Researchers have noted a puzzling difference in the number of children with Attention Deficit Hyperactivity Disorder in the United States compared to some other countries. According to the data published by the National Center for Disease Control, 9% of children aged 5-17 have been identified as suffering from ADHD between 1998 and 2009. The causes and risk factors have not been established and the diagnostic criteria are based on observable symptoms and reports from teachers and parents. Nevertheless, the prevalent opinion among the US medical professionals is that ADHD is a biological disturbance.
A much smaller number of diagnosed children in France, for example, prompted some scholars to question this prevailing view. Dr. Marilyn Wedge, author of “Suffer the Children” argues that difference arises from the specific viewpoint taken by the French. In France ADHD is regarded more as an issue stemming from environmental, social and familial context and is treated with psychotherapy, behavioral and dietary interventions. In the United States, there is an increasing push towards more diverse modalities of treatment that include new technologies.
Multiplicity of Approaches
The difference in the number of diagnosed children as well as the approaches to the treatment, confirm the dynamic of diagnosis identified by the historians of medicine. In his “Rewriting the Soul” Ian Hacking has argued that prevalent diagnosis requires not only a great number of suffering individuals but also a number of doctors willing to resort to a particular diagnostic classification. In the US, doctors rely on Diagnostic and Statistical Manual of Mental Disorders, which, in its incarnation as DSM5, was a subject to a lot of debate. But what is the impact of these debates on a young patient and their families? After all, these patients will be treated by a local medical practitioner, who adheres to the medical wisdom of his respective country. Nevertheless, these debates demonstrate a very important point that there is a lot of fluidity in the identification of ADHD, as well as a variety of approaches to its treatment, and that is a good thing.
Brain Can Be Rewired
The new paradigm of neuroscience that allowed for deeper understanding of the changes in brain functioning, behavior and even personality is named neuroplasticity. Once considered impossible, neuroplasticity is the ability of our brain and nerves to regenerate, refashion, and establish new neural pathways. In other words we can radically change. This idea that we can refashion ourselves, recognized through the centuries of traditional wisdom got its scientific acceptance due to advances in medical imaging. This means that the brain can reactivate dormant circuitry, create new one, rewire circuitry but also quiet aberrant circuits and connections.
This offers a number of possibilities to successfully treat problems of attention. Some of the remedies may be as simple as providing nutritionally sound breakfast, proven to increase concentration both in children and adults. Other remedies may require much more complex interventions such as refashioning the entire teaching philosophy. Dr Judy Willis, neurologist and teacher argues that keeping children curious remedies problems of concentration and attention. She says:
Children are paying attention, just not to the boring things in class
and goes on to compare the brain to an exclusive club where the entry is controlled by a tough gatekeeper – Reticular Activating System. This system controls sleeping and waking states. In other words, to learn children need to surprise, sensory input but also sense of safety that would foster their curiosity and exploration. Functioning of reticular activating system is related to ADHD in other ways as well. People with attention problems can also suffer from sleeping disorders, especially delayed circadian preference. Poor and insufficient sleep, particularly combined with stimulant medication often prescribed to individuals with this diagnosis, adversely affects concentration and attention. Addressing issues related to biorhythm and circadian preference leads to measurable improvements.
Neurological Diversity Is Not A Bad Thing
There are many interventions that can improve attention and concentration. Success stories abound as well. Michael Phelps is one of the examples of overcoming his problems with attention to become incredibly successful athlete despite the negative prognosis of his teacher who predicted that Phelps would never succeed in anything, as he could not focus long enough. How wrong was this teacher’s prediction! Personal histories never narrate only successes or only problems; invariably these two strands are intertwined. This paradoxical doubling is particularly true for ADHD. As Dr. Lara Honos-Webb put it, this condition causes problems but also comes bearing unique gifts:
People of all ages who have the diagnosis of ADHD can reliably be observed to share a set of gifts including creativity, exuberance, emotional expressiveness, interpersonal intuition, ecological consciousness and leadership.
She argues for a new definition of ADHD that will encompass its positive aspects and not focus exclusively on the problems. In other words, not only can we overcome behavioral problems, but a unique brain wiring can also be a rich resource that we need to explore. Indeed, a case for optimism!