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.