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Attention Deficit/Hyperactivity Disorder And The Sociological Perspectives Associated With These Diagnoses

An excellent research paper by Sonya Scott.

Imagine yourself as a parent of a young, active child. You are taking your child to a routine doctor's appointment because although your child has had high energy their whole life, this energy is not being "harnessed" properly as your child is getting older. During the appointment, numerous questions are asked regarding your child's behavior and activity level. Some of these questions may include: What is the duration of your child's attention span? What is their ability to follow directions? Are they able to sit still for long periods of time? Do they interrupt conversations frequently? After replying to the above questions, and with further discussion, your doctor informs you your child has been diagnosed with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). Both of these diagnoses can be commonly referred to as Attention Deficit/Hyperactive Disorder (AD/HD). After this visit and diagnosis from your doctor, you are now among the millions of parents in the United States that lives with this common disorder in their children. In 2003 alone, 4.4 million children ages four to seventeen were diagnosed with AD/HD, 2.5 million were prescribed medications, and 3.3 billion dollars was spent in medical costs relating to these disorders (http://www.cdc.gov).

AD/HD is primarily diagnosed in younger children, aged six to twelve. It is harder to diagnose children under the ages of six, because this age group readily exhibits the traits associated with AD/HD. The symptoms commonly include: talking excessively, fidgeting or squirming while sitting, having a high amount of energy, running or climbing at inappropriate times, having a hard time playing quietly, interrupting frequently, blurting out answers before a question is completed, and having a hard time waiting for a turn (Ashley, 2005:5). Now these symptoms can sound very much like a normal child to many people. It certainly sounds like a normal, active, and healthy child to me. Yet these are the grounds used by doctors and educators for diagnosing a child with AD/HD, and branding them for life with a behavioral disorder. "Attention-deficit/hyperactivity disorder (ADHD) is one of the most common behavioral problems in children. It can be treated, but not cured" (http://www.cspinet.org/new/adhd-bklt.pdf, 1999:1). Sure sounds like a dead-end road to me. Why is it we have many ways to diagnose the disorder, but no way to cure it?
The rate of diagnosis for AD/HD has risen drastically in the past few years. Why the sudden increase of cases? Have we just begun to better recognize the symptoms of these disorders? Have our doctor's become more skilled in detecting the signs of this disorder? Or are we just labeling a phenomenon that we are uneducated and unsure about? Or are we truly creating a new generation of AD/HD suffering individuals? Some people argue that "the disorder is made up by a high-pressured American society that expects more from children at a younger age" (Ashley, 2005:8). Many other people are simply accepting the doctor's diagnosis, and treating it like a regular, often expected occurrence. I can not recall one incidence of AD/HD in any of my schools or classrooms when I was a child. Today, it would be unheard of for an entire class or school to be AD/HD free. To me, this is grounds for alarm.
Based on current trends, it seems the incidences and diagnoses of these disorders are not going to decline in the future. What can we do as a society to prevent this, or lessen the degree of parameters for AD/HD? How can we change our outlooks on, experiences with, and expectations of our Nation's children? How can we change our outlooks on ourselves as parents and educators for our children? How have our attitudes changed over the past twenty years, in regard to children, family, society, and the world itself? I believe that all of these issues can play a part in the rate of AD/HD diagnosis and possible prevention.
First and foremost, I believe that the amount of pressure we now put on children, both emotionally, mentally, and physically, has risen over the past few decades. Think of a child in our society in the 1970's or the 1980's. I don't think they had the same amount of pressures that children today face. Technology has a lot to do with this. We are now living in an extremely fast paced environment. Children's imagination has been overshadowed by videogames. Their recess has been replaced by math class. Children are now driven everywhere, and outside play time has been significantly reduced. We have lost our family meal times. And there also seems to be more peer and social pressure to succeed and thrive. All of these aspects of life today will readily and rapidly affect a child's emotional well-being. "When children are struggling with learning, social, family, or emotional issues, it usually affects their school and homework. Learning disorders, divorce, trauma, and social rejection are just a few of the things that can cause symptoms similar to ADD" (Ashley, 2005:52). With all of these new "modern" ways of living, our children are suffering, and I believe this is leading to them possibly being misdiagnosed with AD/HD. Really, I would be squirming too if my recess had been cut!
A large factor among these "modern" conveniences of our lives today is diet. And the American diet has certainly changed. We as a society have witnessed, and voluntarily taken part in the decline of a well balanced diet for our children (and our adults). Gone are the days of homemade meals, healthy snacks, and the occasional anticipated treat. Here and seemingly to stay, are the days of microwaves, hurried meals, and flashy advertising for junk food. We are happily pumping our children full of sugar, food dyes, and preservatives. "Children (and many adults) are consuming an average of twice as much sugar as the U.S. Department of Agriculture recommends" (Jacobson and Schardt, http://www.cspinet.org, 1991:17). Why haven't our doctor's looked farther into the correlation of diet and AD/HD diagnosis? I find it hard to believe that this correlation is a "new" discovery. There has been up and coming research regarding diet and its effect on AD/HD diagnoses, but it is seen as a more alternative approach. These studies with diet are also slow to take effect. Drugs are still the top choice among many parents for treatment of these disorders.
So if there is now research that proves children diagnosed with AD/HD can benefit from eating a more restricted, healthy diet, why can we not focus on this more? Is our society too busy to feed our children right? Why is good food expensive and often too time consuming to prepare? It seems our society has made it difficult for parents to uphold healthy diets for our children. For example, if you are a busy working parent, and you have an option of a fast food, or pre-packaged meal versus a home cooked meal, most parents choose the fast food option. Really, who wouldn't? For now there are always deadlines and other places to be and things to do. So the child gets the unhealthy option. Even breakfasts are rushed these days. The home cooked breakfast is now seen as a luxury, or a special occasion. Now it's a rushed bowl of sugary cereal (which leads to a sugar crash a few hours later). Granted, this change of diet is nothing new. It has been happening for years. Slowly but surely, the foods we give our children have contained more and more food dyes, preservatives, and sugars. This is bound to affect the mental capacity of a little person.
I remember when I was young, I often felt different than the other children because my diet was not the same. My mother made her own bread, we didn't eat a lot of meat, we didn't get sugar cereals or soda pop, we had home cooked meals for every meal (I remember eating out only a handful of times), and dessert was saved for birthdays. This was due to the fact that my mother couldn't afford certain processed or pre-made foods, which end up being quite expensive. Today I am thankful for my diet as a child. I know that it took my mother more time to prepare, but I also know it was worth it to her, and to us in the long run. Unfortunately, not all families operate like this. Many have too many obligations to focus on healthier diets. My mother had more time than money. Time seems to be in short supply these days. So again, the parent turns to the unhealthy option.
The first controlled diet study was conducted in 1976 by C. Keith Conners and colleagues at the University of Pittsburgh. They tested the Feingold diet, which is a diet free of artificial colors, flavors, and certain foods. The results were that about thirty percent of the fifteen children studied showed behavioral progress. "The Feingold diet is a food elimination program developed by Ben F. Feingold, MD, to treat hyperactivity. It eliminates a number of artificial colors and artificial flavors, aspartame, three petroleum-based preservatives, and (at least initially) certain salicylates" (http://www.wikipedia.com). There has been much debate in regard to the effectiveness of this diet over the last thirty years. Some people swear by it and some people believe that it is a placebo effect. Although placebo or not, it does seem to have a positive effect for quite a few children, and what harm is in that? It's sad to me that a diet study such as this was first conducted in the mid 1970's, and we are still struggling to comprehend its significance so many years later. Why is it so hard to accept change, even if that change is for the better? We've known about differences we could make for our children in regard to diet, yet we have continued to resist.
What do these rampant diagnoses of AD/HD say about our society as a whole? What I find so troublesome is that even though we are aware of certain steps that can be taken to minimize the effects or diagnoses of AD/HD, we as a society are more apt to just give the kids drugs. This is the whole "quick fix" mentality that our modern society suffers from. We would rather pop a pill once a day than take the time to eat healthy or at least more consciously. "In the 1990's, there was a three-fold increase in the number of preschool children taking stimulants despite most not being approved for those less than six years of age" (Ashley, 2005:147). There are a few frightening things about this statement for me. First, children less than six years old are not usually diagnosed with AD/HD, due to their normal "childish" behavior, and second, what are we doing giving drugs to a five year old child for hyperactivity? And what will this constant drug pushing do to the development capabilities of these children in the future?
I think that this "quick fix" of pill popping is a big problem today concerning AD/HD. Our society is so fast paced and full of new technology around every turn. So with disorders such as these, that seem to be caused by modern living, we believe that we need technology to fix the problem. This is in my opinion why we over look the simple solutions, like diet. Because how could food possibly change something when we have this nifty little medicine bottle? I am not saying that medicine does not play a vital role in today's society. I just think that we should look to alternative solutions with this current AD/HD epidemic, and to explore why there are so many children living with this diagnosis today.
This leads me to the topic of age in diagnosis. As I mentioned earlier, the majority of cases are found with kids between the ages of six through twelve, and how it's difficult to diagnose a child younger than six years old because they already "exhibit" the traits common with AD/HD. "These disorders usually aren't diagnosed in preschool children because it's normal for them to be active and have short attention spans. As children get older, more is expected of them, and it is then that is may become clear that a child is less focused, has poorer judgment, and is much more active than his classmates" (Gavin, Dowshen, & Izenberg, 2004:120).
What this statement is suggesting, is that after preschool, children need to become rational little adults, with an abundance of patience, excellent judgment, and know how to harness all their wild-child energy. How unreasonable! Are we trying to make six year olds become adults? I'm certainly confused, because I thought that it was natural for children to be active, unfocused, and impulsive. Isn't that what being a child is all about? When did this rationale change? We start out as children, have poor judgment, and then we eventually start to mature when we begin to learn from our mistakes. This maturing can be a long, if not life long process. I am curious, when does our society deem that children are no longer allowed to be children? And at what point do we start expecting more of our children? Why have our expectations of our children's behavior changes so much over the past few decades? If we are now expecting every child to be controlled and rational after age six, we are in for a terrible, downward spiral. No wonder why the number of diagnoses has risen so drastically! It's interesting, because our society is forcing children to growing up so rapidly, and then upon reaching adulthood, we chastise them for losing their playful "childlike" spirit. Talk about mixed messages. Maybe if these adults ate more food dyes, sugars, and preservatives then they could reclaim their childhood vitality!
I don't believe that there is only one way of dealing with the AD/HD crisis. There are now too many conflicting factors dealing with this epidemic. We as a society need to look at the myriad of issues that surrounds this current AD/HD trend. I have only brought up a few of the issues in this heated discussion. I do believe however, that we need to look at the root of the problem, and not turn so readily to prescribing drugs that is seen as the only cure for a possible misdiagnosis. Hopefully with combined efforts from our doctors, educators, and parents, we can shift our focus to creating a better diet for our children. In my recipe book, a better diet would entail giving children a higher activity level in everyday living, returning to healthier mealtimes, keeping a check on societal and family expectations and pressures placed on them, and most importantly, letting kids be kids.

BIBLIOGRAPHY
Website: http://www.cdc.gov ADHD statistics.

Website: http://www.cspinet.org/new/adhd-bklt.pdf Article. 1999. A Parent's Guide to Diet and ADHD.

Website: http://www.cspinet.org Jacobson & Schardt, Article. 1991. Diet, ADHD, & Behavior.

Website: http://www.cspinet.org The Feingold diet.

Book: Ashley, Susan. 2005. The ADD & ADHD Answer Book.
Sourcebooks, INC., USA

Book: Gavin, Mary. Dowshen, Steven. Izenberg, Neil. 2004. FitKIDS.
DK Publishing, INC., USA