ADHD: You or Someone You Love Could Have It and Not Know It
My sister had Attention Deficit and Hyperactivity Disorder (ADHD) all her life and took it to her grave. I might have had it, but a strange trick of fate at birth caused me to have its opposite. A nephew had all the indicators for ADHD when he was a baby, but his mother sidetracked him from it and he may grow to be a genius as a result.
Before going further, we must establish a few ground rules about discussing ADHD. First, nothing about the human brain is well understood. Nothing about it can be diagnosed and cured or changed easily. Nobody is an expert on the human brain and no one should be believed because he or she claims to have such expertise. We should listen to all points of view before making decisions. This article makes no claims to perfection, it seeks to present a different point of view about a seemingly intractable problem.
However, if we look at ADHD from a different point of view, we may find that it's not the problem that is intractable but our approach that doesn't allow us to see the problem for what it really is.
Nothing about the human brain is cast in stone in terms of being inevitable or unchangeable. Medical hypotheses about the brain have almost always turned out to be wrong. They changed, they evolved, but they were wrong at first. Even now, after extensive research having been conducted for several decades, no one can say anything about the human brain with absolute certainty.
It's easier to prove the existence of God and the non-existence of good science than it is to make definitive and irrefutable statements about the human brain. I have done both--at least to my own satisfaction--yet the brain continues to mystify me and the "expert" statements about it stagger my imagination. Some, I am convinced are just plain wrong.
How, then, do I dare to write an article about one of the great brain mysteries of our time, ADHD? Because when we look at the situation from a non-conventional perspective--one we should be using but don't--ADHD is not a brain problem but a problem of social inadequacy. And, if I may be so candid, social ignorance.
ADHD may indeed be shown to be different from other brain conditions in the sense that those who suffer from it may have brain structure that differs slightly from that of those who don't have ADHD. And ADHD may be shown to have family connections. But it may begin with an inadequate start at intellectual development of a child, not with a physiological difference. In adequate intellectual develop and opportunities for young children may very well run in families without a genetic connection.
Parents who do not know or understand the intellectual needs of a very young child, who may not therefore address the child's early intellectual development, may pass these inadequate parenting skills along to their own children. Most young parents learn most of what they know about parenting from their experiences with their own parents. "I lived through it, so I can do it myself."
Named for its symptoms rather than its discoverer (Alzheimer, Hodgkin) or its genetic markers (H5N1, H1N1), ADHD is a collection of behaviours by which its sufferers are identified. Wikipedia describes ADHD as a "neurobehavioral developmental disorder," which is psychobabble for what it further describes as "persistent pattern of inattention or hyperactivityâ€”impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development." More psychobabble.
What does it mean?
Psychobabble is simply babble used by self described experts to make the uninitiated believe that they know what they are talking about when they really don't. ADHD, then, is the term given to people (mostly to children because most adults with the problem have learned to cope with it by hiding the condition) who exhibit behaviours that are unacceptable in normal social settings. Normal social settings would include a school classroom, at home with siblings or parents, during a quiet church service, in public at the checkout counter of a supermarket, even trying to sit quietly to read. Rarely, ADHD children can even be dangerous to others or themselves, such as when "out of control" behaviour is punished.
A child who is punished for demonstrating socially inappropriate behaviour in a social setting may become outraged at the thought of being punished for something he believes is not his fault. When a child is "out of control," it should be taken as a sign that the parent has no idea what the child needs rather than that the child is "just plain bad." Punishing an out of control child is like punishing a slave for his master's failures. Abolishing slavery didn't make abuse go away and punishing either parent or child will not end the problem. Especially when neither parent nor child understands what the problem is.
Most parents teach their children to behave in social settings. Training children about how to behave in public so that they do not stand out as abnormal is part of what every parent tries to accomplish with their children. It's called socialization. Parents and teachers of children "with" ADHD usually fail. As so many adults fail in these efforts, child development specialists name the child as having an affliction, with a name, because blaming so many parents and teachers for failing to teach their children would bring wrath upon the specialists.
Social scientists and practitioners know that to blame a parent for something the parent knew nothing about, including knowing nothing about how to cope with a situation they didn't understand in the first place, is a dangerous road.
As is the case so often with "unacceptable" human behaviours (that is, socially unacceptable), children with ADHD come to be labelled as problem children, children with behavioural problems, even "bad seeds," kids who have some strange, poorly understood and badly managed illness. It's easier to blame kids because they can't fight back or defend themselves as parents can and do.
Though ADHD has three subtypes, primarily too impulsive, primarily lacking in ability to give attention to situations in their environment, or a combination, most kids with ADHD are identified as fussy, fidgety and flighty. The quick-fix for adults is to claim the kids have a problem, give the problem a name, then recommend drug therapy. Ever since amphetamines lost their panache as a drug of choice for recreational use (known as speed) in the 1960s, they have gained new life within the medical community with names such as Ritalin (methylphenidate).
Ritalin and other medications prescribed by pediatricians calm kids. They make the kids more "normal," meaning they dull the brain so much the behaviours of the children make them less distinguishable from others of their peers who do not have a problem with exhibiting socially unacceptable behaviour. In the case of ADHD kids, drugs accomplish what social training by parents and grandparents does with most children, make them behave in public or in a social situation.
This is where my proposal differs from the most commonly used treatments for ADHD. Rather than using drugs or other therapies in an attempt to make ADHD kids more "normal," I propose that we raise the level and style of education to match their needs. ADHD children "misbehave" because they find themselves like caged animals in their intellectual development. Give them what they require in their own peculiar intellectual development stream and they will act more like "normal" kids.
Children develop in four main ways: intellectually, physically, socially and emotionally (psychologically). Put a few kids together and give them a little space and they will devise games that have a physical component and usually a social component (in their interaction). They develop emotionally or psychologically by making their way through problems, conflicts and hurts, often with the help of adults.
Most kids will incorporate some sort of intellectual component in their play. With simple games such as hide and seek, it's figuring out how to reach "home" without being discovered in their chosen hiding place. With tag, it's how to stay away from the person who is "it" and how to tag someone else when it's their own turn to be "it." That's problem solving, an important intellectual skill. Some children require more than the usual amount of intellectual stimulation.
What might someone you recognize as a genius have been like as a child? Say, Albert Einstein, as an example. Could Einstein possibly have been a normal kid at the age of four, unrecognizable from others his own age? His brain could not possibly have developed rapidly when he reached university age such that he moved to Switzerland to suddenly understand relativity and special relativity. He had to have been different as a young child as well. He must have behaved differently from other kids, as pretty well all kids who grow to be outstanding adults did.
On one occasion I remember reading a statement that Einstein believed each child is born with genius, but we train it out of most of them within their first few years of life. Sorry, I have not been able to find the actual wording of the statement, or even to confirm that Einstein made it. When you think about it, that is not the kind of statement of truth we might want to popularize because it would destroy much of what we have come to believe is good parenting and good educating. We don't want to believe we intentionally or knowingly make kids dumb. In general, western thought believes that children are born dumb (not just without knowledge) and parents and teachers smarten them up as they grow and mature.
Einstein's brain was different from the brains of most people. Larger? No, it was actually a bit smaller than the average, at 2.9 pounds. However, his brain, as examined after his death (it was removed from his body a few hours after his ultimate breath) was structured differently. I submit that Einstein's brain developed differently from the brains of most people according to the stimulus he received as a child and adolescent, not due to accidents of nature. Today we know of brain plasticity, of the ability of people to retrain their brains at any age, even in old age, of the brain's ability to restructure itself at any time if the stimulus is right.
A brain, if stimulated with new and novel thoughts and habits, will grow new neural connections, even in non-conventional parts of the brain. People blind from birth, for example, have the optical parts of their brains taken over with uses and thinking involving the other senses. A blind person may not be able to hear better than a sighted person, but he may be able to process more incoming sound information than the average sighted person. The brain of an older person can change shape with new and repeated intellectual activity just as much as that of a teenager, though the teen's brain usually changes shape faster. That's brain plasticity.
The stimulus for intellectual development was right for Albert Einstein as a child. He would not be labelled as a child with ADHD today because his intellectual needs in early childhood were met. It's behaviour, not physiology, that causes kids to be labelled as having ADHD. The brain may change shape and create new neural networks based on repeated experiences and habits of a child whose intellectual development is impeded, thus creating a child "with" ADHD.
If this is true, then we should be able to change conditions for fussy children so they will be intellectually fulfilled, so they won't need to be fussy. So they can be as intellectually blessed earlier in life as some grow to be as adults.
The intellectual needs of some children in their early years are not met sufficiently. What could a child do about that? The kid can't express his need because he has not developed the intellectual capacity to understand it. Human kids even have trouble expressing their need for touch from their parents, a critically important component of their emotional development, so it's no surprise they couldn't express their need for more intellectual stimulation.
So they fuss. And they fidget. And sometimes they fight. They can't follow the painfully slow teaching style in their classroom, so they quickly become distracted. If there is nothing to interest them intellectually nearby, they devise ways to involve others. They misbehave. At home, they have the same environment day after day, which they come to think of as boring, so they act out. They scream, they pound, they send us signals we misinterpret. We think they should just "be good." Like we adults are.
What would you do if your brain were imprisoned, such as if you became a quadriplegic who couldn't speak? Some people say they would rather die than to live in a body that would not allow them to speak, to write, to communicate, even to move. A child doesn't consider dying because he doesn't even have a clear understanding about what living is yet. He just feels frustrated and anxious. So he acts the way he feels. That is very uncomfortable and anxious.
Fussing, fighting and acting out at least get him attention, which may not be as satisfying as good intellectual stimulation but it's something different, a change from boring.
We in the 21st century still believe that babies are born stupid and only learn to be smarter as they approach adulthood. The same way they develop physically. That way of thinking is wrong. In fact, it's backwards.
In the first six years of life, a child's brain acts like an enormous sponge--even a vacuum cleaner--soaking up everything, absolutely everything it can. Good stuff, bad stuff, everything, because it can't distinguish good from bad, useful from useless. For the most part, a child's intellectual development in their first six years is left up to young parents who have extremely little knowledge about what a child needs and how it develops. Babies don't get a chance to choose their parents. A young child's brain may not have much experience or knowledge, but it's supercharged for intellectual learning experiences.
Why did my sister, who grew up in a similar family environment as I did, develop ADHD? Half a century ago, a child growing up in a relatively unstimulating environment needed more, but had no way to get it. In our family there were no books, no reading to them by a parent, no television (at least of the kind that would be intellectually stimulating for a child), not even access to radio programs that were not geared to adult interests. My sister had such constant needs for intellectual stimulation that were never met that her brain automatically jumped from one focus to another seeking fulfillment. She didn't "apply herself" people said, her teachers repeated on report cards.
The closest she got in her 54 years of life to intellectual fulfillment was when she acted in several musical plays in senior elementary school. She was very good, quite talented, but she received no encouragement, no praise, no support from home. She never grasped how to move to the next stage with what she had learned. No one taught her. As she got older, she accepted an addiction as a substitute, as an emotional surrogate to intellectual excitement, in her case smoking cigarettes. Eventually it killed her, as it did our father and mother. Maybe it wasn't the addiction that was genetic, but the common condition of lacking intellectual stimulation at the right times.
Why did I, who grew up in the same environment--in fact with absolutely no intellectual stimulation for my first six years--not develop ADHD? For reasons still unclear, my brain had a problem processing information, right from birth. Maybe it was a lack of oxygen from blood not reaching my brain for the short period of time it took me to be born breech. (Some claim I have been ass-backwards ever since.) Maybe I inherited a condition whereby my brain functioned much slower than those of other babies. To this day I think and write slowly. I know the condition existed in my father's family.
My brain worked so slowly as a child that I had time to invent, to create, to use my imagination. With never a toy, a child or even a parent to play with, at the age of three I created an imaginary pet. As the only animals I knew were those I saw on the rare occasions I was taken out of our apartment over a store in a lonely farming community--in my case the animals I saw were cattle--I adopted an imaginary cow. The earliest memory I have of my father making a pronouncement about me was when he whispered to my mother that he thought I must be retarded because I had an imaginary pet. What else did my brain have to do but to imagine? He didn't know and didn't realize that it was a problem he should have addressed. A problem I addressed as best I could. I managed to invent a friend and intellectual stimulation.
How about my nephew, son of my wife's sister, the kid who should have developed ADHD but didn't? I remember watching (and listening to) this kid scream at the top of his lungs at the age of 10 months. He was learning to walk. Every time he stood up for a few seconds, he would lose his balance as he let go of a chair and fall down. He hated that. Most babies just keep at it until they master the skills of standing unsupported and walking. My nephew screamed because he was frustrated with himself. He knew he could learn how to walk, but the secret of balance eluded him. He had something important to learn, but he couldn't do it. He despised the fact that he was being held back by his own uncoordinated body.
I told his mother that he was just angry with himself because he couldn't master what he wanted to do, what everyone he knew could do, walk. She knew he was extraordinarily eager to learn. She and her husband fed the intellectual needs of their son admirably. Today, with full support and guidance from home whenever he needs it, the lad gets school awards, wins at sports, succeeds at everything he attempts. He knows he needs intellectual fulfillment and he knows where to find it. Fortunately, he attends a public elementary school that is extraordinary in many ways, one that feeds the intellectual, social and emotional needs of its young charges far beyond what other schools offer. Far beyond what the curriculum asks. Far beyond what most schools would dare or be allowed to do.
Christopher doesn't have ADHD because he got what he needed, both at home and at school. Some day he may find a cure for cancer or develop the mysterious Theory of Everything that Einstein sought all his adult life. Chris is a genius because nobody prevented him from being one. He doesn't even know it yet because no one has told him. What he knows is that life is filled with potential.
Nobody in his life thought that he should conform, to be average, to be like other kids, and insisted on it. The people closest to him thought he should be who he could be. They may have wanted him to be quieter, but rather than punish him for being boisterous or aggressive, they fed his need for new knowledge and skills.
He learned at a blistering pace and he will continue to do so because he knows he can. He can learn as much and as fast as he wants, on any subject of his choosing.
This is not the time for blame, to point the finger at those who have prevented so many other kids from becoming geniuses, from becoming the best they could be. This is the time to change our ways so we no longer dumb-down most kids so they can become obedient employees and consumers as adults.
We have the opportunity to make the 21st century better than any before it. It won't hurt anyone and it should benefit everyone. We just need to do some things differently. It won't be hard. One thing we can do is to provide better stimulation for the intellectual development of young children. That's actually easy because most adults know these things anyway, they just don't know they should be teaching them to their children. We also need to teach new parents (or pre-parents) what they should know about child development and needs.
Let's not wait until Chris is old enough and wise enough to make a difference in the world himself. Let's get started now. ADHD is the label we give to kids with more extreme behaviours of unsatisfaction. The less extreme ones we simply call bratty.
As if young children want to be that way. They don't. They really don't.
Writing this article has already made a difference for me. It has always mystified me why my wife had trouble in high school, sometimes has great difficulty following written directions, often can't follow spoken directions requiring more than one separate action, forgets many things I wish she could remember but has a memory like a steel trap for other things and can learn well with certain teaching methods but fails badly with others. In grade school she was smart. In high school she was made to feel dumb, as if she had hit her intellectual "wall."
I now understand that my wife has an undiagnosed form of Attention Deficit and Hyperactivity Disorder that is sufficiently mild that it stayed beneath the radar of educators and employers throughout her school and working life. Now that she has become aware of it, she can learn how to cope with and make compensations for her ADHD. For me, my wife's unusual behaviour in some situations now makes sense. I can adjust to what I can understand.
Those who lose a foot in a childhood accident learn to conduct their lives differently from most of us because they know they are missing a foot. Those who have ADHD could cope better if they had the necessary direction and skills. Parents who understand ADHD can provide opportunities for intellectual development of their children so they will never become "bad kids."
We can each adjust to the strange behaviour of those we encounter if we understand why they act the way they do. Otherwise they may be punished for acting different or strange. I have not conducted a study, nor have I been able to find research to support or deny this proposal, but I suspect prisoners and adults under medical care for mental or emotional problems would be found to be overrepresentated with ADHD in comparison with the general population.
This is not a scientific hypothesis, but merely an observation. Might our modern insistence upon instant gratification, instant rewards, the frenetic struggle through the "rat race," our desire to find drugs to quick-fix our health after a self-destructive lifestyle harmed it, our seeking of thrills through risky behaviours and addictive indulgences and our habit of finding someone to blame for everything that we don't like be symptoms of culture-wide ADHD on an unimaginably massive scale?
We now have a place to begin, to prevent the proliferation of ADHD in the general population by addressing the intellectual needs of young children and to help those with ADHD and those they come in contact with regularly to understand and to cope with what seems to be unusual, erratic, irresponsible or careless behaviour.
We know where to begin. Let's begin now. Talk it up.
Turning It Around: Causes and Cures for Today's Epidemic Social Problems, a guidebook for teachers and parents who want to understand how children develop and when to satisfy their needs, to encourage those streams of development.
Learn more at http://billallin.com