November-December 2010 Selected Content
Taking Charge - Larry and Susan Kaseman
Homeschoolers' Role in Opposing Labeling and Drugging Kids
There is wide and growing recognition that terms such as ADHD (Attention Deficit Hyperactivity Disorder) are highly subjective and can be and have been very destructive to children and their families. Using drugs to treat such children often causes more damage. However, these labels and drugs continue to be used and often promoted by classroom teachers, people who conduct preschool and kindergarten screenings, university researchers, professionals at specialized clinics designed to treat ADHD, and drug companies, all of whom are making large profits from doing so. As homeschoolers, we can play a key role in educating people about this unnecessary tragedy and reducing the number of children and their families who are affected. This column presents basic background information. It explains why homeschoolers are in such a good position to take action and suggests what we can do to minimize the damage done by labeling and drugging children.
Important Information About ADHD, Labeling, and Drugs
A recent mainstream newspaper opinion piece by a college professor supports information about labeling and related topics that has appeared in several of our previous Taking Charge columns and adds new information. Stephen Herr's short, direct, and powerful article applies common sense and focuses on the needs of children and their families. (See "ADHD: Has this diagnostic fad run its course?" The Christian Science Monitor, August 19, 2010.)
Here are some key points from Herr's article:
• After a generation of diagnosing children as having psychological disorders such as ADHD and giving them drugs like Ritalin, it is clear that the labels and drugs harm children rather than solving problems. Herr points our that it is easier for professionals and institutions to say children have a psychological disorder such as ADHD than to address the difficult conditions they face in daily life, at home, in school, and in their communities. It is now time to stop using the labels and the drugs and instead consider questions such as: Are children getting enough exercise? Enough sleep? A healthy diet? The opportunity to do things that interest them? And to what extent is the behavior that has been labeled ADHD simply part of childhood?
• Herr links the popularity of diagnosing children with ADHD in the 1980s to the increase in parents going to work outside the home and the changes in the roles played by teachers and schools. He is not specific about these changes, but among the important events occurring during the 1980s are the publication in 1983 of A Nation At Risk, which claimed that US students were falling behind those in other countries; the increased reliance on standardized tests to supposedly measure learning; and the moves toward standards in education.
• The facts are stark. By 2006, nearly 4.5 million children had been labeled ADHD with almost half being given drugs. "In 2008, the ADHD pharmaceutical market was worth $4 billion." In addition, ADHD has grown beyond being a diagnosis offered by professionals. It is now part of the popular culture. Many ordinary citizens think they can recognize ADHD and know what should be done about it. This has happened despite the fact that even after a generation of research, there is still no test for ADHD or evidence that treatment with drugs such as Ritalin works. At the same time, Herr writes, "What we do know is that the use of these drugs [Ritalin, Adderall, or Vyvanse] can be debilitating, addictive, and deadly."
In addition, even people who accept the idea that children can be accurately diagnosed as having ADHD (which we don't) recognize the potential for serious mistakes in making the diagnosis. For example, a study to be published soon by Todd Elder at Michigan State University shows that nearly a million children may have been misdiagnosed with ADHD. According to this study, about 20% of the 4.5 million children, or 900,000 children who have been diagnosed as having ADHD probably have been misdiagnosed. These are terrible odds, particularly for a diagnosis that causes so much harm to children and distorts the ways in which parents, relatives, teachers, and others see them and children see themselves.
The main reason for the misdiagnoses cited in this study is that the children's birthdays were just before the cut off date for enrollment in kindergarten, so they were the youngest and often the least mature in their kindergarten class. A teacher's perception of whether a student has symptoms of ADHD strongly influences the diagnosis. The youngest children in any given grade continue to be more likely to be given stimulants such as Ritalin at least through eighth grade, which is especially serious because it is not known how long-term use of stimulants affects children's health. For details, see http://news.msu.edu/story/8160.
• Herr reminds readers that parenting is often challenging, especially when parents are under stress themselves. Children's behavior can be annoying, especially when they don't do what they are told. He points out that the label ADHD was developed in part because it is easier to announce that children have a psychological disorder than to address underlying causes of these difficulties. When adults are fidgety, easily distracted, have trouble concentrating, and lose interest in what they are doing, it is often suggested that they get more exercise and sleep, improve their diet, and find something that interests them. Isn't it likely that children need the same things? Unfortunately, says Herr, labeling kids as ADHD has distracted us from trying to understand why they behave the way they do and how we can help them.
• In light of the information and perspectives that Herr presents, he concludes that it's time to stop labeling children as having ADHD. Instead, we need to develop theories that are "based in fact and verified by research," which theories about ADHD are not. As a society, we need to acknowledge that labels like ADHD and drugs used to treat it "are harming children and that we have no right to ask children to bear those harms." Instead, we need to consider the challenges children face in daily life and what it's like to be a child, help them grow and learn, and "never use our positions of authority to harm anyone."
Additional key points not in Herr's article include the following:
• To the $4 billion that the pharmaceutical market was worth in 2008 must be added the large profits made by professionals and clinics that claim to diagnose and treat ADHD and the increased funding that school districts receive from federal, state, and local governments for each student who is labeled as having "special need." This huge financial incentive is are one of the main factors that stands in the way of giving up the diagnosis of ADHD and addressing the real problems facing children, families, schools, and our society. Also, we need to be aware that as ADHD comes under increasing criticism, professionals are coming up with new, equally subjective and all encompassing diagnoses such as all the labels that appear along what is now referred to as "the autism spectrum."
• The diagnosis of mental disorders, including ADHD, is supposed to be based on symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the DSM-IV, published by the American Psychiatric Association. A review of the information on ADHD shows just how subjective such a diagnosis really is and how easily misdiagnoses can occur. Here is just one specific example: An article in Harper's Magazine reviewed the DSM-IV's description of several adolescent disorders (including Attention-Deficit/Hyperactivity Disorder and Oppositional Defiant Disorder) and concluded, "A close reading of the text reveals that the illnesses in question consist of failure to listen when spoken to, talking back, annoying other people, claiming that somebody else did it, and (among a lot of other stuff familiar to parents) failure to clean up one's room. According to the DSM-IV, adolescence is a mental disorder." ("The Encyclopedia of Insanity-A Psychiatric Handbook Lists a Madness for Everyone" by L. J. Davis, Harper's Magazine, February, 1997)
• The diagnosis of ADHD often disregards the natural and inevitable fact that children learn at different times and in many different ways. Homeschoolers are well aware of these differences and are used to working with them and appreciating each child's strengths, abilities, and developmental timetable.
Why Homeschoolers Can Play a Key Role
Many homeschoolers are aware of the problems associated with labeling children as having ADHD and other broad labels such as autism. Some of us are homeschooling because our children were labeled or because we want to prevent them from being labeled. A number of previous Taking Charge columns have covered this and related issues. (For a list, see below.)
We homeschoolers can play an important role in working to minimize the damage done to children and their families and to our society as more and more children who are labeled and drugged become dependent on society for their care. Among the reasons homeschoolers are key:
• We have had experience standing up to public school officials, professionals, and the educational establishment. We know they are frequently wrong and that it pays to follow our consciences rather than their directions and so-called "expertise." We have been willing and able to counter what they say. This puts us in a stronger position to take action than people who are intimidated by public officials and professionals or who haven't had experience dealing with them.
• We know that children learn in different ways and follow different timetables. We don't expect individual children to fit into a standardized pattern used in conventional schools. Some of us have personal experience or know people who have seen dramatic improvement in children who were not doing well in conventional schools but improved remarkably when they became homeschoolers.
• Herr's list of what children need (sleep, exercise, good food, interesting activities) strikes a familiar chord with homeschoolers. We know that children learn more easily and are more cooperative when their basic needs are met.
• We know that parents and children working together and learning together can accomplish amazing things.
• Homeschooling is a grassroots movement. We have the experience and the networks to get information to people who need it through personal contact, meetings, the Internet, etc.
• If we homeschoolers don't speak up about ADHD and other labels, it's not clear who will. Many parents of children who have been labeled are too isolated, too busy, too overwhelmed, or too scared. Many of the professionals who may be very aware of the problems don't want to rock the boat or risk their income or position.
In short, as homeschoolers, we have a good opportunity and, some would add, the responsibility to work to reduce the damage that labels like ADHD and the drugs that accompany them do to children, their families, and our society.
What We Can Do To Reduce the Damage Done By Labels and Drugs
• We can learn more and keep up to date on the topic. See below.
• We can use these resources as well as our own knowledge and experience to gently yet effectively communicate the problems with these labels and their consequences to family, friends, and others within our community. On a personal level, we can counter anyone (whether a professional, a neighbor, or a stranger in the grocery store) who labels our children. We can look for the real causes of less than ideal behavior. We can also share this information with parents we know whose children have been labeled, offer them support, and mention resources that are available, including the possibility of homeschooling.
• We can make presentations to share this information more broadly. Possibilities include a meeting of our local homeschooling support group, a homeschooling conference, a public presentation to which the public is invited at a local school board meeting, in our public library, a local church, a local public or private school.
• We can share information in other ways. We can post it on blogs and online discussions. We can write letters to the editor of newspapers and magazines. We can ask that publications present articles on the topic based on an interview with us and information we give them.
Strong evidence points to the harm being done by labeling children as ADHD and drugging them. Among other problems, using this and other labels keeps us from dealing with the real causes of difficulties some children face. As homeschoolers we are in a good position to help spread information about the harm done by labeling and drugging children and to point to alternatives, including homeschooling.
1) Previous Taking Charge columns on this and related topics.
• Why Children Are Not for Screening
2) Available on the Wisconsin Parents Association (WPA) Web site at www.homeschooling-wpa.org/issues
• Increased Mental Health Screening? Are You Crazy!?!
• Why Professionals and Politicians Are Wrong About Preschool
• Let's Not Institutionalize 3, 4, and 5 Year Olds
• WPA Resolution #47. Institutionalizing Young Children
• WPA Resolution #49. Importance of Parents
• Testimony on Five-Year-Old Kindergarten Legislation
© 2010, Larry and Susan Kaseman