The school disease

Last night I was hanging out at DailyKos (a political blog, nothing to do with homeschooling) and ADHD came up. I said I had some skepticism about its existence, which was not a popular point of view, let me tell you.

Several people wrote about how much stimulant medication had helped their kids, and what I thought was interesting was that this seemed to be defined mostly by school performance. One mom wrote that her son had been absent minded but that now he was better at concentrating and that his grades had improved. Another mom wrote that her son had gone from F's to A's in school and now is better at bringing his bookbag home and copying down the homework assignments. Another parent wrote that her son had almost been kicked out of preschool because he was so wild and physical, but Ritalin had really helped him. She went on to say: "He is not hyperactive anymore but he does take medication during the school year to help him focus, and having had to help him with assignments that he put off until after the meds wore off, HE NEEDS IT."

According to the ERIC Digest:

Presentation of symptoms can be affected by family interactions, school expectations, and other demands placed on the individual child. Part of the reason that attention deficit is usually diagnosed in school age children (e.g., first to third grade) is attributable to the demands placed on the child when beginning school (American Psychiatric Association [APA], 2000).

Also, teachers usually fill out a questionnaire and participate in the decision to diagnose a child and/or to medicate them. These things make me wonder whether ADHD is simply the "school" disease-- remove school from the equation, and is there still a problem?

There are medical studies showing that people diagnosed with ADHD have different brain activity compared to "normal" people. Yes, well, women and men have differing brain activity, as do children and adults, as do gays and heterosexuals (when exposed to various pheromones). But we are choosing to take a group of people with a particular style of thinking and classify them as ill. We call them diseased primarily, it seems, because they cannot succeed in the public schools.

I argued on DailyKos that I found it hard to believe that 15 million people, out of a population of 300 million, had a disease; that it must be part of normal variability. Another commenter asked if I would classify cancer as normal variability if 2/3 of the population had cancer. No, of course not-- but neither would I blame that level of cancer on people's genes. The vast majority of cases of ADHD are thought to be genetic, apparently (and yet somehow their parents got this far, in spite of being denied stimulants as children).

When there's an epidemic of a non-communicable illness, either a) it is being caused by the environment, b) it is being caused by a cultural shift in behaviors, or c) it's an imagined disease, of which there have been many in the short history of modern medicine. (See Drapetomania.)

So, though it may mean I'll get flamed left and right out there in the blogosphere, my skepticism about ADHD only seems to get stronger. Parents writing about how their kids' lives were improved by stimulant medication, but then defining "improvement" as better success in school, only solidifies the notion that it's "the school disease."