Living with Children - No scientific validity to ADHD diagnosis
Q. Our son, age 8, did fine in school in first grade, but has struggled in second. We’ve taken your advice and not helped much with his homework other than occasional and brief “consultations.” He’s making average grades but his second-grade teacher – she’s fairly young, by the way – tells us that he is actually slightly behind in both reading and math. We met recently with the school counselor, school psychologist and his teacher, all of whom recommended that he be tested for ADHD (they told us that he’s easily distracted) and a learning disability. We really don’t want to go down that road, but they’re making it seem like that’s the only responsible thing for us to do. What are your thoughts on this?
A. I agree. You really don’t want to go down that road. In the first place, the fact that an 8-year-old boy is “struggling” in school and “slightly” behind in reading and math, yet making decent grades does not, in my estimation, indicate a serious problem. The bell-shaped curve – which schools seem to have forgotten (or conveniently ignore) – predicts that some otherwise normal (problem-free) children will perform below the academic mean. Private schools try to weed out children who will bring down their test scores; public schools cannot. So, in public school, one is likely to find a greater proportion of kids who “struggle.” Furthermore, a disproportionate number of the kids in question are likely to be boys – and boys tend to be distractible.
As I have said many, many times in this column, books, and my weekly radio show (American Family Radio), there is no scientific validity to a diagnosis of attention-deficit hyperactivity disorder. Unlike a verifiable physical disease such as cirrhosis, ADHD is a construct, not a verifiable reality. On numerous occasions over the past 30 years, I have publicly challenged my colleagues in the mental-health professions to provide concrete proof of heritability, a biochemical imbalance, or a consistent “brain difference” (all of which they frequently claim concerning ADHD). I have yet to hear a lucid response.
As for determining whether a child “has” ADHD by giving tests, it is fascinating to note that the Diagnostic and Statistical Manual (the diagnostic “bible” of the mental health professions) lists not one test-based criteria for making the diagnosis. The question, then, becomes: Since tests do not figure into the diagnosis, why then are they often administered? The only answer I can come up with is that tests are given to create the impression that the diagnosis is arrived at vis ‘a vis a scientific process (when it is not).
When I make that charge, psychologists tell me that the tests are not given to obtain a diagnosis, but rather a “big picture” of the child. The question then becomes: If the (expensive) tests in question are not necessary to the diagnosis, why do so many parents obtain the impression that they are?
Then there’s the fact that public schools receive supplementary funding for every child diagnosed with ADHD and put on what is called an “individualized education program” or IEP (so do certain private schools, by the way). Call me cynical, but when money is a possible incentive to making a certain diagnosis, I am suspect.
Two things jump out at me: first, that your son didn’t have problems in grade one; second, that the second-grade teacher is inexperienced. It may well be that your son’s struggles say more about her than they do him. I would be inclined to give him the benefit of the doubt and simply recommend that you hire a tutor – ideally, an older, veteran teacher – to work with him during the summer and bring him up to academic speed before he goes back to school in the fall.
The simplest and most obvious explanation for a problem of this sort is usually the correct explanation; furthermore, the simplest and most obvious solution is usually the best solution.
Reach family psychologist John Rosemond at parentguru.com.