Blog Post Four: Diagnosis

Attention Deficit Hyperactive Disorder (ADHD) is a medical term for a disorder which causes people to be hyperactive, impulsive, and inattentive (ADHD Support). Medical institutions have generally had the greatest impact on the study, diagnosis, and treatment of ADHD. ADHD symptoms have historically referred to inattentiveness and hyperactivity in children (“History of ADHD”). Peter Conrad and Deborah Potter’s article “The Emergence of Hyperactive Adults as Abnormal” points out, however, that ADHD began to be more commonly diagnosed in adults in the 1990s. They believe social factors caused this change in adult diagnoses, including the rise in behavioral medications, genetics, and an increase in psychiatric therapy (Conrad and Potter 142-143).

Hippocrates noted ADHD-like symptoms as early as 350 B.C. (“History of ADHD”). Sir Alexander Crichton gave out a diagnosis called “The Fidgets” in the late 1800s for patients who were incapable of concentrating on tasks (“History of ADHD”). Sir Andrew Still is regarded in the medical community for his studies on ADHD in the early 1900s and for providing this information to the British medical community (ADHD Support). He noted that children who lacked “moral control” had cognitive issues that prohibited them from concentrating (ADHD Support). Dr. Still did not, however, give these symptoms a formal name.

It was not until the 1920s that ADHD received its first scientific name: “Post-Encephalitic Behavior Disorder” (“History of ADHD”). In the 1930s, stimulant prescriptions became the treatment for restless children and adults, which have calming effects on hyperactivity (“History of ADHD”). Ritalin was quickly approved by the FDA in 1956 as a prescriptive treatment for ADHD, which became increasingly popular as a treatment over the next several decades (“History of ADHD”). ADHD was formally added to the The Diagnostic Manual for Psychiatric Disorders (“DSM”) in 1980, called Attention Deficit Disorder then (“History of ADHD”). It was in 1994 that ADD was changed to its current name of ADHD, and created three subgroups of the disorder: hyperactive/impulsive, inattentive, or both hyperactive and inattentive (Kearl). These subgroups may go away completely in the 2013 DSM, because people with ADHD can exhibit different subgroups over time instead of sticking purely to their diagnosed one (Kearl).

ADHD is fairly controversial, with some people doubting its existence all together. Its diagnosis assumes societal expectations of productivity and mild temperaments. A lack of these norms, along with the presence of prolonged hyperactivity and inattentiveness, can result in an ADHD diagnosis. This is where some of the controversy with ADHD comes from; do these people really have a medical disorder, or are they merely bored? Isn’t it normal for children to day dream, have a lot of energy, and not finish what they start (ADHD Support)?  

One side of the ADHD argument insists that the diagnosis in children may merely be immaturity, which will even itself out over time. Katharine Harmon’s  article “Are some ADHD-labeled kids just young for their grade?” points out that two recent studies have shown that “students whose birthdays fell just before their school’s age enrollment cutoff date—and thus were among the youngest in their class—had a substantially higher rate of ADHD diagnoses” than their peers (Harmon par. 3). These younger children are twice as likely to be diagnosed with ADHD as children older than them within their grade, but the diagnosis could simply be linked lower “emotional or intellectual immaturity” dependent on their younger age (par. 7). These studies imply that society may be too quickly to diagnosis children and give them prescriptions to help their inattentiveness, when their symptoms may actually subside as they get older.

The prescriptions given to treat ADHD are controversial, as well. The documentary Generation RX cites a 2006 Oregon State University study which examined over 2000 studies on ADHD and Ritalin. The study concluded that there was no quality research proving peoples’ lives improved by being prescribed Ritalin for their ADHD. In fact, the film suggested that Ritalin may cause more harm than help because of links to drug addiction, suicide, and additional lifetime diagnoses in patients (Generation RX).

Controversy also surrounds ADHD because of a lack of concrete tests to diagnosis the disorder. In fact, an ADHD diagnosis can potentially mask other difficulties in people, like anxiety, depression, lack of sleep, or a learning disability (“Attention Deficit Hyperactivity Disorder”). Children diagnosed with ADHD may actually have a lack of education support at home which causes their academic inefficiencies instead of the disorder causing them; perhaps the child’s family has not emphasized the value of education, so they simply do not care to learn.

The controversy surrounding ADHD implies that mislabeling a person with ADHD could have negative effects on the rest of their life. There are, however, many people who believe ADHD is a very real disorder that should be recognized in order to help people who have it. Emily Willingham, a parent of a child with ADHD and academic with a P.h.D in Biology, wrote the article “ADHD: Backlash to the Backlash” to counteract doubts about ADHD. Willingham insists that hyperactivity-controlling medications can prevent the symptoms that cause other children to stigmatize and bully kids with ADHD (Willingham par. 7). Although Willingham does acknowledge studies that link suicidal thoughts with ADHD medications, she cites another study that shows these medications can actually reduce the possibility of suicide in teenagers taking ADHD prescriptions (par. 10).

Willingham moreover brings a personal ethos to the story of ADHD when she insists that ADHD is not the result of poor parenting (par. 10). She says her own experiences in teaching show that ADHD is a label which “refers to a set of behavioral excess that go beyond developmental norms” (par. 2). This implies that ADHD is caused by individual traits (such as genes) instead of poor parenting, like some people believe causes ADHD. Willingham’s extensive research in her article proves that ADHD is a complex issue that has positive reasons for being properly diagnosed:
     a). to prevent bullying and harm to children with ADHD (par. 7)
     b.) so that families can decide the proper treatment for a child’s symptoms (par. 9-13).

The symptoms of ADHD (mainly being inattentiveness and hyperactivity) rest on the social notions of norms and deviances, as well as expectations. People are expected to pay attention, complete assignments on time, and stay on task. Those who are able to complete meet these expectations are regarded positively because they met the social norms.  Those who cannot do these things and instead act unruly are the ones who are typically given the ADHD label. A video by The RSA claims that expectations about children’s intellectual capabilities stem from capitalistic goals that require productive and attentive workers to keep the economy moving forward. This could be where the stigmatization of ADHD symptoms comes from: people who cannot fully concentrate or complete tasks are seen as deviant and possibly harmful to society because they (supposedly) cannot contribute in the same way that non-ADHD people can.

The diagnosis of ADHD is truly a complex issue with positives and negatives for people who are diagnosed. Some people doubt its existence and believe it is a way to mask underlying issues in a child’s home, or that it could conceal undiagnosed learning disabilities. On the other hand, an ADHD diagnosis can result in medications and therapy that help people learn to concentrate, which will then help them be more successful in school and work. Whether or not this disorder does truly “exist,” its current symptoms are rooted in the societal expectations of mild temperaments and attentiveness. As long as these social norms exist, it is likely that inattentive and hyperactive children will continue to be stigmatized for their deviances.

Word Count: 1,243

Works Cited

ADHD Support. Shire US Inc. Web. 25 Mar. 2012. 

"Attention Deficit Hyperactivity Disorder." PubMed Health. U.S. National Library of Medicine, 11 Apr. 2011. Web. 25 Mar. 2012.

Conrad, Peter and Deborah Potter. "The Emergence of Hyperactive Adults as Abnormal." Readings in Deviant Behavior. By Alex Thio, Thomas C. Calhoun, and Addrain Conyers. 6th ed. Boston: Pearson Education, 2010. Print.

Generation Rx: Reading, Writing, and Ritalin. Dir. Kevin P. Miller. A&E Networks, 2008.
Harmon, Katherine. "Are Some ADHD-labeled Kids Just Young for Their Grade?"Scientific American Blog Network. Nature America, Inc., 17 Aug. 2010. Web. 1 Mar. 2012.

"History Of ADHD." ADHD Brain. Web. 25 Mar. 2012. 

Kearl, Mary. "No More ADHD? New Changes to the Guidelines for Diagnosing Children and Adults." ADDitutde. New Hope Media LLC, 12 Feb. 2010. Web. 25 Mar. 2012.

Willingham, Emily. "ADHD: Backlash to the Backlash." Scientific American. Nature America, Inc., 23 Feb. 2012. Web. 25 Mar. 2012.