In our distracted, over-connected society, diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) has been the rage for more than a decade. The case for a hard rethink.
BERLIN - Things weren’t better in the good old days. And there were jittery kids before Attention Deficit Hyperactivity Disorder (ADHD). As early as 1845, Frankfurt doctor Heinrich Hoffmann included a character named Fussy Philip in his children’s book Slovenly Peter that Mark Twain translated into English.
In 1908, Berlin pediatrician Adalbert Czerny diagnosed a certain group of pesky children as follows: "Great need to move about, can’t stick to anything whether it be playing or other activities, disobedience, inability to concentrate on their schoolwork."
So it would appear that ADHD is not an invention of the 21st century. Psychologists have been attributing the problem to ever more hectic daily lives marked by technological developments in both transportation and communication – since the beginning of the 20th century.
According to the just-released 2013 Medical Report published by the German Barmer GEK health insurance company, the number of children and teens diagnosed with ADHD rose by 42% between 2006 and 2011. We should not, however, rush to hasty conclusions blaming technology and ascribing the phenomenon to over-stimulation – even if it is difficult to imagine that the constant flicker of screens in children’s rooms, the over-consumption of computer games, and the permanent stream of music through headphones doesn’t have some sort of deeper impact on the nervous system.
The agitation, the lack of control over their impulses, and the concentration difficulties in children and teens that parents and teachers are becoming increasingly vocal about can be put down to a number things. Gottingen-based neurobiologist Gerald Huther believes that children have too few opportunities, as their brains develop, to build up the structures that enable them to control their impulses and deal with frustration.
Parents keep too close a watch over their kids for this to happen, he says – clearing problems away so kids don’t have to confront them, not giving kids a chance to try things for themselves, not letting kids romp around outdoors enough. They don’t let their kids take risks.
Fewer chores, more free time
For the first time in the history of humanity, Huther says, we are going through a period where children are not actually needed to help with the household chores or go out and earn money. Yet children right through their teens need chores and other tasks because these tasks not only help them grow but give them the experience of how wonderful it is to do something meaningful together with others.
Anybody who has seen how many hours children spend playing computer games can sense the tragedy behind it – all that wasted energy – and understand how it can find expression in disharmony and aggression. And the open question is: are there really more children with behavioral symptoms matching those of ADHD or are doctors just more inclined to diagnose the disorder?
Even if the restless behavior of kids who supposedly have ADHD isn’t really pathological, the high number of children being diagnosed with the disorder tells us something about the way they are perceived by their parents and teachers – as so active that living with them may become unbearable.
But is it really the kids who are overstepping the bounds? Or are the thresholds of teachers trying to get through their workloads, and parents who expect their kids to “function,” too low? Have we lost the ability to deal with impulse? Particularly those of boys, who in kindergartens and schools are almost exclusively taught by women?
According to the Barmer GEK report, ADHD is mainly a problem with boys – the majority of whom are given psychotropic drugs. In 2011, 2% of 11-year-old girls diagnosed with the syndrome were taking what is currently the favorite drug for the condition – Ritalin, which acts directly on brain metabolism – compared with 7% of boys.
This is questionable not only because these kids are being kept quiet artificially, but also because the long-term effects of taking the drug have yet to be fully researched. Yet stressed-out parents are increasingly letting doctors talk them into treating their hyperactive children with medication on the pretext that they may be suffering from some sort of malfunction of brain metabolism.
Let them roam free
Psychotropic drugs for children provide no long-term solution. ADHD is a disturbance in the ability to pay attention – so why don’t we actively try and heighten that ability in children from the beginning? It doesn’t take much: sit quietly on the sofa and read a story together instead of watching 3-D movies and playing computer games.
Or let your children take the time, as you make your way to the playground, to take in whatever captures his or her interest, be it a pebble or a dog, instead of badgering them with the constant and impatient command to “Come on!” And do you really need a weekend trip to Davos with your five-year-old just when the first snowdrops are blossoming in the garden?
Children need the opportunity to develop and hone their senses without being rushed all the time. And that includes doing a lot of the things that made 20th century childhoods rich and that are being lost today. A walk home from school without Mom, where they can dawdle along and have time for their own thoughts. At school, children should be given plenty of time for art and crafts.
Also important are family meals – not only eating together, but not eating microwave dishes, in fact eating real home cooking that doesn’t taste of the same old flavor enhancers but where you can actually make out the individual ingredients.
Children need to know that everything doesn’t have to happen at lightning speed. They need to be both challenged and supported. They also need to have the possibility of learning at their own speed: you cannot force maturity. And they need phases where they aren’t “doing” anything except maybe jumping over a few ditches, feeling the wind against their skin, breathing in the delicious smell of earth.
There are no greater creative moments than those that take place in stillness. We don’t let our kids enjoy these because we enjoy too few of them ourselves. But if they don’t know what it is to experience stillness, how can we expect them to “sit still?”