[Translation of an article by Freerk Huisken from the German magazine Auswege, September 2009]
By attention deficit-hyperactivity disorder (ADHD), it is not meant that children in school are given too little attention. On the contrary, it states that they lack attention, above all in school; something that is already a strange diagnosis. Because such children by no means lack attention. They only direct it at something else, meaning: at something which ties up their interest more than the exercises of the pedagogical demonstrator at the blackboard. The deficit is only in the desired attention paid by the student to the duties to the lesson and the teacher. If children do not “cumulatively” perform the required submission, if children are “above average (?) inattentive,” then a disease is supposed to be present, namely ADHD. Without ado, a missing capability for the desired attention is inferred from the missing willingness to adapt to school requirements and rules with good behavior, and this is connected to a freely invented physiological dysfunction. The “causal” research cannot really be characterized any differently. At the same time, I do not want to maintain that diseases cannot appear in the vicinity of these phenomena. However, this suggests almost complete disregard of the question as to what extent the “symptoms” that appear in school are not perhaps a product of school, and necessarily the suspicion that here – as is common in other contexts – as easily as the common path is taken, behavior declared socially deviant is declared a defective human nature. So abnormalities in the child's nature are held responsible for the non-produced achievement of adaptation to the child-hostile purpose of the education system. As if they were biologically tailor-made for that pre-assigned straight-jacket of duties which designs the actual instruction, so that even eating in the classroom or going to the bathroom, getting up, stretching, or taking a comfortable seating position is to be declared a breach of discipline. Just imagine a sort of instruction in which all this would be allowed and in which distractions of the student's interest would not be forbidden and punished, but would be made a subject of discussion. What would be the “deficit” in it? Indeed: wherever the scientific world of thought is ruled by doctrines like “fulfilling duties is normal and only what is normal is healthy,” the cumulative activities of a child's will which are impermissible in school are already declared to be a disease.
From beatings to the administration of medications
And then the patient is of course to be cured of the disease because the dysfunction has after all been identified, and the paediatrician has the final say. He prescribes pills like Ritalin or Medikinet whose active substance methylphenidate, taken in the correct doses and in the right way, should subdue “drive.” (1) The drug companies want to know nothing about the – well known – side effects. Occasionally, they admit that the research has still not advanced very far, but that is not something to stop a good business with medications. In contrast, their effects are valued all the more by educators: during lessons, teachers remind their inattentive and hyperactive ADHD students, from case to case, to remember to take the pill, and parents at home stabilize their offspring with the active ingredient when they want to get some rest. Finally, student teachers are now regularly visited by pharmaceutical representatives who tout the beneficial effects of their products: students, they know to report, simply function better in school and family because afterwards they no longer disrupt the classroom! Whether the administration of the pills subdues something else in addition to drive, and whether or not they produce the desired attention seems however doubtful, because the child's interest doesn't turn to the lesson to the expected extent along with the chemical increase of dopamine in the child. No medication really effects a determination of the will. So that's all there is to it: the deviant behavior is subdued, distractions caused by the student's behavior are no longer so pervasive, thus instead of ADHD this “disease” would be better named IDS – Instruction Disorder Syndrome. Ritalin is now just what the cane once was. A school system which boasts in its pedagogy about having given up beatings, and emphasizes instead the congruence of the child's will and the reasons for school, concocts cute alternatives: if extortion does not work for voluntary submission, the student's will is just made chemically pliant by means of drug administration.
Doubts about the research
Somehow, rather obvious questions are quickly pushed aside, such as for example: whether the deficits have something to do with the attention required and the regulated activity of the classroom, whether they are not perhaps found in school's organization of learning or can be explained by dealing with the frustration which is chronic not only among school failures. An unusual picture clearly emerges with even a casual glance at the theoretical concern with ADD for the natural sciences – one would think. The certainty of pediatricians in diagnosis and medicating stands in strange contrast to the openly admitted doubts about the tenability of the research results by the researchers themselves. There are a lot of scientists (2) who point out, on the one hand, that the causes “of the disorder … remain unclear,” that the distinction between a child who is active, thus “healthy,” and one who is hyperactive, thus “diseased,” is completely left to subjective judgment, and that, on the other hand, the official symptom catalog (3) contains no clearly verifiable criteria. As well as when, in the corresponding list of “unambiguous (!) signs of an impairment of the developmental social, educational or professional capability,” of all things “oversights in school work” and the inability “to follow details” are spoken of, as well as that (school) work is “often messy, careless and without forethought”; when, by “clear aversion” to tasks, “longer mental strain” is required or even “oppositional behavior against school tasks which require effort and attention” is spoken of. This already asks: which student does not really suffer from ADHD or have frequent ADHD relapses?
Attention and interest are closely related
How downright unintentionally funny the judgments become when the finding of disease is held to despite its recognized senselessness: “For outsiders (!) it is often bewildering that chronic ADD is however not omnipresent. ADD patients have no difficulty remaining attentive in certain activities and concentrating on work. Some children or adolescents with ADD are chronically unable to devote uninterrupted attention to school lessons, but play sports or video games for hours.” (4) Who'd have thought that attention has something to do with interest; and that inattention, messiness, special excitement, aversion or opposition to specific tasks and requirements in school for many children might express their disinterest, thus their displeasure or their – caused by school – incapacity to submit as desired to the lessons and its demands? If, for long periods of time, continuity in the teaching material is lacking and the students only understand “sit down,” if they – not infrequently as a consequence of their “failure” – show off in class in front of their friends and teachers, disobey any rules or try to draw some other circus act attention to get themselves recognized, or if vice versa the material has long been understood and the student has become bored, if a student in view of a permanent grade goes into a panic or can simply not sit still any more, then just calling for attention or even threating detention is already futile. This is especially the case where teaching disturbances are used by children and adolescents quite consciously as a means to draw attention to themselves and their “hyperactive” characteristics – which is not infrequently connected by them with the tip that one cannot punish them because they have ADHD.
ADHD as alibi
So this phantom disease of childhood, which on top of everything falls – not at all strangely – precisely in the time of compulsory schooling and ends as a rule when jobs and other well-known duties begin, functions as a triple excuse: docile school children use the knowledge about their stigma as a carte blanche to continue their “disorder.” Parents invoke their disease-diagnosed children in order to temporarily calm unharmonious family relations by means of the pill. And the teaching staff, assisted by school psychologists, is confident that in no case is the school and its actions, rather than the diseased brain of the student, responsible when the interests of the children and of the school have little overlap; whereby this fabrication once again certifies to the school the best report card: when children jump over tables and chairs, pelt the teacher with chalk or are just “chronically inattentive,” this lies in their physiological or psychological defects, which are a matter for the medical profession – like measles or toothaches.
(1) Which is why this stuff is even administered to U.S. soldiers prior to war. Taken in larger doses as “Sweet Rita,” it was valued in the hippy movement for its hallucinogenic effects.
(2) See for example: Hüther, G., Bonney, H.: Neues vom Zappelphilipp. ADS verstehen, vorbeugen und behandeln. Düsseldorf, 2004; Rothenberger, A./Banaschewski, T.: Hilfe für den Zappelphilipp. In: Gehirn & Geist. Heft 03/2004
(3) DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders.
(4) Brown, T. E.: Chronisch, aber nicht allgegenwärtig – Neue Erkenntnisse zu Aufmerksamkeitsdefizit-Störungen bei Kindern, Jugendlichen und Erwachsenen: Erkennung und Behandlung. In: Fitzner, T./Stark, W.: ADS – verstehen, akzeptieren, helfen. Die Aufmerksamkeitsdefizit-Störung mit Hyperaktivität und ohne Hyperaktivität. Weinheim und Basel, 2000, p. 14.