ADHD: Blaming Parents and Teachers

The New York Times has invited a group of 5 psychiatrists, educators and journalists to offer opinions on the subject of why more Americans are diagnosed with ADHD than in any other country, and whether we are misdiagnosing—and mismedicating—kids who are just typically active and distractable.

Several of these pieces make interesting points; two make arguments that are frankly disturbing. Essentially they argue that the behaviors associated with ADHD—hyperactivity, impulsivity and inattention—are the result of bad teaching and bad parenting.

Donna Ford, a special education professor, argues that black boys are disproportionately labeled ADHD “as a product of prejudice and discrimination.” She gives the boys-will-be-boys defense a racial twist, charging that teachers, predominantly white and female, just don’t know how to handle “culturally and racially different students.” She concludes archly: “We end up with white female teachers working with black male students. So who is the ‘problem’ when it comes to subjective labels of what is normal or abnormal?”

Then comes Dr. Peter Breggin, a psychiatrist, who adds parents to the list of those who are at fault. Dr. Breggin says the diagnosis itself is fake, and that ADHD symptoms are caused by “boredom, poor teaching, inconsistent discipline at home, tiredness and underlying physical illness.” ADHD, he says, “is almost always either Teacher Attention Disorder (TAD) or Parent Attention Disorder (PAD).

I’m not going to disagree that some kids may be misdiagnosed, and I would certainly agree that there are effective teaching and parenting techniques that can improve behavior in very disruptive children (we teach them in Parent-Child Interaction Therapy and Teacher-Child Interaction Training). I’ve heard parents call them “life-changing.” But to argue that these parents or teachers have “created” these symptoms in the first place is outrageous. Remember when autism was the result of “refrigerator moms”?

And one more thing: I would strenuously disagree that diagnosing a child—black or white—with ADHD is a negative thing. If a child is unable to function in a classroom, it’s critical that that child get evaluation and treatment, rather than being ignored until he drops out, or allowed to disrupt the classroom and undermine learning for everyone, or being warehoused until he ages out. A diagnosis is a starting point for real help, not a label used to discriminate.