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Isn't it normal to have difficulty focusing on things that are really boring? ADHD diagnosis rates are several times higher in the US than in other developed c

Isn't it normal to have difficulty focusing on things that are really boring? ADHD diagnosis rates are several times higher in the US than in other developed countries, and orders of scale higher than in low-diagnosis countries (such as France). The biggest risk factors for an ADHD diagnoses include things like "being male" and "being in the youngest quartile of your kindergarten class". That's an amazing thing to pathologize. In the US, the drive to perform well on standardized tests has gotten to such an extreme that kindergarteners are expected to have literacy performance that was expected of 1st-graders a generation ago, and children are expected to come to kindergarten with the alphabet knowledge that they would have learned in kindergarten a generation ago. Meanwhile, the amount of time young children have spent at recess has declined hugely in the last 30 years, with very many schools having no recess at all. Isn't there a margin where this is a disorder because of the interaction between an individual and their environment, where the environment is the problem? Some amount of ADHD-spectrum behavior might should be considered within the range of normal child development, which is being pathologized by a system that doesn't give young children (especially slightly younger boys) enough exercise. The main treatment for ADHD is lifelong amphetamine use, and nobody can say whether this treatment prevents children from developing coping mechanisms that they would otherwise normally develop before adulthood. If something as simple as more exercise can marginally reduce ADHD diagnosis or medication rates, that would be a huge advance.

spacedmountain 11y ago
This speaks to a common commment about ADHD. Where is the border between a 'personality trait' and a disorder? The condition is usually defined by having an impairment in at least two environments (ie school, home, work, sports teams). 'Impairment' is obviously subjective, but implies something more than simply being bored. Playing a game in a boring meeting probably isn't ADHD. Being unable to focus for more than a few minutes in _any_ meeting is a stronger sign, and could really make it harder. On diagnosis rates - in most countries its 2-5% (>10% of children in the USA..). That is about 2 standard deviations from an 'average' person, which can actually be quite a difference. For comparison, a 'genius' is someone who scores in the top 2% of an IQ test. Economic elite are '1%-ers'. I'd agree that there is a continiuous spectrum, and also that it is mis/over-diagnosed in a considerable number of cases. I think it is this over-treatment that you are questioning, but lets be cautious to not add to the stigma around legitmate cases of the condition. I'd agree often the challange is between individual and their environment - although often 'enviroment' includes people around them. Often the environment is hard to change - do the 95% change to accomodate 5%? There is advice for careers that people with ADHD tend to be better at - sales, entrepreneurship, and medicine for their fast-pace and energy, or jobs like the military where there is a lot of structure. I think its more complex than saying exercise would reduce diagnosis or medication rates. In particular, if exercise alone 'cures' ADHD, it is likely a mild or mis-diagnosed case. In my own experiance, exercise (as well as sleep and diet) do affect symptoms, but don't eliminate them.
- panglott 11y ago
  Yea, my concerns are threefold: overdiagnosis, the diagnosis of young children, and the impact of treatment on developing children. I don't doubt that ADHD is a real disorder, but if the true rate of occurrence is 2-5% while the US diagnosis rate is 10%, that means that a huge proportion of American kids are overdiagnosed. And the leading treatment for ADHD is quite intense: lifelong use of very powerful drugs, with no real understanding of how that impacts normal child development. I would be surprised if exercise alone works for people who struggle with a very disabling condition, but I suspect interventions less extreme than a full ADHD diagnosis and medication regimen would do a lot of good for kids who might otherwise be overdiagnosed as ADHD. And as far as the concern as to whether the 95% should change to accommodate the 5%, what we're talking about here is "getting more exercise"—and when huge numbers of schools don't require recess—it's something that the 95% would benefit from.

spacedmountain 11y ago

This speaks to a common commment about ADHD. Where is the border between a 'personality trait' and a disorder? The condition is usually defined by having an impairment in at least two environments (ie school, home, work, sports teams). 'Impairment' is obviously subjective, but implies something more than simply being bored. Playing a game in a boring meeting probably isn't ADHD. Being unable to focus for more than a few minutes in _any_ meeting is a stronger sign, and could really make it harder. On diagnosis rates - in most countries its 2-5% (>10% of children in the USA..). That is about 2 standard deviations from an 'average' person, which can actually be quite a difference. For comparison, a 'genius' is someone who scores in the top 2% of an IQ test. Economic elite are '1%-ers'. I'd agree that there is a continiuous spectrum, and also that it is mis/over-diagnosed in a considerable number of cases. I think it is this over-treatment that you are questioning, but lets be cautious to not add to the stigma around legitmate cases of the condition. I'd agree often the challange is between individual and their environment - although often 'enviroment' includes people around them. Often the environment is hard to change - do the 95% change to accomodate 5%? There is advice for careers that people with ADHD tend to be better at - sales, entrepreneurship, and medicine for their fast-pace and energy, or jobs like the military where there is a lot of structure. I think its more complex than saying exercise would reduce diagnosis or medication rates. In particular, if exercise alone 'cures' ADHD, it is likely a mild or mis-diagnosed case. In my own experiance, exercise (as well as sleep and diet) do affect symptoms, but don't eliminate them.

panglott 11y ago
Yea, my concerns are threefold: overdiagnosis, the diagnosis of young children, and the impact of treatment on developing children. I don't doubt that ADHD is a real disorder, but if the true rate of occurrence is 2-5% while the US diagnosis rate is 10%, that means that a huge proportion of American kids are overdiagnosed. And the leading treatment for ADHD is quite intense: lifelong use of very powerful drugs, with no real understanding of how that impacts normal child development. I would be surprised if exercise alone works for people who struggle with a very disabling condition, but I suspect interventions less extreme than a full ADHD diagnosis and medication regimen would do a lot of good for kids who might otherwise be overdiagnosed as ADHD. And as far as the concern as to whether the 95% should change to accommodate the 5%, what we're talking about here is "getting more exercise"—and when huge numbers of schools don't require recess—it's something that the 95% would benefit from.