The Medicalization of Childhood

Attention-deficit hyperactivity disorder in children is one of the most widely-covered and controversial medical condition of the last thirty years. One of the things that makes it so controversial is that there is no test that can determine if a child has ADHD, in addition to there being no universally accepted symptoms that definitively classify a child as having ADHD. Still, there are some common symptoms usually considered: forgetfulness, distraction, inability to concentrate, constant restlessness, and excessive talking or fidgeting. However, all of these symptoms seem to me to be normal conditions that any human and certainly any child could have at any point. How is it that these symptoms have become the warning flags for a disorder requiring medication?

First, we must consider the "symptoms." All seem to fall under the umbrella of undesirable behavior for children, and it seems like a diagnosis of ADHD could provide parents with a quick fix for a "problem" child instead of taking the time with their child to understand and correct the behavior, or to accept that their child is just being a child. Children can be forgetful; they don't necessarily know when it is or is not appropriate to talk; if they are not engaged in their surroundings, how is it unnatural that they would become restless or fidgety? Meanwhile, by casting these symptoms as the results of a "curable" condition, pharmacological companies successfully create another disorder that they can make money off of through selling treatments to fed-up parents tired of putting their lives on hold to deal with their misbehaving child. Making up conditions is a dangerous thing on its own, but when the medicalization of behavior becomes specifically geared towards children it becomes even more dangerous. Under AACAP (American Academy of Child Adolescent Psychiatry) guidelines, ADHD cannot be diagnosed unless a child presents symptoms for at least six months prior to the age of seven - which means that the majority of ADHD cases are diagnosed far before the child can contribute meaningfully to the discussion of their health. In these cases, children diagnosed with ADHD undergo years of treatment that they themselves have not sought out, for a condition that they have not articulated to be a problem. Instead, the current diagnosis by doctor at the request of the parent leaves the child out of the loop entirely - and to proceed with years of mind-altering medication for a condition whose existence is established on shaky ground at best seems to be no only an example of poor judgment but of grave medical risk-taking.

In an article publish in the British Journal of Psychiatry (2004), child psychiatrists Dr. Sami Timimi and Professor Eric Taylor both agree that ADHD is best understood as a social construct rather than a legitimate disorder in need of medication. The article provides some solid ground for the opponents of the recent rampage of ADHD diagnoses, stating that “there are no specific cognitive, metabolic, or neurological markers or medical tests for ADHD.” Nevertheless, when diagnosing children in the U.S. through the list of common symptoms, the number of affected American children falls at around twenty-six percent of the total child population. Conversely, when studies are conducted using the symptoms used to diagnose patients internationally, the number of affected children falls to less than one percent. This is not a difference that can be explained away by disparate cultural norms. Instead, it seems that in the United States certain behaviors have been identified as unwanted in children, and if those symptoms loosely match the symptoms of ADHD more and more parents feel compelled to rush to the doctor and get Ritalin to make their baby normal again.

In America's quick-fix, progress-obsessed lifestyle, we have gotten into the habit of throwing pills at a problem instead of trying to understand it. Rarely does it cause as much damage as when applied to children who fail to meet our definition of well-behaved, ultimately resulting in our refusal to learn how to better educate and stimulate these children and instead simply forcing more pills down their throat. When one takes into account that on average thirty to fifty percent of children diagnosed with ADHD in childhood go on to “suffer” from adult ADHD, a disease with an entirely different set of symptoms, it's hard to believe that the pharmacological promises of a cure are anything more than an inefficient band-aid, and probably much less. Instead, there is something else going on here. Many of the people diagnosed with ADHD, both adults and children, have been roped into a vague, fabricated disorder that requires them to take mind-altering medication every day of their life just so that they can “function normally.” However, it doesn't have to be that way. By recognizing as a society that not all children can be boxed into a single definition of "acceptable” behavior, and by taking time to better understand why some children have a hard time adopting certain attitudes and activities, along with how we can better stimulate and educate them, we will ultimately be better off .

Well, most of us would be better off - the pharmaceutical companies currently lining their pockets with the money taken under false pretenses would hurt a little.