president? A girl. The vice president? Girl. Head of the student government? Girl. Captain of the math team? Girl. Editor of the yearbook? Girl.

The female lock on power at Lawrence is emblematic of the stunning gender reversal in American education …

"Girls are on a tear," says Thomas G. Mortenson, a senior scholar at the Pell Institute for the Study of Opportunity in Higher Education in Washington. " In the past 30 years, nearly every inch of educational progress has gone to them." …

Advocates for boys claim that schools have become boy-bashing laboratories with overly feminizing classrooms that try to engineer androgyny.

Take the prevalent sit-still-and-listen paradigm. It isn’t great for anyone, but girls often tolerate it better. Boys tend to be more anti-authoritarian, competitive and risk-taking. …

Though a boys body tells him to run, he must sit still for almost seven hours a day. Biologically, he needs about four recesses a day, he’s lucky if he gets one.

Fall behind and he’s apt to wind up in special ed (boys comprise more than 70 percent of such classes). Squirm, clown or interrupt, and he’s four times as likely to be diagnosed with attention deficit hyperactivity disorder. …

Some observers call [Ritalin, prescribed for ADHD] the new K-12 management tool.

I have two boys and one girl in school. I am not sure I would describe the differences in the way schools handle boys and girls so starkly as the article, but I have seen that boys are usually punished for "boyish" behavior while the same kind of behavior in girls is usually merely reproved.

The ADHD question

I agree with Dean that school-age boys are over-medicated, but I also think that those arguing that ADHD is a wholly invalid diagnosis at all (e.g., Burkholder and Leitner, cited by Dean, and talk-radio host G. Gordon Liddy) are badly misinformed (in Liddy’s case, willfully misinformed). They are using the children as their political football in a game of beat-up-the-schools for ideological reasons, not because they are oncerned about the kids. Dean observes,

While I would certainly agree with him [the Green Man site - DS] that there are cases of children who badly need such medication, I would also agree that there's something fishy about so many kids being medicated.

That seems about right to me. I have a lot of experience with some of these children and their parents, and have talked with mental-health professionals about the issues as well. Here is a condensation of what I have learned about ADD/ADHD:

It is not a new thing, just a newly-recognized thing. I know a man born in 1927 who told me that when he learned in the early 1990s through a family member what ADHD was, "I finally understood my own childhood." He told me he had constantly broken rules at home and school and was constantly punished, sometimes severely, but to no avail. He credits Boy Scouts - in the 1930s much more rigorously structured than now - with breaking his behavior pattern.

This is a very typical pattern for ADHD kids (admitting, however, that the gentleman concerned was never so diagnosed). Liddy and his ideological allies claim that the problem is entirely with the schools - they teach pablum and smart kids are bored, therefore misbehave, and boys are much more likely to misbehave.

I know that pablum is found in the schools’ curriculum, I have found it in my own kids’ school lessons. But Liddy et. al. either ignore empirical data or deign not to learn it. This behavior occurs in every setting, in all circumstances, not just at school, and occurs not only in high-IQ kids (though high-IQ kids are more likely to exhibit it).

The chief of psychiatry at Vanderbilt University Psychiatric Hospital told me that one reason ADHD is misdiagnosed is that parents are now predisposed to explaining away the child’s misconduct as a mental disorder, which relieves them of responsibility for appearing to be raising a "bad child." He said he has had parents bring their children to him, asking for an ADHD diagnosis.

But he said that more investigation than merely psych tests are required. Often, he said, children misbehave because of external factors that they cannot verbalize and the adult world is unaware of. One badly misbehaving girl he told me of tested an IQ of 110 (hardly likely she was bored with schoolwork), but the good doctor discovered that her family had recently moved from another state, leaving all her friends behind, and she had overheard her parents discussing divorce.

"I’d misbehave, too," said the psychiatrist. "Acting out is often the only way these children have to deal with their fears and concerns and sense of loss."

Nonetheless, said the doctor, ADHD is a real condition. He gave me the most sensible definition of it I have ever heard: persistent behavior that adversely affects the child’s well being, caused by no recognizable external reason. In other words, some kids are just plain that way. They frequently test high on oppositional behavior and self centeredness.

However, such children do not exhibit behaviors unique to them. Take any list of adverse child behaviors, especially those in a social setting, and every kid does some of them some of the time. A classroom of "normal" kids will, as a group, commit all the behaviors.

What sets ADHD kids apart is –

the frequency of the behaviors. They commit adverse behaviors much more frequently than other children.

the intensity of the behaviors. They commit adverse behaviors more strongly and with much less self-control than other children.

the persistency of the behaviors. They do not cease re-commission of the behaviors when rewarded for doing so (they take the reward, but misbehave again anyway) and they do not cease misbehaving when punished for doing so (they endure the punishment but misbehave again anyway, knowing they will be punished again).

Sadly, almost all these children recognize at a very early age that they cannot control their actions in a way that other children can. They are unable to explain why they don’t stop because the behaviors take place at a subliminal level: most of the time they are literally not aware they are doing the behaviors, such as excessive fidgeting, tapping, other repetitive behaviors or blatant inattention to task. Neither are they aware that their behaviors often affect other children adversely, and frankly don’t much care, anyway.

What makes this condition a disorder is that their wellbeing and that of others is adversely affected by the condition. It is inherent. It is not caused by diet (sorry, dietary sugar has nothing to do with it) or chemicals in the environment.

I have known mothers and fathers at the absolute end of their ropes even before the child begins school; what school does is thrust a child into a social setting where s/he is much less supervised than at home. Hence, misbehaviors are more serious and often affect the welfare of other children, especially aggressive behaviors. But parents are not surprised when they are informed of these behaviors. They are just embarrassed.

The behaviors occur also at churches, playgrounds, the dinner table, watching TV, playing sports, at the movies, you name it. So much for the "academic boredom" hypothesis.

Some kids outgrow the condition. Some never do. Medication is not a cure, but it can help the kids cope by enabling the reflective functions of their mind intervene to check impulsive behaviors.

These kids are often highly resistant to parental or other just adult authority. They don’t care what their friends want, either. (In fact, they have very few friends.) On the bright side, they are much less prone to "go along to get along" with their peer group, so peer pressure is not much of an issue for them.

by Donald Sensing, 9/22/2003 04:39:08 PM. Permalink |