ADHD in America: Growing Problem or Convenient Excuse?
Rambunctious children unable to focus on a task or sit still for an extended period of time used to be criticized for a lack of discipline and will power. These children, previously called "wild" and "out of control," may be suffering from attention deficit hyperactivity disorder (ADHD). ADHD was virtually unknown 15 years ago, but now "is the most common behavioral disorder in American children." (Wallis, 42) This recent surge in the "popularity" has `given some doctors cause for concern. Is ADHD the latest "fad" in the medical community or is it a truly a widespread affliction whose scope is just now being discovered?
The nature and causes of ADHD are still largely unknown to the medical community. Common characteristics of ADHD include extreme distractibility, the inability to sit still for extended periods, and increased anxiety and impulsiveness. These factors are so common by themselves that doctors and researchers have even gone so far as to hypothesize that ADHD is not actually a disorder, but rather a number of characteristics that tend to "bunch" together. These behaviors have the tendency to appear concurrently and thus account for the symptoms of ADHD.
These questions have potentially significant implications for American schools, who would need to seriously consider reorienting a significant part of their budget to research and implement programs to teach ADHD children both cost-effectively and efficiently. American companies would also need to make changes to working environments and training to help maximize the effectiveness of their employees in order to comply with the 1990 Americans with Disabilities Act (Wallis, 44).
Views and arguments tend to take one of two major arguments. The more prevalent view is that ADHD is an actual identifiable disorder whose true extent among the American public is just now being discovered. A second view, which is gaining support amongst doctors due to the massive surge is ADHD diagnoses, is that ADHD is instead a grouping of symptoms from other disorders which should not be bundled into a single disorder. These two viewpoints represent a possible need for significant changes in American society, especially with regards to education and the early developmental stages of children.
Those supporting the view that ADHD is a widespread disorder, the extent of which is just now being diagnosed, rely on a 1990 experiment by Dr. Alan Zametkin as primary evidence of this fact. Zametkins experiment indicated that metabolic rates in the cerebral cortex were involved in the control of attention and motor activity. (Wallis, 3) These results have given researchers to suspect structural "defects" in the frontal lobe of the brain, where behavior is controlled (Enns, 395). The fact that these areas also are "rich in the neurotransmitters dopamine and norepinephrine which are influenced by drugs like Ritalin." (Wallis, 4) is key evidence proving the existence of ADHD.
Evidence documenting continued ADHD symptoms from childhood through adolescence further confirms the possible extent of the disorder. Adults suffering from ADHD are far less likely to be diagnosed than children, who deal with a much more supervised environment, filled with professionals more likely to recognize signs of ADHD early in childhood. After passing through childhood without treatment, the tendency for ADHD symptoms to continue is significant.
"However, it is reasonable to assume that impairment in social functioning would continue, as approximately 70% to 80% of adolescents with a childhood diagnosis of hyperactivity continue to meet criteria for ADHD in the teenage years." (Guevremont & Dumas, 167).
Further supporting the possibility of widespread ADHD, gender and genetic heritage also seem to be important factors in the distribution breakdown of ADHD. Males are roughly 2-3 times more likely to be diagnosed with ADHD than females (Wallis, 42). Likewise, people with ADHD diagnosed parents are 40% more likely to be diagnosed with it. This genetic link is especially evident with twins, where surveys indicate that identical twins have a 80% - 90% chance of both being diagnosed as suffering from ADHD (Wallis, 46). These gender and genetic differences have many researchers wondering what difference within the male biochemistry is responsible for such a difference in diagnosis rates, and probably represents the best avenue for determining the origin and basis of ADHD.
While the exact nature of ADHD is currently confusing researchers, the question of who has ADHD is confounding doctors, and this fact is the base argument of those convinced that the diagnosis of ADHD can cover important psychological abuse or disturbances. The symptoms of ADHD, such as the inability to concentrate for long periods or constant fidgeting, can be confused with the indications of many other disorders. The similarity of symptoms between disorders is now creating a wave of ADHD diagnoses as many other problems are being diagnosed as ADHD. These can include serious issues such as child abuse or other family-related disorders. Even accounting for possible misdiagnoses, "between 3% and 5% of U.S. students (1.35 million to 2.225 million children) have been diagnosed as have ADHD" (Smelter et al, 430).
Those worried about the rapid increase of ADHD diagnoses point to emerging modern social trends to partially explain the sudden "popularity" of ADHD:
"We suggest that in the current atmosphere of acceptance and explanation,
it is far easier to feel good about ones negative behaviors than it was 50
years ago. Doing a bad thing implies responsibility and guilt, as well as the need for some punitive actions on the part of ones social peers. But
having a dysfunction carries no such social stigma. " (Smelter et al., 429)
Overuse of medication is now becoming a problem. Both parents and doctors are becoming increasingly quick to blame behavioral and social problems on ADHD and are quick to utilize medication to fix the situation. The problem with this, warn some doctors, is that by being so quick to prescribe drugs to correct a condition, is that a person might be overlooking other possible causes for such a problem. People alarmed with the sudden increase in ADHD diagnoses are quick to question the validity of such diagnoses:
"Although some correlation has been noted between fevers in early childhood and ADHD, no causal connection has been proved, and the symptoms of ADHD may be indicative of many other disorders, including a wide range of behavioral disorders." (Smelter et al., 432)
Regardless of the differences between these two arguments, the need to make substantial changes within American society is clear. Both sides agree that people with ADHD can be productive members of society with substantial support during childhood, which will lead to the need for only minor support within the workplaces. Current law is now beginning to reflect the growing importance that ADHD plays in society. Under the 1990 Americans with Disabilities act, workplaces are required to furnish special assistance to workers affected by ADHD (Wallis, 44). Such accommodations are generally relatively minor, but represent a major movement forwards from an era where an easily distractible employees job could be constantly at risk as he or she struggled to remain competitive within a constantly distracting environment.
Changes in public schooling are evident as well, as many schools are now increasing funding to their Special Education departments to help deal with special needs of ADHD students. For example, in Irvine, California, teachers and administrators have begun a program specifically targeted at helping ADHD students in an educational setting (Burcham and Carlson, 43). These changes are crucial steps by society to realize and begin to deal with a problem that may affect a great number of Americans.
While ADHD still remains somewhat of an enigmatic mystery, both in origin and in treatment, it is clearly an affliction that can be dealt with. It is important to continue research into the causes and treatment of ADHD, so that we can continue to help people with the disorder live normal, functional lives with little fear of competency or bias. The steps that we are making right now, such as accommodations in working environments and special education classes are the first steps toward this goal.
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