Is the ADHD epidemic a symptom of modern life?
The teacher raises her voice in an instinctive but ineffectual attempt to drown out the extra-curricular conversations disrupting her classroom. She speaks urgently in the hope that her hyper-animated and emotive delivery will divert student eyes and thumbs away from their under-the-desk smartphone activities. She is fighting a hopeless cause; in the battle for young hearts and minds, she fails to capture even eyes and ears.
Are children and young adults less attentive and respectful than they once where? Is uttering the perennial platitude “kids these days” disguising actual behavioural decline? Perhaps the perceived rise in disruptive behaviour and inattentiveness shares its roots with the rise of the contentious psychiatric condition known as Attention Deficit Hyperactivity Disorder.
It’s difficult to describe the symptoms without at least half the audience thinking: “I have that.” They include the following: “Often loses things needed for tasks and activities (such as toys, school assignments, pencils, books, or tools)” and “Often talks excessively”. Who hasn’t met at least one person who “often has trouble waiting their turn”?
With ADHD, however, it’s really all about the frequency and severity, and the extent to which such behaviour interferes with home, school and social life. ADHD is classed as a disruptive behaviour disorder, alongside Oppositional Defiant and Conduct Disorder.
The controversy with ADHD is that it is viewed as being on the same continuum as “normality”, and there is a social determination about where we choose to draw the line between normal and abnormal. One woman’s shyness is another woman’s social anxiety disorder. A naughty boy in one society has a conduct disorder in another.
A diagnosis of ADHD is far more likely when using the North American diagnostic system (the DSM), than the international diagnostic system (the ICD), commonly used in Europe. Some reports suggested that ADHD is diagnosed 20 times as often in the US than in France and it increased by 3 per cent a year between 1997 and 2006.
This overwhelming increase in ADHD diagnosis is a hotly debated issue. Perhaps it is part of a more general, society-wide increase in the disorder’s constituent symptoms of inattentiveness, impulsivity and hyperactivity. That would certainly be a recipe for a more disrupted classroom.
Some suggest physician over-diagnosis, vested drug-company interests, and the “psycho-pathologising” of childhood as key factors. Another theory is that some schools are keen to have poor-performing children receive the diagnosis because their exam results will then be excluded from annual performance evaluations.
However there may also be environmental factors implicated in the rising incidence and one very important potential environmental factor is diet.
A study published in The Lancet in 2007 used a rigorously controlled double-blind experiment that effectively demonstrated a definitive link between certain food additives and hyperactivity in young children. These findings prompted the UK’s Food Regulatory Agency to step in to encourage food manufactures to refrain from including the problematic ingredients in their products. The ingredients implicated in hyperactivity are known collectively as the “Southampton six” – after the university where the research was undertaken.
In our distraction-filled information age, education is a battle for eyes and ears, before hearts and minds. Anything that can reduce inattentiveness and impulsivity in the classroom will improve how well students learn. But before we consider psychiatric diagnoses and pharmaceutical interventions, let’s consider diet and possible food-related interventions.
Dr Justin Thomas is an associate professor at Zayed University and author of Psychological Well-Being in the Gulf States
On Twitter: @DrJustinThomas
Updated: July 10, 2016 04:00 AM