Thursday, December 10, 2009

How Come All the Boys're on Ritalin? מדוע כל הבנים נוטלים ריטלין

ADHD. Say it in a roomful of parents, and you won’t have to worry about small talk for hours. Everyone’s got an opinion, from the anti-TV crusaders to the armchair anthropologists [“It’s a trait that was useful when we were hunting mammoth”; “It shows up more in the descendants of immigrants”]. For a long time now, I’ve suspected an element of gender stereotyping in the “ADHD soup”.

First of all, we need to reintroduce a term that unfortunately has gone out of use: hyperkinetic, meaning simply “can’t stop moving”. I knew one kid in my childhood who actually had this disorder; it is indeed organic, and present from birth. I recall reading an article in some women’s magazine decades ago written by the mother of a hyperkinetic teen. She described a parenting nightmare for about the first 14 years, when according to her description, the condition began tapering off. At her writing, her son was 16 and well-adjusted. She never mentioned drugs, although these perhaps could have been a livesaver for her. Hyperkinesia is rare.

Whenever people begin to speculate about the explosion of ADHD in the population, and someone laments, “What happened? It used to be a rarity.” I want to respond, “True hyperkinesia is still a rarity. What is now referred to as ADHD is simply a product of too much screen time, too little parenting, and a large dose of gender stereotyping, all of which may respond to drugs, but none of which are congenital.” Except parents let themselves off the hook by choosing to believe that it is congenital.

I did some Web research and found two articles about the prevalence of ADHD among boys. The first does a nice job of explaining the phenomenon. The second does a good job of reinforcing stereotypes:

“When girls are under increased stress, they fold their hands and get quieter. When boys are under stress, they become a behavior problem.”

A commentor on an Amazon review of The Trouble With Boys:
“As a female classroom teacher… I understand the difference of learning styles between boys and girls.”

Furthermore, the article claims that schools are more rigorous than they once were:
“…schools ratchet up their expectations, says Lawrence Diller, a psychiatrist in the Bay Area who has been an outspoken critic of the ADHD industry. “More kids — and particularly more boys — look as if they might have a problem. Teach­ers now demand a standardized level of performance from all students. Many can’t tolerate too much motion, too much noise, too many questions — even within the range of normal — if it interferes with the pace of their class.”

“The way schools are run we have kids sitting at desks for a very long time,” says principal Susan Charles.

Let’s take a look at these claims:

Teach­ers now demand a standardized level of performance from all students? - You could’ve fooled me. I thought we’d gotten away from all the soul-sucking uniformity, having shifted over to the “tailored-to-the-individual” and “learn-at-your-own-pace” philosophy.

Today’s teachers can’t tolerate too much motion, too much noise, too many questions? As if teachers in previous generations could?

We have kids sitting at desks for a very long time? Certainly not that I’ve noticed. On the contrary, from what I’ve observed, not only is there much more motion in my kids’ classrooms than there was in my classrooms as a kid, but moving about the room is much more accepted today, as is a certain noise level. In fact, I have my doubts about my former kid self being able to concentrate in today’s classrooms precisely because of the casual atmosphere.

My mother began teaching in 1943. She was assigned a combined class of 40 second and third graders in a school with a working- and middle-class enrollment. I asked her if she recalls any discipline problems. “No,” she replied. “They all behaved.” I’m pretty certain, too, that they were all seated at desks and required to remain quiet for hours at a time, in surroundings far less comfortable or kid-friendly than those in today’s schools. So what gives?

My theory? “He’s ADHD” is the new, PC “Boys will be boys”. I suspect a link between parents’ expectations of their sons’ behavior conforming to "boy" stereotypes, and the likelihood of those sons being diagnosed ADHD. After all, all the other explanations — TV and computers, single-parent homes, food additives, environmental toxins — affect both genders equally, yet up to four times as many boys as girls are diagnosed ADHD. I blame parents’ throwing in the discipline towel sooner with their sons than with their daughters, thereby perpetuating the stereotype of rambunctious boys and compliant girls. Ever noticed that one never hears parents of daughters describe their offspring as “high-energy”, “noisy”, or “rambunctious”?

I would love to construct a study of two groups of parents: one composed of parents who believe that the genders are inherently different and express it in their parenting, letting gender stereotypes take over in the home; and one composed of parents who actively oppose gender stereotyping and who hold their sons to the same behavior standards as they do their daughters. These concepts being almost completely subjective and difficult if not impossible to measure, it would seem that such a study will not be conducted anytime soon. Therefore, while I can’t prove such a link, I am here, throwing it out to anyone who will listen. If anyone knows of a study like the one I describe, please let me know.


  1. ADHD, does it exist? - well. I've just finished a whole thesis on it, and I'm still not sure!
    What I am sure is that there is something going on beyond bad behaviour. I also suspect there are equal numbers of girls out there struggling, but expressing it in less noticeable ways, so just well, not being noticed.
    My theory is that it's describing something at the gentle end of the autistic spectrum. The disruptiveness is what gets noticed at school, but to me the more worrying thing is the difficulty with concentration, friendships and understanding those social cues that help you make friends, and be part of society.
    Now a little plug for why I've been so interested in it.... It responds really well to homeopathy! I suppose you could argue that if there was nothing wrong, then it couldn't be helped, but I've seen kids really turn their lives around - magical stuff.

  2. Philippa, thanks for writing in. It seems to me that "there are equal numbers of girls out there struggling, but expressing it in less noticeable ways" begs the question: They're expressing it in less noticeable ways because...? I believe it's because they're socialized to be quiet, passive, and cooperative (or at least not disruptive). A study showed that preschool teachers allow boys to go 33% further from them before being called back. That's just one example of the thousand and one unconscious gender messages we grownups send.

  3. I have wondered why boys have ants in their pants so much more than girls, and found stereotypes giving me explanations. I think that even if girls manage to exercise more self-control than their counterparts, remaining still in the classroom isn't the best way to learn. My idea of a fantasy school has much more physical activity. This year I teach in an Orthodox elementary school and bought a soccer ball to play with the boys to reward them when they study well. The principal didn't like this, too bad, I was having such fun!! I guess his sterotypes won't allow for a female teacher playing soccer with her boy pupils.

  4. Ela, wonderful idea, but I'm wondering how come soccer is the reward for the boys only. Orthodox girls can't play soccer? Haven't they seen Bend It Like Beckham???

  5. I worked for Atlanta Public Schools for over 30 years.
    So true!

  6. A friend who's an ADHD coach disagrees with my conclusions / speculations and gave me a copy of the Fall 2009 issue of ADDitude, a periodical for ADHD families, to read. Here's my impression:

    I skimmed a few articles and features. The Getting Organized for School section seemed to me to contain tips that would be helpful to any school-age population. I don't know...I'm still not convinced. What I see is a condition -- let's say we don't call it Attention Deficit; we can call it Condition X -- that in a single generation seems to affect a wide swath of the population: It makes boys go crazy, and girls go spacey. It responds to various drugs. It's neural, but I'm not convinced it's present from birth. Many adults are "discovering" that "_that's_ what's been wrong all this time -- why I could never sit still and get organized" -- and are getting treated.

    I'm not a neurologist, or any kind of professional, but from my lay perspective, it just seems to me that a significant percentage of symptoms could be alleviated -- or not present in the first place -- if kids engaged in more physical and / or outdoor and less electronic activity, ate more wholesome food and less plastic food from boxes, and had more present, thoughtful parenting. I am not blaming parents; perhaps the chemical imbalances in the brain is the brain trying to compensate for what kids need that they're not getting?

  7. Adding onto this post in the form of a comment. Hope that's kosher blog-wise. Went deeper into the Fall 2009 issue of ADDitude. Two particular articles struck me: "Accommodations & Aids" that parents might suggest to their ADD child's teacher. Can't list them all, but by I was struck by how many of them could be summed up by "Make School More Like TV", i.e., shorten assignments; break them into smaller parts; increase immediacy of awards and study breaks. Not only that, but with presumably more than one ADD kid in most classrooms, how can teachers be expected to seat each one in a "low-traffic, low-distraction zone", "near a good role model", and increase the distance between desks? I especially liked "Does not work well with others > Encourage cooperative learning". As a kid, I hated group work, and I'm not ADD; so in what way is it helpful for a teacher to force an ADD kid into group tasks, thereby not only frustrating her, but also her peers, with whom she's presumably already at a handicap socially? Let her work alone, for gosh sake.

    Another article seemed to push "lightening the ADDer's load": speak slowly; provide information in small units; give them a discount on written work / allow them to do it orally. What this seems to imply is that teachers should be gearing their teaching toward AD at the expense of the rest of the class. Why should my kid be getting taught in byte-size bits with large doses of visuals and verbals if she can handle larger chunks and the conventional quantity of reading and writing?

    The only thing I took from ADDitude was the brilliant suggestion of having two sets of textbooks -- one for home and one for school -- thus eliminating once and for all the problem of forgetting. This should be instituted across the board. So, it looks like the 21st-century classroom is going to cater to attention deficit. Anyone?

  8. Hi Yam - I found your blog via the comments on Free Range Kids. Just wanted to share mine, Like yours, mine is dedicated to/advocates nontraditional name choices. I live in the Midwest and kept my name at marriage. When our first child was born we reverted to tradition and gave him my husband's name. But after realizing the decision never felt right, we gave our second child my last name. Just read a few of your posts, and invite you to do the same. Check out the Oct and August archives for some posts on research out of Indiana University about how name choice reflects gender attitudes - a little reported story here, and probably far less in Israel.
    Anyway, just wanted to send a shout-out to someone of like mind. Be well.
    Cari Noga

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