ADHD in Children: Causes, Effects, and Treatment Debate

Introduction: ADHD as a Contested Diagnosis

Among public schools in the United States, Attention-Deficit-Hyperactivity Disorder (ADHD) has become a buzzword in the classroom, with teachers and parents often engaged in a debate regarding the disorder. Scholars have staged literary arguments regarding nearly every component of the disorder, from its cause to its diagnosis to its treatment. Commonly, laypeople have been discouraged by ADHD's bad reputation, assuming that the disorder may simply be the result of poor parenting (Kewley, 1998). However, Kewley (1998) rejects this consensus by arguing that contenders have not considered information regarding the possible genetic explanation for ADHD. Indeed, Kewley (1998) suggests that studies of the brain and studies involving twins show a biological — more specifically neurological and genetic — component at least partially explaining the disorder.

Kewley (1998) argues that the disorder is underdiagnosed in Britain, but because ADHD is almost always diagnosed in the United States, some have argued that there is a cultural component to the disorder, while others have simply suggested that U.S. teachers and parents are overly anxious to make this diagnosis (Boyd and Bee, 2009). Thus, the political, psychological, and medical situation surrounding ADHD is tumultuous, to say the least. Researchers have continued to delve deeply into the disorder, considering the possible neurological, biological, social, and cultural components of its existence. Through an examination of the nature of ADHD, its effects, and its treatment, a better understanding of the most current research regarding the disorder can be grasped.

Defining ADHD and Its Types

Classified as a mental disorder, Boyd and Bee (2009) write that sufferers of ADHD are either more hyperactive or have more trouble paying attention than other children in the same cohort. Two primary types of ADHD exist: the hyperactive and impulsive type, which includes those who have trouble staying calm or who exhibit a high activity level, and the inattentive type, in which children have difficulty paying attention.

Kewley (1998) writes that ADHD can be difficult to diagnose because of the variety of ways in which the disorder can present itself. Furthermore, the author notes that many other disorders share similar symptoms, including depression, anxiety, and Asperger's Syndrome. Even day-to-day problems such as difficulties in relationships can produce symptoms in children that look remarkably like ADHD. This is why Kewley (1998) argues that symptoms must be ongoing before a diagnosis is made. Kewley (1998) also advocates assessing children's symptoms both at home and at school before making a diagnosis, since it may be the environment that is simply encouraging the child to display ADHD-like symptoms.

Contrary to popular belief, most children diagnosed with ADHD do not grow out of the disorder when they become teenagers. In fact, 60 percent of those who suffer from ADHD in childhood carry the disorder into adulthood (Kewley, 1998). As will be seen in the discussion of the effects of ADHD, the disorder can be quite detrimental to sufferers, as it causes children to act in ways that clash with cultural norms.

Causes of ADHD: Biology, Neurology, and Culture

Nearly no one would debate that the symptoms produced by ADHD are serious. The controversy over the disorder arises when its roots are considered. Some argue that biology can be held accountable for the child with ADHD, and this does appear to be at least partially true. Although it is important that scientists not too quickly assume that relationships found in longitudinal studies indicate causation, ADHD has been positively correlated with time of birth. Children born prematurely tend to have ADHD at greater rates than those born full-term (Boyd and Bee, 2009). Other possible biological causes include brain malfunctioning, or especially developmental problems limiting the functional development of the right hemisphere of the brain. Others argue that ADHD sufferers lack the required amount of serotonin production or have a biological need for increased sensory stimulation (Boyd and Bee, 2009).

Another controversial explanation implicates culture as a contributing factor. Researchers forced to address the fact that the disorder has not been diagnosed frequently outside of the United States face only a limited number of explanations for this data. The first, used by critics of the disorder and of medication-based treatment, suggests that there is an over-diagnosis problem in the United States. A second explanation is that parents, psychologists, doctors, and teachers outside the United States have not diagnosed the disorder properly. The third explanation is that a cultural component exists, making the disorder more prevalent in U.S. culture (Boyd and Bee, 2009).

Kewley (1998), a British pediatrician, suggests that similar controversies have led to an illusion of over-diagnosis in Britain. The truth, however, is that there is an underdiagnosis of the disorder in the United Kingdom, according to Kewley (1998), who cites widespread misconceptions about the disease as the foundation for this problem.

Conclusion

ADHD may be one of the more controversial childhood disorders, but it is not without foundational research. From defining it as a disorder, to setting guidelines for diagnosis, to determining its effects and treatment options, researchers have expanded the knowledge of both professionals and laypersons regarding ADHD. While topics related to the disorder will continue to be debated and further research will emerge, it is clear that, in the meantime, treating those already affected by the disorder is both possible and necessary.