“He couldn’t sit still. The teacher was always on him.” the parent will explain to me when I ask questions about the etiology of a diagnosis of ADHD, Attention Deficit Disorder.
“How old was he?” I will follow up.
“How realistic is it to expect a five year old to be able to sit for long periods of time?”
The parent will usually display a range of emotions at this point, depending on their feelings about the diagnosis, “Probably not.”
It is worth noting that ADHD is diagnosed more heavily in the US than in other places in the world. And I do want to emphasize that it is a real disorder. Yet it also likely way over diagnosed, especially in boys who have a lot of energy.
I am also leery of the trend in diagnosing ADHD in younger and younger children, especially ages 3-7. More and more, schools are designed to favor the children who can sit still for long hours at a time. Yet more and more research shows that children, boys especially, do not learn well this way. Boys who are more physically active have an easier time learning to read than boys who aren’t, yet in the classroom, when boys start fidgeting, the teacher starts yelling.
As the parent of an active boy, trust me, I know how exhausting this gets. But I also know that incorporating physical activity into learning nets results. At the same time, given the logistics of dealing with 20 students and how much material teachers have to cover, I can see why it would be challenging to incorporate physical activity.
Challenging, but not impossible.
My mom used to teach kindergarten and she would occasionally have a student with ADHD. She would tell the class, “Benny learns better when he can get up and walk across the room.” She would block areas off with tape for the student to wander around in. She got creative and found ways to incorporate them into the classroom, and they learned and were successful! And the other students accepted that the student learned differently and didn’t cry fowl.
More and more, though, schools are pressuring parents to turn to medicating their children into being still and silent. This may be a quick fix that gets them through elementary school, but it is a ticking time bomb for when they hit adolescence, when the hormonal changes wrought by puberty wreck havoc with whatever medicated homeostasis has been achieved, and this is usually when distraught parents bring their children to see me because of violence, aggression, and suicidal threats their child has made.
Further, it does nothing to solve of the problem of the environment not being optimal for that child’s learning. They may be medicated to the point that they aren’t disruptive, but are they learning the material? I remember one 8 year old I worked with who was diagnosed ADHD and on medication. One day I was going through his reading homework with him and discovered that he couldn’t read. He couldn’t even sound out the letters. But since he was medicated and quiet in class, this went unnoticed. Is the goal of our schools to get our kids to be silent and still for 8 hours, or is it to find a way to teach them? Last I checked, there’s no magic pill for teaching kids to read. It comes down to the learning environment we are creating for our children. And I fear that for too many children, there is a huge mismatch between their learning environment and the ways they learn best.
I don’t think all medication is bad. However, I strongly feel it is used as a first resort when it should be used as a last resort, when other behavioral interventions have been tried and failed. I think we need to fight for plenty of recess and free play time in our schools. And I think we need to stop harping on little boys so much for being little boys. They need to move and fidget and run.Medicating them won’t fix that.