Everyone is a genius. But if you judge a fish on its ability to climb a tree, it will live its whole life believing that it is stupid.” (Albert Einstein). ADHD (Attention Deficit Hyperactivity Disorder) is one of the most common disorders in children and also one of the most controversial topics between experts in the neurological field. Is ADHD a reality or a myth? Is it a medically identified disorder or just a misunderstood difference in intelligence? Is it a cover for an underlying condition? Experts seem to have diverging opinions on the matter. The following paragraphs will cover those conflicting points related to ADHD.
As for the year of 2017, 6.4 Million American children between the ages of 4 and 17 have been diagnosed with ADHD. ADHD has been on the rise in the past decade and the number of children affected by the disorder has increased by 42% in the past eight years, affecting 4% to 12% of school-age children around the world. (Holland & Riley, 2011). ADHD is defined as an impulse control disorder, marked by sustained symptoms of inattention, hyperactivity and sometimes impulsivity that interferes with the way someone acts and focuses. (Novella, 2017) ADHD becomes noticeable around five years of age and can continue into adulthood.
Numerous studies have reported multiple abnormalities in the brain structure and functionality of a patient diagnosed with ADHD. Evidence from longitudinal and cross-sectional structural imaging studies have shown that ADHD is characterized by a delay in brain maturation, reduced cerebral volume, reduced total gray matter, and a reduced functional connectivity between associated networks. (Rubia et al., 2014) Those specific regions of the brain are linked with motor control, problem solving, memory, impulse control and sensory perception development which would explain the symptoms ADHD patients are experiencing. Although, several research studies conclude with similar findings, the New Commentary of the National Institute of Health (1999, p.10) states: We do not have an independent, valid test for ADHD. There are no data to indicate that ADHD is due to a brain malfunction. Because we do not have sufficient technologic advancement as for now, ADHD is currently being diagnose based on symptoms only rather than using objective laboratory measure. (Perez, 2017). While, the National Institute of Health (1999) states that we cannot objectively test and conclude that a patient has ADHD, the existence of the medical condition should not be in question. ”Mood, thought and behavior largely rely on brain function that cannot be imaged.” affirmed Novella (2017, para.3). ”The same is true, for example, of migraine headaches [bipolar, depression, anxiety, schizophrenia]. It is entirely a clinical diagnosis”. Mental illnesses cannot be proven neither can ADHD. But can we rule out their existence based on the fact that they cannot be clinically verified?
Numerous experts believe ADHD is the tip of the iceberg: underlying conditions would be the real problem. In his publication, Armstrong (2017) speculates that hyperactivity is a symptom and not the disorder itself. Saul (2014) discloses a similar statement and observed in his patients with ADHD either a normal hyperactivity/distractibility level or an underlying condition that has ADHD-like symptoms such as allergies, sleep disorders, vitamin deficiency, depression, learning disability, anxiety. Similarly, the underlying condition could also be as simple as the child feeling bored, stress-out, or have not yet reached the expected maturity level to meet with the demand placed upon them. For instance, experts report that boys and girls who are the youngest in their classroom are 70% and 60% respectively, more likely to be diagnose with ADHD (Miller, n.d., para.3). Most young, healthy children have shorter attention span, have a hard time waiting for their turns, following instructions and it is considered to be an age-appropriate behavior. In fact, experts admit that they cannot dissociate the symptoms of immaturity from the symptoms of ADHD. (Pagan, 2018). Also, children from families living under the poverty level are twice as likely to get an ADHD diagnosis, which indicate that a stressful environment can provoke ADHD-like symptoms as well. (Holland & Riley, 2011).
Other experts believe in the theory of multiple intelligence rather than ADHD. According to Armstrong (2018), one of the reason why a person is exhibiting ADHD-like symptoms could be that they possess a different learning style that is not typically used in a traditional learning environment. Teachers should diverse their teaching method to try to accommodate most learning styles (Armstrong, 2018). Both, Armstrong (2017) and Perez (2017) comment that ADHD can be improved via exercise and behavioral therapy. They also observed that ADHD symptoms tend to disappear under certain circumstances. For example, during one-on-one interaction with a trusted adult, during an activity where the outcome can be controlled, during the performance of a hobby they truly enjoy, during vacation: a time where stress goes away. ”If ADHD can disappear under these conditions, then how can ADHD really exist as a medical disorder [or have genetic origin]?” Questions Armstrong.
Despite all the controversy that ADHD brings we cannot deny its existence nor the way it affects people’s lives. Everyone is unique. Everyone has a brain that is wired differently, develops at different pace, and learns best in different setting. That is what makes ADHD such a complex disorder. Even though our medical technology does not allow for the validation of the disorder, there is sufficient amount of evidence coming from self-observation in patients to identify that the disorder exists. While an overwhelming amount of research have been done on the topic of ADHD, a lack of clarity remains as far as what causes the impairments and why. With the rapid advancement of technology, Cecchi (2017) anticipates that within 5 year, their artificial intelligence innovation, will be advanced enough to help specialist predict, identify, monitor and understand mental illnesses using speech pattern analysis, allowing for earlier and more efficient intervention. The future is promising for ADHD.
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