ADHD: A Manufactured Epidemic?

By JAMES K. FITZPATRICK

It was about 20 years ago that the discussion took place. It was a Sunday morning and I was sitting and counting the weekly collection with the parish committee that opened the envelopes and prepared the money for deposit in our local bank. Somehow the topic came up of school nurses dispensing drugs such as Adderall and Ritalin for students said to have Attention Deficit Hyperactivity Disorder (ADHD).

Someone in the group said he saw nothing wrong with the practice; that it was a sound way to treat a disability, in much the same way that glasses are used to treat nearsightedness.

An Irish priest who was assigned on a temporary basis to our parish was sitting with the group, before going out to help distribute Communion. He nearly choked on his coffee. He couldn’t believe that anyone would compare a physical disability to a student lacking in self-discipline. He was convinced that this “rationalization for bad behavior” was a symptom of modern society’s loss of an understanding of free will and moral responsibility.

The intensity of the debate over the use of drugs to control student behavior has not abated over the years since that Sunday morning. We still hear school psychologists and social workers defending the drugs as a necessary way to keep certain students on task in a classroom setting. And we still hear those who think the drugs are assigned too often in situations where a no-nonsense teacher would have been able to handle the problem with some firm but fair discipline 50 years ago.

Who’s right? Rich Lowry devoted a recent column to a New York Times story that backs up those who are wary of using drugs to control student behavior. The Times story quotes Dr. Keith Conners, a longtime advocate for recognizing ADHD in young people, who thinks there has been an over diagnosis of ADHD “concocted to justify the giving out of medication at unprecedented and unjustifiable levels,” and that it has become “a national disaster of dangerous proportions.”

Lowry calls it a situation that “has run wildly out of control on the promise of an easy pharmaceutical fix to the natural rambunctiousness of childhood.” Lowry places much of the blame on pharmaceutical companies seeking to protect a “$9 billion-a-year business with alluring ads suggesting…children will become little angels through the wonders of risk-free stimulants.”

To support his position, Lowry calls our attention to a forthcoming book titled The ADHD Explosion. In it we find that “in North Carolina, an astounding 30 percent of boys over age 9 are supposedly suffering from ADHD. Overall, 6 percent of children and adolescents in the United States are now on drugs to treat ADHD.”

Lowry contends that it’s “a wonder more kids aren’t diagnosed with it, given the overlap between the description of the disorder and the failings to which we are all prone,” such as, according to the above-mentioned New York Times story, “failure to wait his or her turn” and “making careless mistakes.” It makes one wonder if the goal of certain elements of the education establishment is to get every child in our schools on Ritalin and Adderall.

On a separate but related topic: the perennial debate over whether a student’s behavior and abilities are more the result of inborn traits or a consequence of influences encountered in life: the “nature versus nurture” debate.

A reader from New York has forwarded to First Teachers a link to the December 23 issue of the British newspaper The Telegraph, which tackled this question in depth. The author, Sarah Knapton, the newspaper’s science correspondent, concluded:

“Nature is really more important than nurture, as scientists have found that genetic traits are mostly responsible for the gulf in educational achievement. It is a debate which has rumbled on for decades, but it now appears that nature really is more important than nurture when it comes to exam success. Scientists have found that genes are far more responsible for the gulf in educational standards than teaching or upbringing.”

The evidence? “A study of more than 11,000 identical and non-identical 16-year-old twins concluded that 60 percent of the variation of GCSE results in English, math, and science was attributable to individual DNA.” (The GCSE is Britain’s General Certificate of Secondary Education, given to students who have demonstrated mastery of their secondary school subject matter.)

“In contrast, just 29 percent of the difference was attributable to shared environmental factors such as schools, neighborhoods, and households. The rest was down to non-shared environmental influences — such as an illness.”

“Our research shows that differences in students’ educational achievement owe more to nature than nurture,” said study leader Nicholas Shakeshaft, from the Institute of Psychiatry at King’s College London.

The authors of the study hope that their findings “will help educators devise curricula and teaching methods that will meet their students’ individual needs,” rather than the current “one-size-fits-all” approach.

“We suggest that one possible implication is that a system of teaching which effectively treats children as though they’re all the same is less likely to get the best out of everyone than a system which acknowledges that children are different,” added Shakeshaft. “If our goal is that every child should have the opportunity to take their education as far as they can, then a personalized learning approach seems more likely to succeed.”

Professor Robert Plomin, a senior author at the Institute of Psychiatry at King’s College London, added, “It’s important to recognize the major role that genetics plays in children’s educational achievement. It means that educational systems which are sensitive to children’s individual abilities and needs, which are derived in part from their genetic predispositions, might improve educational achievement.”

Professor Michael O’Donovan, from the Medical Research Council which funded the research, told the Telegraph reporter, “The findings from this substantial cohort add to a convincing body of evidence that genes influence characteristics that are ultimately reflected in educational performance.

“But it is equally important to stress that the researchers found that environments for students are also important and that the study does not imply that improvements in education will not have important benefits.”

Not everyone in Great Britain agrees. Dr. Simon Underdown, principal lecturer in biological anthropology, Oxford Brookes University, said the “nature versus nurture” debate was not over yet.

“The results highlight the important role played by genetics in intelligence but they must be treated with caution,” he said.

“While the genetic influence is slightly more than 50 percent, that still leaves a massive role for environmental factors.”

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Readers are invited to submit comments and questions about this and other educational issues. The e-mail address for First Teachers is fitzpatrijames@sbcglobal.net, and the mailing address is P.O. Box 15, Wallingford CT 06492.

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