A lot of water has passed under the bridge since my last blog post. Life has been, well, just life when you’re starting twins, including one with ADHD/ODD, in Kindergarten. And, as that last sentence suggests, we have a diagnosis now. Wanting to be able to proceed on firmer ground with his school and feeling less concerned that a doctor might decline to diagnose due to his age, we finally opted to have my son formally evaluated. The child psychiatrist concluded that he has ADHD, and while I was relieved that my son wouldn’t have the stigma of an ODD diagnosis, when I mentioned that to the doctor, he said that my son fully qualified for that diagnosis, but he believes that ODD should only be used as a placeholder diagnosis, that there is always an underlying cause for it. (He is far from alone, and his belief has interesting implications both for the way the DSM treats sensory processing issues and statistics we read about the co-morbidity of ODD, but I’ll save those thoughts for another post).
So, we’re lucky to have that ADHD diagnosis. It’s more accessible to the general public, and people at least think they understand what we mean when we say it. Which leaves a lot of space to wander in during conversations, because what people think they understand about ADHD can be more daunting than admitted ignorance.
There are few medical disorders for which the public feels as free to disbelieve, ignore, or dismiss the evidence of researchers and doctors than ADHD. And one reason for that is the steady stream of skeptical media pieces that circulate on social media. They are typically authored by professionals who are not MDs. Sometimes the writers are not childhood professionals of any kind; rather, they are writing in the stance of investigative journalists, whether or not they have any credentials to support that. And the gist of almost all of them is that the mainstream medical view of ADHD is, at best, fatally misguided and, at worst, a money-making conspiracy.
Perhaps Facebook Public Enemy Number One for parents of ADHD children is an article published several years ago by Psychology Today titled “Why French Kids Don’t Have ADHD.” I’m not going to post the URL, because it has metastasized to every corner of the Internet, and you can jolly well find it yourself. In it, the author argues that the French don’t have to resort to medication in their country, because the parents there are way cooler and firmer than U.S. parents, plus they keep food dyes and preservatives out of their diets! Never mind that the only proven dietary factor in childhood psychiatric illnesses is a connection between a few specific food dyes and behavioral problems in a small number of susceptible children. Never mind that Psychology Today printed not one, but two, rebuttals to the article. Most insidiously, however, the article plays on U.S. adulation of French culture (The women don’t get fat! They bring up bébé with aplomb while we shvitz like, uh, the fat porkers we are over every infant snit!), while exploiting ignorance over the real state of French child psychiatry.
And that’s worth knowing, because according to a child psychiatrist interviewed in one of the Psychology Today rebuttal pieces, “[i]n France it is difficult for parents to get an evaluation and treatment for their ADHD child. It takes 8 months for a child to get an appointment with a specialist, and it can take another 8 months before a child is prescribed medication (Getin, 2011).” (https://www.psychologytoday.com/blog/here-there-and-everywhere/201209/french-kids-do-have-adhd-interview) Furthermore, as noted in my previous post on the trials of parents of ODD kids, as of 2012, the French were still treating autism with psychoanalysis (http://www.bbc.com/news/magazine-17583123). For all that science does not understand about autism, given what it does understand, that’s only a few shades better than leeches and cupping, yet without that information, many of us lap up this image of Gallic savoir-faire banishing a neurobehavioral disorder like avalanche survivors offered cognac after being pulled from a snow drift.
But there’s plenty more misleading information on ADHD, most of it emanating from the faux medical sites I discussed in a previous post (https://childstorm.wordpress.com/2015/05/14/caveat-lector-the-slimy-companies-that-exploit-people-seeking-medical-information/). Another frequent offender is alternative and naturopathic medicine sites like mercola.com. The theme of many of these articles is that Big Pharma drives ADHD diagnoses by pushing its drugs to doctors, who are motivated to prescribe, because insurance frequently doesn’t cover behavioral therapies. It’s true, insurance companies are much more likely to cover pills than behavioral therapies, but few parents have the luxury of leaving any therapeutic stone unturned. Pills rarely “fix” ADHD on their own. Still, behavioral therapies are time-consuming, cause lost time from work for parents, and can be difficult to implement in the course of routine family living, plus families may not realistically be able to approach behavioral therapy until medication alleviates disruptive symptoms. Having had three unsuccessful attempts at medicating my son, while genetic testing is suggesting that large swaths of the formulary may be unsuitable for him, all I can say is, “Big Pharma, send more pills!”
Another subject that gets a lot of Facebook sharing is the impact of requiring younger and younger children to sit still for longer periods of time in the name of early literacy. That is a legitimate issue for all children, and it may be that this pushes the point at which kids with borderline attention issues or sensory needs become a problem. But let’s be clear: the culture isn’t causing ADHD, and that’s a nuance that some the articles do not convey effectively.
So, what harm does it do to pass these bits of questionable and false information around social media? It’s harmful because most of the people reading them don’t look into the credentials of the people writing them, don’t question the bias of the source of the material, and if the material reinforces their pre-existing biases, it will likely lend authority to their point of view. And this may lead those people to
- criticize parents who medicate their children
- criticize parents who allow their ADHD kids to have foods reputed, despite lack of hard evidence, to aggravate behavioral problems
- criticize parents who seem insufficiently “firm,” because they believe they are seeing lax parents when they may be seeing exhausted ones
- criticize parents for even believing the doctors who told them their child has ADHD, because the reader “knows” that ADHD is a cultural and medical hoax
And this stuff tears families apart. Some parents on an ODD parent support forum where I participate have had to cut off contact with grandparents because of it. Schools are booby-trapped with staff who have bought into these ideas, who will undermine IEPs and 504 plans, and even shame and mistreat ADHD students. Random strangers will give grief to already-struggling parents in public places. Churches, which should be a source of kindness and support, become places of bitterness and judgment.
So, before you click that “Share” button, think about what you’re reading and who will read it if you share it. Occasionally, when I probe to find out what motivated friends to post something that seems uncharacteristically wrong-headed (and not just about childhood psychiatric problems) to a social media site, they will tell me that they didn’t have any real investment in the ideas it contained, they just found it interesting. I’ll take that at face value, but remember that what you find intriguing, someone else may find a useful buttress for their structure of ill-informed prejudice, and unless you have an ADHD child (or have ADHD yourself), you won’t be suffering the consequences.