Is nobody watching the Great ADHD Myth?

[ILikeTrains]

I was expecting to see lots of chatter about this. 1/2hr in - interesting!

I watched this program last night and I have absolutely no skin in the game - I don't have an ADHD diagnosis, my now adult children have never had ADHD diagnosis, and I don't know anyone who has a diagnosis, although they could be keeping it private.

I thought it was a biased program - it only gave airtime to the view that ADHD is a made up condition based on interpretation of observed behaviours not a physical condition. I agree with the idea that it is not a neurological difference otherwise all you would need is a brain scan to show that specific areas of the brain were different in some way, like diagnosing a broken leg with an x-ray.

I was not surprised that the boy's behaviour changed during the 6 weeks. He was getting a lot more positive interaction with his family and being exposed to different environments - playing outdoors with them rather than them all being cooped up in the flat with mostly screen based entertainment. I am only guessing that the mum was also spending time on screens before.

I did think it was sad that the boy went back onto medication 'just' so that his schoolwork improved. I would like to think that in a better funded school environment he, and children like him, could get more individualised teaching rather than using drugs to make him fit into the classroom and rigid curriculum based system that we now have.

Not only that, but unmedicated ADHD means more likely to commit a crime, more likely for to commit violent crime, more likely to be incarcerated, more likely to become addicted to drugs or gambling, more likely to have a road traffic accident, an increased risk of suicide or self harm, more likely to develop cardiovascular disease, and an increased risk for premature death.

I think some people assume that those seeking an ADHD diagnosis are just seeking a stimulant but there is a non stimulant treatment option, as well as positive evidence that supplementation with certain vitamins and minerals can support attention and behavioural outcomes.

I haven't watched the programme yet but I think it does society a huge disservice to paint a picture that ADHD is simply a behavioural issue to be fixed. There is merit to also changing the environment, but also with clinical supervision and plenty of neurodivergent informed early intervention.

Honest question- does this kind of diagnosis really help? So many NHS resources are currently being channeled (directly or indirectly) into ADHD assessment and treatment- and also Autism assessment. Such high numbers of people with a diagnosis of one or the other - or both - that it seems meaningless. I am genuinely concerned that these high levels of diagnoses are diluting public interest, sympathy and appetite for making adjustments- which will impact those with more significant needs. Maybe I will start a thread…..

I did think it was sad that the boy went back onto medication 'just' so that his schoolwork improved

I think that's the message that the program wanted to give, but his teacher said he was disrupting the whole class, though it was brushed over and she focused on the changes in Mason himself, so I'm not sure it was the whole story.

ADHD goes with risk. Lots of children are badly hurt or killed by the risk taking that goes with uncontrolled ADHD. I've got part of a front tooth missing because of risky behaviour at 7 years old. Lots of the boys end up in young offender prisons and then adult prisons.

The program missed out completely how medication mitigates the risk to young people.

There have been quite a few threads.

Yes it helps on a personal level.

I agree with you that focus is being removed from people who really need it.

I found the whole premise of the show irritating. Shower a child with attention and lots of outdoor play and behaviour improves; this would happen for every child. The fact that he finds school more challenging without his meds says it all. Yes, there is an issue with the curriculum, but children with ADHD should have a choice about whether they wish to succeed academically and receive praise at school rather than punishment. My ADHD daughter was chatty and unorganised, but not disruptive. We pursued a diagnosis because she was getting endless detentions for forgetting things and chatting in class. Once diagnosed, her progress 8 went through the roof, she enjoyed school more, and her confidence increased because she was being praised in class. Every child who is strugging at school should be given these opportunities.

It helps remove the potential costs elsewhere. A&E and trauma care, substance-use services, mental-health treatment, criminal justice, road collisions, unemployment/underemployment, educational support and premature mortality, state welfare.

Not to mention helping individuals and families.

It helps kids focus on the task at hand, not simply just academics. It helps adults stay in a job and perform well, rather than the cycle of job hopping due to poor performance. It can be the difference between leaving important things somewhere or intentionally putting important things somewhere, think keys, phone, passports, life saving medications. It reduces explosive behaviour in children and adults with ADHD.

As for autism diagnoses, we simply have a better understanding of autism and early development. We understand comorbid conditions a lot better. You can't medicate autism, but once you understand autism you're better able to provide support and social scaffolding in different environments for that person to reach their fullest potential and advocate for their needs.

You'll probably also notice over the next decade an increase in dyspraxia and dyslexia diagnoses too, as these are being more understood, publicised and diagnosed, and you'll be asking then what the point of a diagnosis is, what the benefit is, but it's mostly about reducing risks in other areas too and offering the appropriate support.

There is a huge societal benefit.

NRTFT, but I found it frustrating! Dr Max Pemerton is a scientist and he should know his experience of ADHD is anecdotal, as is the case of Max. It takes RCT to establish
reliable outcomes at population level.

One person with ADHD is just one person. Three people in my family have ADHD and they all present differently. DH has had to work harder, but he has been a successful professional, as Dr Pemberton clearly has. However, I do all the life admin and organisation in our house. The mortgage company would have repossessed the house, and the gas and electricity would have been cut off long ago, if it were left to DH!

DD2 imo is more severely affected than DH, and she hasn’t developed his coping strategies. She can’t keep a job, and cannot live independently. She can’t drive or cook with three saucepans, because it’s too complicated for her limited attention. She doesn’t understand what people are saying, she doesn’t understand what she reads or films/tv programs of length. IMO, it’s complicated by autism, but she turned down an assessment as an adult.

She was on methylphenidate for years, as an adult and it enabled her to do a job, that required precision. She found its effects to be positive - she didn’t make silly mistakes and she wasn’t as emotionally volatile. She didn’t walk out of jobs, while she was on it.

DGD is also more severely affected than DH. She can’t learn in a mainstream classroom, because of specific learning difficulties, which could be alleviated by medication; and she struggles socially, because of autistic traits.

It’s all very well professionals saying children shouldn’t be medicated to fit into our education system; but when they cannot understand what is going on, that’s not just about suppressing lively behaviour.

I agree that it’s diluting public interest. In fact it’s making people actively hostile on the subject. It’s time to have a conversation about real change as it’s quite clear a large proportion of the population isn’t fitting into the current system.

But those children were minorities! They are not now... There wasn't multiple children in every class ending up in prison or dropping out of school and disappearing into obscurity. Most of the 'naughty' children in my class at school were not even naughty by today's standards. Naughty was a minor fight at playtime, talking too much in class, being a bit cheeky, not getting on with your work, stealing another child's nice pen etc.

Now, we have children who regularly swear at teachers, classrooms have to be evacuated while a child rampages, children tip up chairs and storm out of classrooms, they regularly have major fights over football, a few abscond over the railings and we have to have high security fences and all external doors locked to prevent this, there are tantrums with children screaming 'get away from me' at staff, children kicking furniture repetitively to disrupt lessons etc. and this is in a normal primary in a 'nice area', I hear of much more frequent behaviour like this from friends working in other schools and see it in online forums all the time too.

I think some of what you’ve said suggests a misunderstanding of what ADHD actually is. It isn’t simply about children being more energetic, shy, outgoing or behaving differently. It’s a neurodevelopmental condition that affects things like attention, impulse control and executive functioning, and for some people it can have a profound impact on their education, relationships and everyday life. You need to understand that distinction when discussing diagnosis and medication.

I intend to watch this later. I do find it interesting that the only other thing I have read about ADHD this week is Farage declaring a "crisis of over-diagnosis" and Tice thinking we should spend less on education and more on transport. I think we can guess where funding came from for this and who a lot of these people align with politically.

ISTR that there is a view that ADHD personality traits exist because it is evolutionary successful to have a portion of the population that 'moves on quickly'. Think gathering berries, an ADHD personality would quickly move on if the patch is poor, vs someone else wasting time unproductively vs basket weaving, where you want the personality to sit down and do the same thing all day with attention to detail.

The issue is that modern society has become more fit for the latter trait than the former. This isn't a new thing or a Western thing - Asian education systems have always been extremely formal and disciplined - the difference is that in the past (or in Asia) we let the others leave formal education early. (education in Japan and China is only compulsory for 9 years until you are 15 for example)

Congratulations.

Not sure I can be bothered to watch it. I definitely think the orthodoxy around adhd and autism needs to be questioned and it is expected that those who benefit from the current orthodoxy will push back. But it all tends to become very polarised and political rather than a proper scientific examination.

That was DH, as a child in the 60s! Screens consisted of “Children’s Hour”! MIL’s idea of cooking was the traditional meat, potatoes and two veg, cooked from scratch. Mushrooms were too exotic for her! DH spent all his free time, out playing football with the neighbours’ children. It didn’t alter the fact, he couldn’t understand what he reads, and he did geography at university, the scientific side like botany, etc with lots of maps, diagrams and drawings!

Go on holiday with DH for a week, and you’d be in no doubt ADHD hyperactive type exists! (We go to Greece and live on organic, locally produced food, cooked from scratch)

Whereas I spend a LOT of time telling parents that a ‘label’ won’t change anything at school. It won’t change the support we are able to provide. We respond to the need in front of us - as far as we are able to with the lack of funding and resources, chiefly the lack of staff.

Responding to a previous poster too, respectfully, I often wonder if anyone who goes for a private diagnosis is ever refused one.

I thought it was very good but I think adhd affects people differently. My son was hyperactive as a child but was well behaved in school due to fear of being told off, something I didn’t do at home, I would speak with him about why he did something that wasn’t acceptable and how we could change that in future. He would erupt after school, full of anger and anxiety. He explained it was like he held his breath all day to behave and try to concentrate but once he felt safe with me he could let go, so I got all his frustration and stress from the day all at once. We eventually home schooled him aged 14 which was much better for him.

They are still minorities, unless you're saying 51% of pupils have a diagnosis of ADHD or autism?

A liberal guess would be about 3 per classroom of 26-30 either on the pathway or having a diagnosis.

There's also more and more specialist schools being closed down under the guise of "inclusion", over a year in many places for tribunal hearings for SEND support delaying pupils being placed or supported adequately, and depending how old you are, many disabled children were denied access to a legal school placement when a lot of us were children, even after they were permitted there were a lot of what would be seen now as unlawful exclusions.

The increase in presence in these children isn't simply just due to an increase in diagnoses, which we do have due to a better understanding and the relentless need for documentation before your child can get the support they need, but a lot of political and environmental decisions and factors that have resulted in children with mixed needs being homogenised together in a mainstream education classroom.

This is simply not true.

There is a long body of work that the people in the documentary were drawing from. Critical psychology, critical psychiatry, sociology etc.

I do agree with PP that it was biased in that it didn't explain up front which work/perspective it was drawing from.

It used to be seen as something akin to "woke" to question the biomedical model in this way and look at the social constructedness of things like ADHD. I studied it at undergrad in the 00s.

But identity politics and scientism has changed peoples perception of this - now people are very happy to give themselves labels and not challenge why and how they came about.

The people in the doc are not right wing at all.

I too went to school in the seventies and remember two boys in my primary school class constantly getting into trouble. Not as bad as I’ve experienced in class when teaching, mind.

I am in doubt that ADHD exists. What I struggle with is the occasional use of it as an excuse rather than a reason. Too many parents of disruptive, aggressive children just want to shrug and say it’s their ADHD rather than dealing with improving their child’s engagement or encouraging them to take responsibility for their actions. It might be the reason for their impulsivity or disruptive behaviour but we are doing the children a disservice if we don’t help them with learning to control it.
I also struggle with ‘inclusion’ being spoken of as a more individualised curriculum. Last year 58% of my class had some kind of additional need. I am more than happy to adapt learning wherever I can, but let’s not pretend that one teacher can teach a class while personalising learning for more than half of the children - when a lot if the time those children just need some support or attention. There is only one of me!
This is a crisis waiting to explode.
Lots of high schools have nurture hubs or inclusion bases - which might work for the 20 or so kids across the school that access it currently.
They won’t work when it’s more than half of the school population, because currently in primary that’s what we are having, increasingly, to deal with, and imo what we are doing is accepting too much disruption to the learning of others.
When one or two children suck up 80% of the teacher’s attention or mean that the class can’t go on trips, or supply teachers walk out of the room, surely we have to accept that it’s not ok.

But it’s not as simple as that. Are we really saying that a child’s ‘natural tendencies’ to scream, run around the classroom, leave their desk mid lesson to visit friends, or crawl on the floor disrupting others should simply be encouraged? Should an 8yr old's inability to sit still for a 40min lesson with preference to rock back and forth on the chair, be treated as normal? And what about being so overstimulated during a football game that they can’t stop running? These behaviours affect everyone in the room, pretending they’re just harmless ‘natural tendencies’ doesn’t help the child or the class.

Responding to a previous poster too, respectfully, I often wonder if anyone who goes for a private diagnosis is ever refused one.

Talking only of adults, the rejection rate will be very low because nobody will put themselves forward to pay for the process without knowing that they already have the traits. Feeling the impact of those traits on your life is why you spend the money.

I feel incredibly lucky that my own private diagnosis through the Priory was carried out by the NHS adult ADHD psychiatrist, because it stops people telling me that I've only got a diagnosis because I paid for it.