PUTNEY — When I present to educators on the topic of learning differences, I emphasize how vital it is to engage multiple perspectives or frames of reference in order to gain a rich understanding rather than a one-dimensional one.
I picked up this habit during the years I worked as a journalist in my 20s: that idea that you need to hear a story from all sides, and that the true story begins to emerge only after you have done this.
I tend to focus on attention-deficit/hyperactivity disorder (ADHD), since it is our current epidemic: 11 percent of school-age kids have been diagnosed with it at some point. I like to lay out for educators several different approaches.
History provides one guide: what we now call ADHD was first labeled a “failure of moral development.” Social and educational policy is interesting: the social legislation in the area of Medicare, Supplemental Security Income, and Special Education in public schools all changed around 1990 to expand coverage to ADHD. The disorder had been incentivized.
Between 1990 and 1993, the number of people diagnosed with ADHD in the U.S. expanded from about 900,000 to 2.1 million.
The clinical or psychiatric perspective holds that there is a chemical imbalance in the brain: a problem with transmission and re-uptake of dopamine, a neurotransmitter related to a broad range of functions and feelings, like satisfaction, motivation, and focus.
This imbalance reduces the ability to stay focused and motivated, and to inhibit response to novelty and stimulus. Stimulant medications substitute for this missing chemistry, functioning for people with ADHD the way eyeglasses do for people who are nearsighted.
Researchers in cognitive psychology who are interested in creativity provide another perspective.
ADHD and creativity have been rarely studied, but the core deficit in ADHD - a failure to inhibit distraction - has been studied in relation to creative and divergent thinking. It turns out that the worse you are at inhibiting distraction, the better you are at tests of creative and divergent thinking. The research on this score is conclusive.
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I also offer educators a Marxist thought experiment worth considering.
The post-industrial American capitalist society in which we all live, which is ruled economically by a very small number of individuals who control most of the wealth, depends on compliant workers who are able to sit or stand still for long hours in narrow spaces, performing routine and mundane tasks that are so dull as to numb the mind.
Because of this, we have engineered our educational system in the public schools to assure compliance and the ability to sit still for a long time while experiencing and performing mundane tasks.
We test the ability to comply with these mundane tasks, and those children who do not comply - who have trouble sitting still, who don't do well on the tests - are drugged into compliance with our new social order.
It is just a thought experiment, I say. I don't stand behind it. I'm just a journalist. To be honest, I don't have the whole story yet. No one does.
We cite the research in the National Institutes of Mental Health's seminal Multimodal Treatment of Attention Deficit Hyperactivity Disorder study to justify all of our approaches to ADHD. In clinical population studies, the disorder shows up at about 3-5 percent of those tested using these rigorous and traditional criteria.
But according to the federal Centers for Disease Control and Prevention, incidences of ADHD surged from 7 percent in 2003 to 11 percent of our kids. I'm not making this up.
Since ADHD is diagnosed in three boys for every girl, that means that about 15 percent of males between ages 6 and 17 have been diagnosed - maybe more. In some states, the number is almost 25 percent.
About two-thirds of these kids are given medications with side effects that include anxiety, insomnia, loss of appetite, and sometimes depression, with a strong correlation with loss of growth height.
Medicated kids wind up shorter. Really?
Really.
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Steven Hinshaw, who operates inside the ADHD clinical frame of reference, has demonstrated a strong correlation between the adoption of No Child Left Behind laws regarding school regulations and high-stakes testing, and the incidence of ADHD diagnosis.
The reality is that some people are more distractible, more prone to go with whatever is before them than to stay focused on a goal. Losing track of time, losing one's keys or wallet, being bored with a mundane task and putting it off, failing to turn off the engine in time to get a good sleep or to turn it back on in time to wake - these all are real challenges.
The genetic research suggests that about 30 percent of us have some degree of difficulty with these life skills, and the factor increases with the environment of one's upbringing - not just parenting, but also poverty and disadvantage.
But is having trouble in school really a medical disease?
Right now, in the United States, it is, and we treat it as such - mainly with medications that, when we pull them out of the benign gloss of the psychiatric worldview, are actually controlled substances that in another context are called speed or amphetamines.
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I don't have any difficulty in seeing the merit of allowing adults to use any substance that will help them do their work, or to live (or endure) their lives.
I am libertarian when it comes to substances. We should legalize all drugs, given that the most dangerous drug of all is legal - alcohol, the only drug that causes complete blackouts and by far the most deaths each year.
So I have no difficulty with the idea that any adult might use stimulant medication - and of course there should be some regulation of any medication, as with alcohol and tobacco, and now weed in some states, even with adults.
But it is difficult not to think that we are drugging our children into compliance rather than providing them with the educational system that would allow them to flourish and be themselves.
The great psychiatrist and anti-psychiatry prophet, Thomas Szasz, named the two most vulnerable things in this world: children and liberty.
Szasz was flawed in many ways. I do not think he saw the ways in which the right medications administered in the right ways could save lives and mend souls. I believe in this dimension of psychiatry, and am grateful for it - some of the people to whom I am most close are well because of it.
But a world in which nearly one out of five boys is diagnosed with a psychiatric disorder because he can't sit still or learn long division, and then medicated, is a very sick world.
And it is our world now.