How to Diagnose ADHD

ADHD
Is ADHD real? The fact that there is not a diagnostic test that one can use to show that ADHD exists as a neurological disorder is not a good indicator that it is real (Armstrong, 2003). What is more likely to be going is a combination of external and internal factors—or nature and nurture combining to influence the child’s behavior. Thus, there could be some sort of stress, tension or anxiety in the child’s environment mixing with the child’s internal needs. So though ADHD might not be a real neurological disorder, what is called ADHD could be a symptom of some sort of relational issue that the child is having. In other words, it could indicate that something in the child’s environment is not sitting well with child—whether it is parental at root, peer-related, food-related, media-related or something else.
The fact that three million kids are on drugs because they have problems focusing is another frightening statistic (Sroufe, 2012)—that’s about 4% of all kids in the nation. If 4% of the childhood population is suffering from the same problem, it better be contagious—otherwise there is something suspicious going on. As far as anyone knows, ADHD is not contagious. If it is not contagious, what is happening that is making doctors and parents think that so many kids should be medicated? Could it be the same thing that caused so many doctors and adult patients to think they needed to use OxyContin to treat pain? The opioid produced by Purdue Pharma, now being sued by several states across the nation for failing to disclose the negative effects of its drug on patients, was pushed on doctors by the company’s sales agents and doctors in turn pushed it onto patients. What ensued was an opioid epidemic that has yet to abate. The truth is that just because a doctor prescribes it does not mean it is good. Doctors are often incentivized by the pharmaceutical companies to push their drugs—and it could very well be that this is what is happening with children who are diagnosed with ADHD. The manufacturers of Ritalin are surely not complaining. But do kids really need to be on Ritalin? Maybe there is something going on in the child’s environment that needs to be addressed.
One also needs to consider the side effect of drugs like Ritalin. They do not solve the problem. They simply allow a child to focus over the short-term. The drug is being used like a band-aid, and instead of parents and doctors discussing other factors that might be causing the child to have attention issues, they simply slap on the band-aid as if there is nothing else to worry about. The ADHD diagnosis, in fact, is often just an excuse to prescribe drugs to kids. It is big business for the pharmaceutical industry. For that reason, I would have to say that ADHD is definitely over-diagnosed in the U.S. If so many kids in the U.S. suffer from ADHD but it cannot be confirmed as a neurological disorder, one has to wonder why so many children are being diagnosed this way. The only logical answer is that Big Pharma is up to its old tricks—pushing pills on people so that it can turn a handsome profit.
The drug companies cannot be the only thing to blame, though. There is some reason the kids are acting like they have ADHD in the first place. Armstrong (2003) argues that one explanation could be that fewer kids are actually getting in enough play time. They spend too much time using technology (TVs, video games, hand-held devices) and not enough time actually engaging with other kids, playing outdoors, getting out their energy or all-around simply just developing in the ways kids need to develop, as many differ social psychologists have pointed out over the years. Vygotsky for instance is famous for emphasizing the idea of the zone of proximal development: that area where kids learn skills from being around other kids, observing them and interacting with them. So few families today are having a lot of children that in some neighborhoods there are simply no children to be found and thus there is no way for kids to get into the zone of proximal development. They are missing out on the fulfillment of a fundamental need they have for cognitive and socio-emotional development. Yet when they are told to sit still in a desk for 8 hours a day parents and teachers are shocked that the child just wants to get up and run around. The doctors diagnose him with ADHD and the child is drugged up enough to where he will sit still. Problem solved.
Or is it? Parents seem to be willing to accept this diagnosis if it will get them off the hook. Instead, they should be trying to figure it if the problem is environmental. Perhaps the child is not getting enough time just being kids. They are too entertained, which is a very passive activity—especially if the child is just watching TV—there is no active engagement and no training of the mind and body to be actively engaged. Thus, when a child is asked to sit still and to engage, he is not able to do so because he has simply never learned. The child who never learns how to engage and be an active participant in things is one who will likely not be able to sit still when it comes time for him to be a good student. Children need to play because they actually learn a great deal from playing. They are not fully developed the way adults are, and some adults forget that. They do not realize that all the entertainments they take for granted, like TV watching, do not impact them the same way they impact kids.
After reading these essays and studying the diagnosis, I would say that my ideas have changed a little regarding ADHD. I always had the suspicion that something was not right with the diagnosis and that parents were probably being duped by doctors into thinking their children had a neurological disorder (though I would not have been able to put it into those terms prior to reading these articles). I have always been skeptical of doctors and the health industry overall just because it is so complex and opaque, and I feel that anything so opaque is probably not going to be on the up-and-up.
What I think parents should be concerned about is how they can actually help their children rather how they can get the band-aid quick fix, and I feel that doctors should be actually trying to help parents and kids by engaging in preventive medicine rather than by kowtowing to Big Pharma and helping the pharmaceutical industry push its drugs onto kids. The realities of this life are that human development requires nourishment and parents have to be able and willing to provide that nourishment. TV is not a good or healthy babysitter. Healthy active play and competition is actually good for kids. It is a way for them to work out their aggression, learn self control, and learn focus. Getting a kid enrolled in sports or involved in some sort of activity like martial arts can be a great way for kids to learn to focus and to become more socially and emotionally stable.
Kids need guidance and so do parents. Doctors should know better to provide this kind of guidance, but let’s face it: doctors are there to make money just like anybody else that is offering a service. If they are going to get incentives from Big Pharma to tell parents what they want to hear, which is that they can slap on the Ritalin band-aid and not worry about raising their child the right way, then they will do it. Not everybody is going to be a saint in this life.

References
Armstrong, T. (2003). Attention deficit hyperactivity disorder in children: One
consequence of the rise of technologies and demise of play. All work and no play: How educational reforms are harming our preschoolers, 161-176.
Sroufe, L. A. (2012). Ritalin gone wrong. New York Times, 29.