Daniel Willingham--Science & Education
Hypothesis non fingo
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Who is responsible for your child's health?

8/20/2012

 
In an op-ed piece in August 19th's New York Times, Bronwen Hruska tells of her experiences with her son, Will, between the 3rd and 5th grade. Will was misdiagnosed with ADHD.

Hruska and her husband were initially approached by Will's teacher, who thought his behavior indicated ADHD. Though they were doubtful, they took him to a psychiatrist who said that Will did indeed have ADHD and prescribed stimulant medication. Will took the medication for two years but stopped when he concluded that Aderall is dangerous. Now a happy high school sophomore, there is not much reason to think that the medication was ever necessary.

How did this happen?

The title of the piece--"Raising the Ritalin Generation"--provides a clue to the author's conclusion. Hruska suggests that our society is sick. Teachers are too quick to suggest medication for kids. Schools "want no part" of average kids; they expect kids to be exceptional, extraordinary. And we, as a society, are teaching kids that average is not good enough, and that if you're only average you should take a pill.

But there's an important piece missing from this picture--parents.

From what's written, it sure does sound like Will was misdiagnosed. But I can't help but wonder why his parents didn't know it at the time.

ADHD diagnosis requires that symptoms be present in at least two settings. So it's not enough that Will shows troubling symptoms in school: he would also need to show them at home, in social settings, or in some other context for him to be diagnosed. There's no indication of a problem outside of school.

It's also notable that the mere presence of symptoms is not enough: the symptoms must be clinically significant; in other words, they obstruct the child's ability to function well in that setting and Hruska maintains that Will seems like a typical kid to her.

This is where Hruska loses me. Why would she accept the diagnosis if symptoms were observed in just one context, and if she believed there was limited evidence that the symptoms were clinically significant in that context? Why wouldn't she challenge the physician who diagnosed him?

I'm led to wonder if she knew the diagnostic criteria. They aren't hard to find. Google "adhd diagnosis." The first link is the CDC site that offers a reader-friendly version of the DSM IV criteria.

Are our kids pill-happy? Are we raising a Ritalin generation? If so, the solution is not to lay all of the blame on schools and society or even on physicians who make mistakes, and to portray parents as powerless victims. The solution is for parents to make better use of the wealth of scientific information available to us, and to ask questions when a doctor or other authority makes claims that fly in the face of our experience.

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    The goal of this blog is to provide pointers to scientific findings that are applicable to education that I think ought to receive more attention.

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