Glenna Colerider-Krugh is a third year Spanish and Sociology double major at Grinnell College.
In the past few decades, the United States has seen a dramatic rise in ADHD diagnoses in children. While there are possible therapeutic remedies, the primary method of treatment is medication, specifically powerful stimulants like Ritalin. According to one father featured in the 2008 PBS documentary The Medicated Child, these medications often produce an “old lady who swallowed the fly” effect, in which further medications are prescribed to treat the side effects of the initial medication. The popular diagnoses and subsequent boom in the childhood mood-stabilizing drug industry have garnered quite the debate as to the “realness” of ADHD, the notion of “disease mongering,” and the medicalization of behavior formerly perceived as normal.
While some scholars claim the surge in ADHD diagnoses reflects broader cultural awareness of the condition [1], others find that explanation to be overly simplistic. Insinuating that many symptomatic children in previous eras simply went undiagnosed and untreated fails to consider recent societal changes that produce a climate conducive to the medicalization of hyperactivity.
One explanation for the diagnoses boom is the change in significance placed on children’s actions. As child and adolescent psychiatrist Sami Timimi explains, “There has been a change in the way we think about, classify, and deal with children’s behavior…a move from thinking about certain aspects of children’s behavior as boisterousness to thinking about these behaviors as symptoms of a medical disorder” (134). By pathologizing behavior previously considered “normal,” the recent decades have reared children with a slew of now-widely recognized behavior disorders, including ADHD.
Beyond giving typical kid behavior new significance, the last 60 years have seen other crucial shifts that form the landscape for ADHD diagnoses. From the political and social upheaval of the Vietnam era to the economic strains of the early 21st century, much about childhood and the American family has changed. With the rise in technology following World War II, home appliances became commonplace, along with two staples of modern life: fast food and the family car. The availability of products designed to make life easier heightened the expectation of maximum enjoyment with minimal effort. Perhaps the heart of this change is the heightened demand for immediate gratification.
In regards to children, the demand for immediate gratification is most clearly seen in the ways that playtime has evolved. Many child psychologists emphasize the benefits of creative play; in addition to developing empathy and social skills, children who engage in extensive imaginative play have been shown to do better in school [2]. Despite these advantages, many children are spending increased time inside, entertained by television and video games. Offering children technological diversions is often the best parents can do while under pressure to raise their children while working full-time jobs. Immediate gratification demands the newest, flashiest thing, and that’s not feasible without hours of hard work. Thus, parents feel the strain to provide materially for their children at the expense of spending quality time with them. Historian Elliott West sums up this conundrum, explaining, “While working hard for their children, they [parents] are helping to shorten childhood itself.” [3]
Instant satisfaction is also a reason why parents often choose to pursue medical rather than therapeutic solutions in the wake of an ADHD diagnoses. Already caught between the home and work divide, parents often opt for medication because of its convenience, and the fact that it is far more likely to be covered by medical insurance than therapy. [4] Really, parents are doing what they think is best; medication offers the promise of getting their children back on track most efficiently and allays fears about their children falling behind academically or socially. [5]
Beyond changes to society overall and family dynamics, it is important to consider the role of schools in ADHD diagnoses and management. Teachers and school officials are the people most likely to draw parents’ attention to a child’s ADHD symptoms, often citing academic difficulty as their primary concern. [6] Knowing this, an essential question looms: if so many children are doing poorly in school that the ADHD diagnoses rate has skyrocketed, are classrooms and lesson plans designed for the way children optimally learn?
Perhaps not. While the advantages of engaging, imaginative play in classrooms have long been touted by educational experts, teachers, like parents, are often caught with many responsibilities and few resources. With such value placed on standardized tests and district rankings, teachers are often pressured to cover material quickly and not in the sensory way that is most memorable to children. [7] Thus, the rise in ADHD diagnoses may not be the fault of improper brain-wiring in children, harried parents, or unsympathetic teachers. Rather, ADHD is a symptom of larger societal ills: the demand for instant satisfaction, material goods versus quality time, and the emphasis on grades at the sake of education.
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- Timimi, Sami. “Why Diagnosis of ADHD has Increased so Rapidly in the West: A Cultural Perspective” in Rethinking ADHD, ed. by Sami Tamimi and Jonathan Leo, 133-155.New York: St Martin’s Press LLC, 2009.
- Olfman, Sharna. “Where do the children play?” in Childhood Lost: How American Culture is Failing Our Kids ed. by Sharna Olfman. Westport: Praeger Publishers, 2005.
- West, Elliott. Growing Up in Twentieth-Century America: A History and Reference Guide. Westport: Greenwood Press, 1996.
- DeGrandpre, Richard. Ritalin Nation. New York: W.N. Norton & Company, Inc., 1999.
- Rafalovich, Adam. Framing ADHD in Children: A Critical Examination of the History, Discourse, and Everyday Experience of Attention Deficit/Hyperactivity Disorder. Oxford: Lexington Books, 2004.
- Rafalovich, 2004.
- Brown, Gillian. “Child’s Play” in The American Child: A Cultural Studies Reader ed. by Caroline F. Levander and Carol J. Singley, 13-36. Piscataway: Rutgers University Press, 2003
