A diagnosis of ADHD may come with some costs
Parents may be more prone to the ‘nurture trap’
Many teachers tell me that there are large increases in cases of ADHD in their students — sometimes up to half the class. The research backs this up, but with a twist. European and American research has shown diagnoses for ADHD have increased fivefold in ten years, but with no increase of total clinical symptoms in the population. This suggests that the diagnostic bar may have been somewhat lowered.
Israeli researchers believed the increase was attributable to a few factors including a relaxed adherence to diagnostic criteria. These clinicians stated their belief that sometimes obtaining an ADHD diagnosis was seen as a means for the student to do better academically. They reported some children said they wanted the opportunity to get the medication, “like our friends” do.
Furthermore, we can’t underestimate the impact of screens on children’s ability to focus and the negative influence of electronics on their sleep patterns and cognitive skills.
I don’t suggest all ADHD cases are false positives. Of course, some children need such a diagnosis to receive extra support to reach their potential. But just how much support is a key consideration.
With a diagnostic label, often comes an assumption that from this point on, the child is far less capable. Parents and clinicians may ask the school to give their child reduced expectations because of their perceived challenges.
The diagnosis of ADHD can come with a belief that the child is hindered in many areas. In fact, sometimes after a parenting talk, a parent might say to me that what I have suggested is less applicable for their child with ADHD. I fear that if every single best-practice parenting strategy is thrown out, then these children are more at a disadvantage.
If children have milder forms of ADHD, the diagnosis might come with some risk. These children might not be challenged in the same way as peers with similar skill but no label. Too many additional allowances for minor issues, risk making diagnosed children less capable over time.
Additionally, research suggests that parents of children who have been given a diagnostic label, often help them more often and more intensely. This tendency is called “the nurture trap”. A child who is overhelped risks becoming less autonomous than they could be. It’s good intentions, but with harmful outcomes.
When children are born, they have very little independent skill and rely completely on their parents’ help. But as they move through the stages of growing up, they need to rely less on others, and commensurately build their independence and capabilities.
When that first happens, their performance is likely to go down as they master new skills. But then, slowly, they will become better at new responsibilities and become mature.
A diagnosis often reduces parents’ comfort in doing this. For example, a child who is a little more disorganized because of their ADHD will struggle when they become more self-managing of their workload. They may need a bit more scaffolding. But they must be allowed to eventually learn to manage daily challenges themselves, without others’ help.
Relying solely on other people’s assistance needs to be eventually reduced for every child, regardless of their challenges in organization or focus. If not, then children won’t be ready for future workplaces that might not be able to provide such intensive support.
Our belief in our children needs to extend to our belief in their ability to learn to cope. Every time we allow our children to avoid facing challenge, we inadvertently hold them back. We can support them in overcoming their unique challenges, but truly loving parenting helps children eventually become ready for the world beyond parental care.
Takeaway for parents
Children with ADHD do have challenges, but there are some things that help.
· Get the diagnosing clinician to be clear about your child’s strengths and what they can do, rather than focus only on the negatives of the diagnosis.
· There is ongoing research, but some therapies are shown to be useful.
e.g., Cognitive Behavioural Therapy (CBT) can help adults with the disorder.
· If children and teens are taught organizational skills, their inattention can be moderately improved.
· Stimulant medications, such as Ritalin, will reduce symptoms of ADHD, but can be dangerous if used by those without the disorder.
