22 ms·

When starting school, younger children are more likely to be diagnosed with ADHD

167 points by Reedx 8y ago

Reedx 8y ago
This is a striking statistic: "...children born in August in those states are 30 percent more likely to receive an ADHD diagnosis, compared with their slightly older peers enrolled in the same grade."
- rusabd 8y ago
  It is similar to hockey paradox when NHL players are most likely to be born in December
  - dudul 8y ago
    How is it a "paradox"? It makes total sense that kids older and bigger will dominate most sports. It will re-enforce their self esteem and confidence and help them get even better. I don't dispute the phenomenon, I've never heard it called a "paradox".
    - mathgeek 8y ago
      I think what was meant here is the Relative Age Effect: https://en.wikipedia.org/wiki/Relative_age_effect https://en.wikipedia.org/wiki/Relative_age_effect Many here probably recall if from Super Freakonomics.
      - rusabd 8y ago
        Ah, "effect", of course. This is what I meant
    - SilasX 8y ago
      Sufficiently unintuitive reality is indistinguishable from paradox.
    - rusabd 8y ago
      Well, I made a mistake by saying that "NHL players most likely to be born in December" when in fact they most likely to be born in January. December is the horrible month to be born for a future NHL star (https://www.quanthockey.com/nhl/birth-month-totals/nhl-players-career-stats.html https://www.quanthockey.com/nhl/birth-month-totals/nhl-playe...). So it is not that obvious, isn't it? :)
- Oletros 8y ago
  Is there a cut for date for starting school? Here in Spain, everyone born in the same year goes to the same class, is it different in USA?
  - dudul 8y ago
    As per the article itself, many states implement the "1st of September cut date". A kid born in September has to wait an entire year to start school compared to one born on 08/31.
    - throwaway123032 8y ago
      And in Switzerland, 1st August. Retardness.
  - bigpicture 8y ago
    > Here in Spain, everyone born in the same year goes to the same class, is it different in USA? So Spain has a cut date of 1 Jan while the USA is 1 Sept. The overall effect is exactly the same: When a school term begins, some of the students will be nearly 1 year older than some of the others.
- WhompingWindows 8y ago
  It's yet another piece of evidence that ADHD is a developmental disorder, it develops over time, and those who are younger have brains which are underdeveloped. Their ability to tamp down disruptive behaviors and use executive functioning to effectively manage planning is reduced compared to other children. So, in younger children, those who are borderline ADHD will appear to be more solidly ADHD, and those with moderate or severe ADHD will seem to have worse symptoms, as we're putting them in a classroom and comparing them with children whose brains have a higher EF capacity. It's also worthwhile to note that the gold standard diagnosis of ADHD involves observation of childrens' behavior in the classroom, where they will be compared to older, more neuro-developed classmates.
  - jonhendry18 8y ago
    Except sometimes it doesn't go away with age.
- x220 8y ago
  It's almost as if we diagnose children with ADHD for acting how healthy young children naturally act.
  - bayesian_horse 8y ago
    The problem is that children with ADHD are acting somewhat how healthy - but much younger - children naturally act. There seems to be another component though. Adults with ADHD can be quite "mature" in most respects, while still having trouble related to the disorder. Hyperactivity and lack of impulse control are only part of the disorder, and not necessarily that pronounced.
- 24gttghh 8y ago
  I think it would make more sense to have an evidence-based determination for what grade a child should start in, rather than some arbitrary cut-off date like we have now.
dudul 8y ago
My kid was born in September and I remember my wife doing a little research around that "for fun" (yeah, that's how she has fun) a while ago, how kids far and/or close to the cut off do. She found a few studies mentioning that older kids (like born between September and February or something) were doing way better in terms of the academics as well. Which in a way makes sense, but maybe indicates that either children start school too young or that programs are too agressive.
- ngngngng 8y ago
  On that note, my little brother repeated a year for academic reasons, but it also had benefits on sports. He's older than nearly anyone else in his grade (12th), and he's just about the best swimmer in the state. I only see positive benefits from his repeating a grade.
- gizmo686 8y ago
  I don't think it indicates that students start too young, as much as 1 year increments is too granular for grouping young children.
  - dudul 8y ago
    That's a good point yeah. But I think when I said that younger kids didn't do as well it meant both in terms of ranking (they were in the lowest percentiles) which indicates that they don't do as well as their peer, but also in terms of future opportunities to attend college or university.
  - pbhjpbhj 8y ago
    This. My older kids have birthdays later in the academic year but have ended up in groups for more advanced students. Mind, nursery was a complete wash when it came to academics -- learning to count to 3 when you can already count to 20 is rather futile. Public schools just can't tailor to individual students. Socially though, nursery was well timed for them IMO.
- thetest3r 8y ago
  https://www.businessinsider.com/how-your-birthday-affects-your-chances-of-success-2014-7 https://www.businessinsider.com/how-your-birthday-affects-yo...
DoubleCribble 8y ago
The September 1st cutoff for Kindergarten is treated as a distinct milestone when it really should be treated as part of a developmental window. As far as California is concerned, if you have a kid born on September 1st, they get 2 years of Kindergarten (TK + K). If their sibling happens to be born on August 31st, they get 1 year of Kindergarten (K only). And that 1 day distinction could be the difference between a childhood of grade appropriate behavior (older, more mature) or being labeled as ADHD (younger, less mature) with many years of drug treatment to look forward to.
povertyworld 8y ago
Anecdata, but this was my experience. I have a November birthday, and the school district in Massachusetts gave my parents the option of having me start a year younger than everyone or wait a year. My parents opted to send me to school a year earlier. I performed poorly, and at one point was labeled with ADHD. On the standardized tests they gave in 6th grade I scored at the 12th grade level, so I don't think my problems were cognitive as much as behavioral. Also, in high school having some peers who have been held back a grade being 15 years old while one is just turning 13 can lead to some rather unpleasant physical bullying. I often wonder how those early experiences may have limited my life. I was so tempted to send that article to my mom, but I didn't know how she would take it.
- unixhero 8y ago
  Do it. You deserve closure.
- jonhendry18 8y ago
  I was born in September, so was usually younger than most of my grade peers. Did fine in K-6. Behavior was never an issue. But I was diagnosed with ADHD in college.
  - povertyworld 8y ago
    By behavior I mean not doing the class work.
ravenstine 8y ago
I don't dispute that ADHD is an observance of a real phenomenon, but maybe the prevalence of the diagnosis is a result of society overoptimizing human productivity? Having ADHD, especially now that ADD is ADHD-PI, seems very normal these days, but it we treat it more like an affliction than a common behavior the modern world needs more compassion towards. If I have a child and they seem to have ADHD, I would pull them out of the public school system so as they don't have their time wasted and their esteem destroyed. If the system doesn't become more understanding, then it's up to me. At least then my child can be brought up to learn good coping mechanisms they'd be lucky to otherwise learn before it's too late.
- WhompingWindows 8y ago
  I researched ADHD and was a teacher to boot. You wouldn't think it's about human productivity when you have ADHD children standing on their chairs, shouting, wandering the classroom during examinations. It's a serious neurological disability and it's not just down to societal pressures for productivity. Some sad facts: Those with ADHD are much more likely to be friendless, to have fights with parents, to abuse alcohol, nicotine, marijuana, and cocaine, and to develop mental health problems like depression, anxiety, and conduct disorder. The brain of those with ADHD is not "normally" developed and that leads to a lot of issues.
  - all_factz 8y ago
    Another sad fact: medicating such kids is often a problematic solution. ADHD drugs make one lethargic and just feel "off" (according to my sister, who was on them for a long time). What we need are more vocational schools to give the "hyperactive" among us a realistic, career-oriented outlet.
    - 2trill2spill 8y ago
      I got "diagnosed" with ADHD and tried taking the medicine for two weeks and it was terrible. What's the point of doing better in school if you feel terrible, lose your appetite, and have problems sleeping?
ende 8y ago
Get rid of a single long summer break and the entire concept of a “school year”. Divide the year into quarters. Students can start in summer, spring, winter, or fall.
- rtkwe 8y ago
  > Students can start in summer, spring, winter, or fall That's much harder to do than it sounds because now you have 4 groups 3 months apart in the curriculum. The only way to really do it would be to segregate the kids from the different start times into separate classes otherwise it'd be pretty impossible to teach. There will also be a slight variation in class size depending on the quarter it's for. as August and September are over represented as birthdays. I do think year round schools probably make more sense overall so there's not such a huge gap where kids forget so much.
  - bigpicture 8y ago
    My local elementary school has 3 classrooms per grade. If we broke the year into quarters and made each student attend 3 out of 4 quarters, what you'd end up with is more efficient use of school facilities making up for a slightly higher teacher cost. Probably.
    - rtkwe 8y ago
      I think before we do rolling quarters moving to a year round schedule would do more to improve student performance than the more granular age groupings. Could also just group the kids into however many classrooms are in each school to do both.
WhompingWindows 8y ago
ADHD researcher here, this was already known. ADHD is a neurodevelopmental disorder, the key is that developmental disorders occur over the time-course of typical development. To have a diagnosis of ADHD, there must have been symptoms before the age of 7, and furthermore, it's much more likely to occur in younger children because their executive functions are less well developed. On the neurological level, there are different dopaminergic systems developing throughout childhood, such as the motor cortex, the prefrontal cortex, and the dopamine-based reward system. If the motor cortex develops too quickly before the PFC, which controls/regulates behavior, well you'll have hyperactivity that's unregulated. With less developed EF's comes getting out of the chair, losing things, daydreaming, hyperactivity, and all of the diagnosable symptoms of ADHD. Naturally, those who are 6-9 months younger (which might be a 10% age difference in kindergarten) are going to be in very different developmental stages. Requiring younger children to sit still and pay attention may be a much more challenging task since their brains are actually less developed. Thus, they more easily get pushed over the diagnosis line compared to their older classmates. There is another wrinkle here beyond age, which is gender: boys are around 2.5-3X as likely to be diagnosed because they are more hyperactive naturally, i.e. their neurological systems develop at different rates than girls. This sort of behavior in the classroom is much more disruptive than what girls exhibit. Girls tend to be diagnosed with primarily inattentive subtype, since their motor cortex is not usually as over-active, but they still may suffer underdevelopment of the EF that helps them to focus. A girl daydreaming is much less disruptive than a boy standing on his chair, rolling on the floor, or wandering the classroom (all of which happened multiple times in my own classroom).
- hour_glass 8y ago
  > ADHD researcher here > (all of which happened multiple times in my own classroom) are you a scientist or a school teacher?
  - deleted 8y ago
    [deleted]
  - simongr3dal 8y ago
    I imagine it is a very natural part of ADHD research to work with children, either as a counselor, teacher, or a supporting teacher.
caymanjim 8y ago
My birthday is in November, and the cutoff when I started school was October 31st. I was always the oldest kid in my grade, all the way through highschool. Back when I went to school, ADHD didn't exist as an identified condition. If it had, I may have been diagnosed. Everything was way too easy for me, and I acted out a bit, perhaps out of boredom, or simply because I had way too much free time. I've always been "book smart", even among people my age, and it was particularly true when I was six months older than the median student in my class and nearly a full year older than some. I'm highly skeptical of ADHD as an actual condition. Some kids clearly have learning and behavioral problems, but I've got plenty friends and family whose kids were diagnosed as ADHD and they are now medicating them into submission. I think most of them are more like me; they're not being stimulated enough at school, or stimulated properly. These kids need better schooling and better parenting. They don't need to be drugged up.
- WhompingWindows 8y ago
  Anecdotal evidence isn't enough. There is actual neurological evidence that those with ADHD have mismatching development of their motor cortex and their PFC which controls the executive functioning of the brain. Most meta analyses of the diagnoses in recent years do not support your skepticism, in fact, some researchers believe the condition is properly or even UNDER diagnosed.
  - caymanjim 8y ago
    I agree. I'm not completely dismissive of the diagnosis. Just highly skeptical of its application. The sad state of modern medicine is that these diagnoses come not from extensive detailed study of every individual by a specialist, but from a few brief Q&A sessions where behavior is compared to a checklist. It's certainly not hard science at the individual level.
    - andkenneth 8y ago
      The hard science went into developing the DSM-5, which is used for diagnosis. We don't need to conduct a study every single time a phychiatrist is presented with a kid who might have ADHD. Yes, the DSM is a checklist but it's a checklist for pretty much every single mental disorder that exists, by definition.
LiterallyDoge 8y ago
Can we stop drugging children and just give them a little more recess?
- black6 8y ago
  When we sit children down to do low-grade, menial clerical tasks for eight hours a day with minimal breaks, what do we expect?
  - vibrio 8y ago
    When we sit adults down to do low-grade, menial clerical tasks for eight hours a day with minimal breaks, what do we expect?
  - bayesian_horse 8y ago
    Adults who can perform knowledge work and have sufficient impulse control. I believe that sitting children down for a couple of years, compulsory, is a strong factor in what we call civilization and the overall decrease in violence. You can think of it a bit like Zen's "just sitting" meditation practice, if you want.
- mholmes680 8y ago
  I believe that's the guiding principal behind Creative Curriculum: https://www.creativecurriculum.net/ https://www.creativecurriculum.net/ My kids' daycare has adopted it. It seems perfect for my daughter who seems self-driven, but maybe too open-ended for my son (who we pushed ahead..so far - mid-november bday with 10/31 cutoff). Or maybe better: https://www.montessori.com/montessori-education/ https://www.montessori.com/montessori-education/
- nixpulvis 8y ago
  I can't say that nobody gets some benefit from the drugs, but having grown up with some friends on them in elementary/middle school I can safely say it's a serious thing to be on, and it's not to be taken lightly. EDIT: I'm talking about drugs like Ritalin.
- tylerjwilk00 8y ago
epmaybe 8y ago
Actual paper (paywall but abstract available): https://www.nejm.org/doi/full/10.1056/NEJMoa1806828?query=featured_home https://www.nejm.org/doi/full/10.1056/NEJMoa1806828?query=fe... One part out of many that interested me in the discussion: "data from insurance claims do not allow us to determine when a child starts school. Parents may delay school entry for children born in August, which would mean that those children start school at 6 years of age rather than 5 years of age. Because we did not directly observe children’s ages when they entered school, we cannot know how often this occurred" There are other confounds, but suffice to say that this is not a very well controlled cohort study. It is however interesting for guiding further research.
dawhizkid 8y ago
Listen to Jordan Peterson on this topic...
- x220 8y ago
  Why don't you quote him? I'll go ahead and summarize it for others: Jordan Peterson, among other things, thinks that we are using drugs to alter the brain structure of little children because they can't sit still for 6 hours a day. He thinks it's harmful and we over-diagnose ADHD in children who act naturally.
  - cma 8y ago
    Don't forget the part about lobster dominance structures apply to human society.
    - deleted 8y ago
      [deleted]
wnevets 8y ago
"Fun" fact in the not so distant past lobotomies were used to treat hyperactivity in children. I wonder if the next generation will look back at the massive drugging of children for ADHD in a similar light.
- bayesian_horse 8y ago
  Probably not, because the benefits and side effects of appropriate ADHD drug treatments are completely reversible and the scientific evidence for treatment being positive is extremely strong.
  - Amezarak 8y ago
    Everyone benefits from taking stimulants. That’s why we drink coffee. The efficacy of ADHD medication is not limited to people with ADHD. Should we all take them? The long-term effects of taking stimulants from childhood onward are not well understood, let alone completely reversible. We’re performing uncontrolled experiments- but that’s nothing new. Not sure creating a situation where people are incentivized to get a diagnoses giving them access to performance enhancing drugs is a great idea, though.
    - bayesian_horse 8y ago
      The line between disease/disorder and "unsatisfactory performance" is drawn somewhat arbitrarily. But in general, those patients with an ADHD diagnosis have much more to gain from "stimulants" than those who do not have this diagnosis. The potential for abuse of a drug should not limit its appropriate use, though this happens all the time. Also, the safety of ADHD medication is quite well understood, and even the long-term effects seem to be less than the disadvantages of the disorder itself. There may still be a lot of room for exact quantification, but at the moment it looks like ADHD medication is a "good deal" in general.
dgzl 8y ago
My best mate in college started using Adderall when he was about 11 and abused it through college. He's growing up to be a high functioning lunatic. My best analogy of him would be a Bender from Futurama, but with a few STEM degrees.
bigpicture 8y ago
In my area, it is very common for parents of boys that will be "young" when starting kindergarten to hold them back a year. They call it redshirting (a reference to US college athletics). Our local school district prohibits the practice, but really can only enforce it at the kindergarten level. So many parents continue to enroll their boys in private preschool for two additional years and then enroll them in first grade when the school district can't say no. It is very rare for girls because of the assumption that emotional and behavioral development is far ahead of boys at that age.
- corpMaverick 8y ago
  I want to do this with mine. He is younger, short and very active.
qazqwert 8y ago
Some might say we expect from our kids and push them for too much... we should let them be kids... I personally wish i was pushed more. (I had to teach my self about the world and....) - let kids be kids Don't fill them up with drugs for being young... i'm not saying you should lower your expectations from them it's just that people these days are getting dumber and want their kids to be better then them (and that's great) but it doesn't mean kids should be drugged to be more like adults Push your kids don't drug them. They're just being kids.
swsieber 8y ago
PSA: If you have ADHD symptoms, the first thing you should do is see if getting enough sleep makes them go away. I'm not saying all ADHD is sleep related, but bad sleep spawns ADHD in otherwise non ADHD people.
- bayesian_horse 8y ago
  The first thing you should do if you see symptoms of virtually any disease/syndrome/disorder is to see a doctor ;-)
- 333c 8y ago
  I'm currently reading "Why We Sleep" [1], which argues (among many other things) that over 50% of children diagnosed with ADHD are actually suffering from a lack of sleep. [1]: https://www.goodreads.com/book/show/34466963-why-we-sleep https://www.goodreads.com/book/show/34466963-why-we-sleep
TangoTrotFox 8y ago
FiveThirtyEight ran an article on ADHD prescriptions [1]. It's getting pretty silly. If people don't know ADHD was not recognized as a disorder until 1968. And the popularity of drugging people for it didn't really take off until the 90s when a pharmaceutical industry astroturfing group called CHADD (Children and Adults with Attention Deficit) started marketing ritalin hard. Since then the use of using various pharmaceutical stimulants has become extremely widespread - jumping up by multiple orders of magnitude. I'm unsure what the latest numbers are but they offer the data to 2013. And just between 2008 and 2013 adult usage of ADHD medication doubled. It was at 2.8% and has likely continued to rapidly increase. That's completed dwarfed by what we're now doing to kids and particularly boys. In 2013 we were up to 9.8% of all boys 12-18 years taking ADHD drugs. And those numbers again were, and presumably still are, rapidly increasing. I have this likely decreasingly controversial view that history is not going to look back so kindly on psychology and our decision to start pretending we can create a pill for everything. I mean what could possibly go wrong getting 10%+ of boys setup with stimulants, and increasingly often other sorts of psychotropics as well, from their earliest and most critical developmental years? ----- Of course I'm sure people will now respond with how these drugs saved their life and without them they'd be homeless, in prison, etc. To these people I have a simple logical question. Let's assume this is true that you would indeed be homeless, in prison, etc without these drugs. We now see these drugs numbers are absolutely skyrocketing to the point that sizable chunks of our entire population are on them. So if we go back in time, why don't we see skyrocketing prison/homelessness/etc as a consequence of people not being able to have these drugs? Given the exponential increase in prescribing rates you don't need to go back far. We should be able to see huge and causably linked differences just over the last decade or two. [1] - https://fivethirtyeight.com/features/dear-mona-how-many-adults-take-adhd-drugs/ https://fivethirtyeight.com/features/dear-mona-how-many-adul...
- bayesian_horse 8y ago
  Treating infections with Penicillin only took off after people figured out it helps a lot.
- RickS 8y ago
  The realities are a lot more mundane than your last paragraph tries to paint them. I was 29 when I finally got treatment (therapy + low dose of adderall). I had been making 100k for years. It's perfectly possible to have an okay life with ADHD. But stuff falls through the cracks. You forget to brush your teeth. To pay your bills. There was a year when I was making over 150k and every single quarter, as often as was possible, my water got shut off to my house. I had to shower at the gym and call the company with my tail between my legs and pay over the phone and it was turned on 2 days later. I had the money. I had the desire to pay the water bill. I just... couldn't. It was stupid. I felt like a caveman, scared that a coworker in my open office would overhear this frantic call and wonder WTF was wrong in my life that I couldn't pay my water bill. I turned down promotions onto the manager track because it felt ethically dubious to manage people when I couldn't even manage myself. Do you want a person who can't remember to pay their water bill to be pulling the strings of your career lader? I stayed on the IC Principal track to try and localize the logistical fallout of my inabilities. It's a little better now. It's not the difference between homelessness and elon musk. It's the difference between a guy who pays his bills on time, has a clean dishwasher, and goes to the dentist, versus a guy who is constantly browbeaten by everyday life as the shit that most people think of as routine and invisible derails you over and over in tragicomic ways. I'm not sure what statistic would capture that. On paper, barring a decrease in collections notices and faster email response time, I appear to be exactly the same person. But my life is better now. There are still cracks in the sidewalk – my life is still pretty scattered, but you're not as likely to lose a leg when you trip on one.
bayesian_horse 8y ago
They don't really talk about the harm that could be done by "overtreating". Between treatment options being quite safe and there being a continuum of maturity/impulse control I would guess it is relatively low. Especially compared to the consequences of ADHD not being treated (lower academic success, lower social abilities, more violence, maybe even addictions later on).
sudosteph 8y ago
It's interesting because one thing about ADHD, and Autism Spectrum disorders too, is that diagnosis is very dependent on people having a base point to compare against. That's why for most of these disorders, you're more likely to be diagnosed if you're 2nd born and 1st born doesn't have it. The parents are familiar with how the first child developed and can see the discrepancy sooner. Meanwhile, in cases like my family, where me, my sister, my Dad, some cousins, and probably my mom's siblings too all fit the criteria for ADHD (we're a family of troublemakers) - my parents couldn't tell anything was off. When my cousins got a diagnosis through school, my parents were skeptical of the whole thing. But the treatment they got for it early on helped a ton and those cousins turned out better adjusted in many ways than my sister and I who didn't get diagnosed til adulthood. It's funny though because now I have a step-niece (no biological relation) and my mom keeps commenting on how crazy well behaved she is, because she doesn't run around every time they go to a restaurant or talk incessantly or constantly run into things... So from her perspective, children without ADHD-behaviors are the abnormal ones. Go figure.
WeAreGoingIn 8y ago
There has always been ADHD around. When my normative group were kids, we climbed trees, played Indian and cowboys and had a lot of outdoor fun. There were some kid or two who was more risky or over the edge, but hey, we had fun. Today, looking back, I would consider some of my childhood friends to have ADHD or some kind of other diagnose. Yesterday, these ADHD-kids, was not a great deal. There were also a lot of local jobs and other opportunities as well that didn’t demanded a high education. Now kids don’t play outdoor and it’s easier to single out the ones with ADHD. Further more people have moved to the cities and there is a greater pressure to study. Today it’s hard to find a decent job for a supporter of a family without a good education. Hence, without a diagnose, these kids would not stand a chance. They need all the help, support and understanding they could get.
- jonhendry18 8y ago
  Even in the old days when there were good jobs for people without high school educations, I'm sure the jails were full of people with ADHD. As they probably are today.
  - ts1543636885 8y ago
    Indeed. https://add.org/undiagnosed-adult-adhd-a-high-cost-for-society/ https://add.org/undiagnosed-adult-adhd-a-high-cost-for-socie...
baryphonic 8y ago
I'm a bit surprised I haven't seen any comments (admittedly, I got too distracted to read them) about the decline of children's free play and the increase in adult-guided activities in America over the past 50 years. I was diagnosed with ADHD when I was 15 and have intermittently suffered through it over the years. I took meds for a while, but I felt like an amped-up zombie and stopped some time during college. Kids have not always gone to school for full 7 hour days starting at age four or five, where they have been subject to strict rules that emphasize obedience to adults and "sitting still." In fact, some research indicates that children at a young age learn best how to regulate themselves through play with other kids, including through games (that they themselves create) and role-playing. Kids figure out how to regulate themselves from each other, not from adults. (This could explain why increases in ADHD, bullying and teen suicide seem to be happening at the same time.) I look back and think that at least in my case, this might explain a bit of my issues. In my case, I think there are probably underlying causes that are only now, years later, being looked at, including pretty serious trouble sleeping and some hormone problems. But I also think that I lacked the child-oriented play that kids really need, and was wound up in adult-guided activities where I didn't learn to govern myself. I'm not anti-schooling, but I do think that the schools have gotten too high-stakes at earlier ages, and we should probably limit younger kids to shorter school days and allow them to engage in relatively hands-off free play with each other. (Of course, this is much easier said than done - teachers unions and the lawyers' guild are quite powerful, and we moms and dads love the free babysitting we get at the public expense.)
eatitraw 8y ago
I am really surprised at all the skepticism about ADHD in this thread. 1) Attention (or executive functioning in general) is normally distributed, just like a lot of other human traits. If you don't doubt that intelligence is normally distributed (and that some people are smarter than other), what makes you think that there is no variability in executive functioning / attention? Executive functioning also improves as brain develops, and that's why problems of younger kids are probably more noticeable. 2) Re: diagnosing using checklists and interviewing. That's literally how every other psychiatric disorder is diagnosed. Depression? Checklists and interviewing. Anxiety? Checklists and interviewing. Schizophrenia? Also checklists and interviewing. Studies show that there are measurable differences between ADHD brains and normal brains. People complain that these are not used for diagnosis. The reason these scans are not used for diagnosis is because the resolution of common brain scan methods is not high enough, and these differences are seen on the population level. 3) Some graphs on brains differences: https://adhd-institute.com/burden-of-adhd/aetiology/neurobiology/ https://adhd-institute.com/burden-of-adhd/aetiology/neurobio...
- devoply 8y ago
  Maybe the ADHD brain is the normal brain and there is something abnormal about domesticated human brains, the ones that conform to the needs of modern corporations and the schooling system that supports them. Maybe the ADHD brain is a better hunter gatherer / forager brain.
  - eatitraw 8y ago
    There is a 'hunter vs farmer hypothesis'. It is certainly a cute idea. But even if it is true, the society isn't going back to back to persistence hunting. There is some real human suffering right now (simply by definition from DSM - if there is no impairment, it is not ADHD). "I guess I picked the wrong time to be a human being".
    - devoply 8y ago
      So we eliminated the ADHD brains only to found most of our jobs automated and most of our schooling irrelevant.
crazy1van 8y ago
This first part of this article about the realities of diagnosing ADHD is worthwhile reading: http://slatestarcodex.com/2017/12/28/adderall-risks-much-more-than-you-wanted-to-know/ http://slatestarcodex.com/2017/12/28/adderall-risks-much-mor... One particularly interesting quote: "Trust me, no matter how unsuitable a candidate you are, no matter how bad a liar you are, somewhere there is a psychiatrist who will give you Adderall. And by “somewhere”, I mean it will take you three tries, tops."
- roguecoder 8y ago
  Ironically, having ADHD makes it much harder to do all those things required to get Adderall.
agigao 8y ago
https://m.soundcloud.com/instituteofartandideas/e123-minds-madness-and-medicine-lucy-johnstone-david-nutt-david-healy https://m.soundcloud.com/instituteofartandideas/e123-minds-m...
roguecoder 8y ago
It is surprising to me that people are so dubious of ADHD when for people with the disorder who metabolize caffein normally diagnosis is remarkably simple: give a six year old a cup of coffee. If they settle down or go take a nap, they quite likely have ADHD. Give a neurotypical kid a cup of coffee and then live with the results because no way are the parents going to thank you for helpfully demonstrating how normal their child is.

167 points by Reedx 8y ago

This is a striking statistic: "...children born in August in those states are 30 percent more likely to receive an ADHD diagnosis, compared with their slightly older peers enrolled in the same grade."

rusabd 8y ago
It is similar to hockey paradox when NHL players are most likely to be born in December
- dudul 8y ago
  How is it a "paradox"? It makes total sense that kids older and bigger will dominate most sports. It will re-enforce their self esteem and confidence and help them get even better. I don't dispute the phenomenon, I've never heard it called a "paradox".
  - mathgeek 8y ago
    I think what was meant here is the Relative Age Effect: https://en.wikipedia.org/wiki/Relative_age_effect https://en.wikipedia.org/wiki/Relative_age_effect Many here probably recall if from Super Freakonomics.
    - rusabd 8y ago
      Ah, "effect", of course. This is what I meant
  - SilasX 8y ago
    Sufficiently unintuitive reality is indistinguishable from paradox.
  - rusabd 8y ago
    Well, I made a mistake by saying that "NHL players most likely to be born in December" when in fact they most likely to be born in January. December is the horrible month to be born for a future NHL star (https://www.quanthockey.com/nhl/birth-month-totals/nhl-players-career-stats.html https://www.quanthockey.com/nhl/birth-month-totals/nhl-playe...). So it is not that obvious, isn't it? :)
Oletros 8y ago
Is there a cut for date for starting school? Here in Spain, everyone born in the same year goes to the same class, is it different in USA?
- dudul 8y ago
  As per the article itself, many states implement the "1st of September cut date". A kid born in September has to wait an entire year to start school compared to one born on 08/31.
  - throwaway123032 8y ago
    And in Switzerland, 1st August. Retardness.
- bigpicture 8y ago
  > Here in Spain, everyone born in the same year goes to the same class, is it different in USA? So Spain has a cut date of 1 Jan while the USA is 1 Sept. The overall effect is exactly the same: When a school term begins, some of the students will be nearly 1 year older than some of the others.
WhompingWindows 8y ago
It's yet another piece of evidence that ADHD is a developmental disorder, it develops over time, and those who are younger have brains which are underdeveloped. Their ability to tamp down disruptive behaviors and use executive functioning to effectively manage planning is reduced compared to other children. So, in younger children, those who are borderline ADHD will appear to be more solidly ADHD, and those with moderate or severe ADHD will seem to have worse symptoms, as we're putting them in a classroom and comparing them with children whose brains have a higher EF capacity. It's also worthwhile to note that the gold standard diagnosis of ADHD involves observation of childrens' behavior in the classroom, where they will be compared to older, more neuro-developed classmates.
- jonhendry18 8y ago
  Except sometimes it doesn't go away with age.
x220 8y ago
It's almost as if we diagnose children with ADHD for acting how healthy young children naturally act.
- bayesian_horse 8y ago
  The problem is that children with ADHD are acting somewhat how healthy - but much younger - children naturally act. There seems to be another component though. Adults with ADHD can be quite "mature" in most respects, while still having trouble related to the disorder. Hyperactivity and lack of impulse control are only part of the disorder, and not necessarily that pronounced.
24gttghh 8y ago
I think it would make more sense to have an evidence-based determination for what grade a child should start in, rather than some arbitrary cut-off date like we have now.

dudul 8y ago

My kid was born in September and I remember my wife doing a little research around that "for fun" (yeah, that's how she has fun) a while ago, how kids far and/or close to the cut off do. She found a few studies mentioning that older kids (like born between September and February or something) were doing way better in terms of the academics as well. Which in a way makes sense, but maybe indicates that either children start school too young or that programs are too agressive.

ngngngng 8y ago
On that note, my little brother repeated a year for academic reasons, but it also had benefits on sports. He's older than nearly anyone else in his grade (12th), and he's just about the best swimmer in the state. I only see positive benefits from his repeating a grade.
gizmo686 8y ago
I don't think it indicates that students start too young, as much as 1 year increments is too granular for grouping young children.
- dudul 8y ago
  That's a good point yeah. But I think when I said that younger kids didn't do as well it meant both in terms of ranking (they were in the lowest percentiles) which indicates that they don't do as well as their peer, but also in terms of future opportunities to attend college or university.
- pbhjpbhj 8y ago
  This. My older kids have birthdays later in the academic year but have ended up in groups for more advanced students. Mind, nursery was a complete wash when it came to academics -- learning to count to 3 when you can already count to 20 is rather futile. Public schools just can't tailor to individual students. Socially though, nursery was well timed for them IMO.
thetest3r 8y ago
https://www.businessinsider.com/how-your-birthday-affects-your-chances-of-success-2014-7 https://www.businessinsider.com/how-your-birthday-affects-yo...

DoubleCribble 8y ago

The September 1st cutoff for Kindergarten is treated as a distinct milestone when it really should be treated as part of a developmental window. As far as California is concerned, if you have a kid born on September 1st, they get 2 years of Kindergarten (TK + K). If their sibling happens to be born on August 31st, they get 1 year of Kindergarten (K only). And that 1 day distinction could be the difference between a childhood of grade appropriate behavior (older, more mature) or being labeled as ADHD (younger, less mature) with many years of drug treatment to look forward to.

povertyworld 8y ago

Anecdata, but this was my experience. I have a November birthday, and the school district in Massachusetts gave my parents the option of having me start a year younger than everyone or wait a year. My parents opted to send me to school a year earlier. I performed poorly, and at one point was labeled with ADHD. On the standardized tests they gave in 6th grade I scored at the 12th grade level, so I don't think my problems were cognitive as much as behavioral. Also, in high school having some peers who have been held back a grade being 15 years old while one is just turning 13 can lead to some rather unpleasant physical bullying. I often wonder how those early experiences may have limited my life. I was so tempted to send that article to my mom, but I didn't know how she would take it.

unixhero 8y ago
Do it. You deserve closure.
jonhendry18 8y ago
I was born in September, so was usually younger than most of my grade peers. Did fine in K-6. Behavior was never an issue. But I was diagnosed with ADHD in college.
- povertyworld 8y ago
  By behavior I mean not doing the class work.

ravenstine 8y ago

I don't dispute that ADHD is an observance of a real phenomenon, but maybe the prevalence of the diagnosis is a result of society overoptimizing human productivity? Having ADHD, especially now that ADD is ADHD-PI, seems very normal these days, but it we treat it more like an affliction than a common behavior the modern world needs more compassion towards. If I have a child and they seem to have ADHD, I would pull them out of the public school system so as they don't have their time wasted and their esteem destroyed. If the system doesn't become more understanding, then it's up to me. At least then my child can be brought up to learn good coping mechanisms they'd be lucky to otherwise learn before it's too late.

WhompingWindows 8y ago
I researched ADHD and was a teacher to boot. You wouldn't think it's about human productivity when you have ADHD children standing on their chairs, shouting, wandering the classroom during examinations. It's a serious neurological disability and it's not just down to societal pressures for productivity. Some sad facts: Those with ADHD are much more likely to be friendless, to have fights with parents, to abuse alcohol, nicotine, marijuana, and cocaine, and to develop mental health problems like depression, anxiety, and conduct disorder. The brain of those with ADHD is not "normally" developed and that leads to a lot of issues.
- all_factz 8y ago
  Another sad fact: medicating such kids is often a problematic solution. ADHD drugs make one lethargic and just feel "off" (according to my sister, who was on them for a long time). What we need are more vocational schools to give the "hyperactive" among us a realistic, career-oriented outlet.
  - 2trill2spill 8y ago
    I got "diagnosed" with ADHD and tried taking the medicine for two weeks and it was terrible. What's the point of doing better in school if you feel terrible, lose your appetite, and have problems sleeping?

ende 8y ago

Get rid of a single long summer break and the entire concept of a “school year”. Divide the year into quarters. Students can start in summer, spring, winter, or fall.

rtkwe 8y ago
> Students can start in summer, spring, winter, or fall That's much harder to do than it sounds because now you have 4 groups 3 months apart in the curriculum. The only way to really do it would be to segregate the kids from the different start times into separate classes otherwise it'd be pretty impossible to teach. There will also be a slight variation in class size depending on the quarter it's for. as August and September are over represented as birthdays. I do think year round schools probably make more sense overall so there's not such a huge gap where kids forget so much.
- bigpicture 8y ago
  My local elementary school has 3 classrooms per grade. If we broke the year into quarters and made each student attend 3 out of 4 quarters, what you'd end up with is more efficient use of school facilities making up for a slightly higher teacher cost. Probably.
  - rtkwe 8y ago
    I think before we do rolling quarters moving to a year round schedule would do more to improve student performance than the more granular age groupings. Could also just group the kids into however many classrooms are in each school to do both.

WhompingWindows 8y ago

ADHD researcher here, this was already known. ADHD is a neurodevelopmental disorder, the key is that developmental disorders occur over the time-course of typical development. To have a diagnosis of ADHD, there must have been symptoms before the age of 7, and furthermore, it's much more likely to occur in younger children because their executive functions are less well developed. On the neurological level, there are different dopaminergic systems developing throughout childhood, such as the motor cortex, the prefrontal cortex, and the dopamine-based reward system. If the motor cortex develops too quickly before the PFC, which controls/regulates behavior, well you'll have hyperactivity that's unregulated. With less developed EF's comes getting out of the chair, losing things, daydreaming, hyperactivity, and all of the diagnosable symptoms of ADHD. Naturally, those who are 6-9 months younger (which might be a 10% age difference in kindergarten) are going to be in very different developmental stages. Requiring younger children to sit still and pay attention may be a much more challenging task since their brains are actually less developed. Thus, they more easily get pushed over the diagnosis line compared to their older classmates. There is another wrinkle here beyond age, which is gender: boys are around 2.5-3X as likely to be diagnosed because they are more hyperactive naturally, i.e. their neurological systems develop at different rates than girls. This sort of behavior in the classroom is much more disruptive than what girls exhibit. Girls tend to be diagnosed with primarily inattentive subtype, since their motor cortex is not usually as over-active, but they still may suffer underdevelopment of the EF that helps them to focus. A girl daydreaming is much less disruptive than a boy standing on his chair, rolling on the floor, or wandering the classroom (all of which happened multiple times in my own classroom).

hour_glass 8y ago
> ADHD researcher here > (all of which happened multiple times in my own classroom) are you a scientist or a school teacher?
- deleted 8y ago
  [deleted]
- simongr3dal 8y ago
  I imagine it is a very natural part of ADHD research to work with children, either as a counselor, teacher, or a supporting teacher.

caymanjim 8y ago

My birthday is in November, and the cutoff when I started school was October 31st. I was always the oldest kid in my grade, all the way through highschool. Back when I went to school, ADHD didn't exist as an identified condition. If it had, I may have been diagnosed. Everything was way too easy for me, and I acted out a bit, perhaps out of boredom, or simply because I had way too much free time. I've always been "book smart", even among people my age, and it was particularly true when I was six months older than the median student in my class and nearly a full year older than some. I'm highly skeptical of ADHD as an actual condition. Some kids clearly have learning and behavioral problems, but I've got plenty friends and family whose kids were diagnosed as ADHD and they are now medicating them into submission. I think most of them are more like me; they're not being stimulated enough at school, or stimulated properly. These kids need better schooling and better parenting. They don't need to be drugged up.

WhompingWindows 8y ago
Anecdotal evidence isn't enough. There is actual neurological evidence that those with ADHD have mismatching development of their motor cortex and their PFC which controls the executive functioning of the brain. Most meta analyses of the diagnoses in recent years do not support your skepticism, in fact, some researchers believe the condition is properly or even UNDER diagnosed.
- caymanjim 8y ago
  I agree. I'm not completely dismissive of the diagnosis. Just highly skeptical of its application. The sad state of modern medicine is that these diagnoses come not from extensive detailed study of every individual by a specialist, but from a few brief Q&A sessions where behavior is compared to a checklist. It's certainly not hard science at the individual level.
  - andkenneth 8y ago
    The hard science went into developing the DSM-5, which is used for diagnosis. We don't need to conduct a study every single time a phychiatrist is presented with a kid who might have ADHD. Yes, the DSM is a checklist but it's a checklist for pretty much every single mental disorder that exists, by definition.

LiterallyDoge 8y ago

Can we stop drugging children and just give them a little more recess?

black6 8y ago
When we sit children down to do low-grade, menial clerical tasks for eight hours a day with minimal breaks, what do we expect?
- vibrio 8y ago
  When we sit adults down to do low-grade, menial clerical tasks for eight hours a day with minimal breaks, what do we expect?
- bayesian_horse 8y ago
  Adults who can perform knowledge work and have sufficient impulse control. I believe that sitting children down for a couple of years, compulsory, is a strong factor in what we call civilization and the overall decrease in violence. You can think of it a bit like Zen's "just sitting" meditation practice, if you want.
mholmes680 8y ago
I believe that's the guiding principal behind Creative Curriculum: https://www.creativecurriculum.net/ https://www.creativecurriculum.net/ My kids' daycare has adopted it. It seems perfect for my daughter who seems self-driven, but maybe too open-ended for my son (who we pushed ahead..so far - mid-november bday with 10/31 cutoff). Or maybe better: https://www.montessori.com/montessori-education/ https://www.montessori.com/montessori-education/
nixpulvis 8y ago
I can't say that nobody gets some benefit from the drugs, but having grown up with some friends on them in elementary/middle school I can safely say it's a serious thing to be on, and it's not to be taken lightly. EDIT: I'm talking about drugs like Ritalin.
tylerjwilk00 8y ago

epmaybe 8y ago

Actual paper (paywall but abstract available): https://www.nejm.org/doi/full/10.1056/NEJMoa1806828?query=featured_home https://www.nejm.org/doi/full/10.1056/NEJMoa1806828?query=fe... One part out of many that interested me in the discussion: "data from insurance claims do not allow us to determine when a child starts school. Parents may delay school entry for children born in August, which would mean that those children start school at 6 years of age rather than 5 years of age. Because we did not directly observe children’s ages when they entered school, we cannot know how often this occurred" There are other confounds, but suffice to say that this is not a very well controlled cohort study. It is however interesting for guiding further research.

dawhizkid 8y ago

Listen to Jordan Peterson on this topic...

x220 8y ago
Why don't you quote him? I'll go ahead and summarize it for others: Jordan Peterson, among other things, thinks that we are using drugs to alter the brain structure of little children because they can't sit still for 6 hours a day. He thinks it's harmful and we over-diagnose ADHD in children who act naturally.
- cma 8y ago
  Don't forget the part about lobster dominance structures apply to human society.
  - deleted 8y ago
    [deleted]

wnevets 8y ago

"Fun" fact in the not so distant past lobotomies were used to treat hyperactivity in children. I wonder if the next generation will look back at the massive drugging of children for ADHD in a similar light.

bayesian_horse 8y ago
Probably not, because the benefits and side effects of appropriate ADHD drug treatments are completely reversible and the scientific evidence for treatment being positive is extremely strong.
- Amezarak 8y ago
  Everyone benefits from taking stimulants. That’s why we drink coffee. The efficacy of ADHD medication is not limited to people with ADHD. Should we all take them? The long-term effects of taking stimulants from childhood onward are not well understood, let alone completely reversible. We’re performing uncontrolled experiments- but that’s nothing new. Not sure creating a situation where people are incentivized to get a diagnoses giving them access to performance enhancing drugs is a great idea, though.
  - bayesian_horse 8y ago
    The line between disease/disorder and "unsatisfactory performance" is drawn somewhat arbitrarily. But in general, those patients with an ADHD diagnosis have much more to gain from "stimulants" than those who do not have this diagnosis. The potential for abuse of a drug should not limit its appropriate use, though this happens all the time. Also, the safety of ADHD medication is quite well understood, and even the long-term effects seem to be less than the disadvantages of the disorder itself. There may still be a lot of room for exact quantification, but at the moment it looks like ADHD medication is a "good deal" in general.

dgzl 8y ago

My best mate in college started using Adderall when he was about 11 and abused it through college. He's growing up to be a high functioning lunatic. My best analogy of him would be a Bender from Futurama, but with a few STEM degrees.

bigpicture 8y ago

In my area, it is very common for parents of boys that will be "young" when starting kindergarten to hold them back a year. They call it redshirting (a reference to US college athletics). Our local school district prohibits the practice, but really can only enforce it at the kindergarten level. So many parents continue to enroll their boys in private preschool for two additional years and then enroll them in first grade when the school district can't say no. It is very rare for girls because of the assumption that emotional and behavioral development is far ahead of boys at that age.

corpMaverick 8y ago
I want to do this with mine. He is younger, short and very active.

qazqwert 8y ago

Some might say we expect from our kids and push them for too much... we should let them be kids... I personally wish i was pushed more. (I had to teach my self about the world and....) - let kids be kids Don't fill them up with drugs for being young... i'm not saying you should lower your expectations from them it's just that people these days are getting dumber and want their kids to be better then them (and that's great) but it doesn't mean kids should be drugged to be more like adults Push your kids don't drug them. They're just being kids.

swsieber 8y ago

PSA: If you have ADHD symptoms, the first thing you should do is see if getting enough sleep makes them go away. I'm not saying all ADHD is sleep related, but bad sleep spawns ADHD in otherwise non ADHD people.

bayesian_horse 8y ago
The first thing you should do if you see symptoms of virtually any disease/syndrome/disorder is to see a doctor ;-)
333c 8y ago
I'm currently reading "Why We Sleep" [1], which argues (among many other things) that over 50% of children diagnosed with ADHD are actually suffering from a lack of sleep. [1]: https://www.goodreads.com/book/show/34466963-why-we-sleep https://www.goodreads.com/book/show/34466963-why-we-sleep

TangoTrotFox 8y ago

FiveThirtyEight ran an article on ADHD prescriptions [1]. It's getting pretty silly. If people don't know ADHD was not recognized as a disorder until 1968. And the popularity of drugging people for it didn't really take off until the 90s when a pharmaceutical industry astroturfing group called CHADD (Children and Adults with Attention Deficit) started marketing ritalin hard. Since then the use of using various pharmaceutical stimulants has become extremely widespread - jumping up by multiple orders of magnitude. I'm unsure what the latest numbers are but they offer the data to 2013. And just between 2008 and 2013 adult usage of ADHD medication doubled. It was at 2.8% and has likely continued to rapidly increase. That's completed dwarfed by what we're now doing to kids and particularly boys. In 2013 we were up to 9.8% of all boys 12-18 years taking ADHD drugs. And those numbers again were, and presumably still are, rapidly increasing. I have this likely decreasingly controversial view that history is not going to look back so kindly on psychology and our decision to start pretending we can create a pill for everything. I mean what could possibly go wrong getting 10%+ of boys setup with stimulants, and increasingly often other sorts of psychotropics as well, from their earliest and most critical developmental years? ----- Of course I'm sure people will now respond with how these drugs saved their life and without them they'd be homeless, in prison, etc. To these people I have a simple logical question. Let's assume this is true that you would indeed be homeless, in prison, etc without these drugs. We now see these drugs numbers are absolutely skyrocketing to the point that sizable chunks of our entire population are on them. So if we go back in time, why don't we see skyrocketing prison/homelessness/etc as a consequence of people not being able to have these drugs? Given the exponential increase in prescribing rates you don't need to go back far. We should be able to see huge and causably linked differences just over the last decade or two. [1] - https://fivethirtyeight.com/features/dear-mona-how-many-adults-take-adhd-drugs/ https://fivethirtyeight.com/features/dear-mona-how-many-adul...

bayesian_horse 8y ago
Treating infections with Penicillin only took off after people figured out it helps a lot.
RickS 8y ago
The realities are a lot more mundane than your last paragraph tries to paint them. I was 29 when I finally got treatment (therapy + low dose of adderall). I had been making 100k for years. It's perfectly possible to have an okay life with ADHD. But stuff falls through the cracks. You forget to brush your teeth. To pay your bills. There was a year when I was making over 150k and every single quarter, as often as was possible, my water got shut off to my house. I had to shower at the gym and call the company with my tail between my legs and pay over the phone and it was turned on 2 days later. I had the money. I had the desire to pay the water bill. I just... couldn't. It was stupid. I felt like a caveman, scared that a coworker in my open office would overhear this frantic call and wonder WTF was wrong in my life that I couldn't pay my water bill. I turned down promotions onto the manager track because it felt ethically dubious to manage people when I couldn't even manage myself. Do you want a person who can't remember to pay their water bill to be pulling the strings of your career lader? I stayed on the IC Principal track to try and localize the logistical fallout of my inabilities. It's a little better now. It's not the difference between homelessness and elon musk. It's the difference between a guy who pays his bills on time, has a clean dishwasher, and goes to the dentist, versus a guy who is constantly browbeaten by everyday life as the shit that most people think of as routine and invisible derails you over and over in tragicomic ways. I'm not sure what statistic would capture that. On paper, barring a decrease in collections notices and faster email response time, I appear to be exactly the same person. But my life is better now. There are still cracks in the sidewalk – my life is still pretty scattered, but you're not as likely to lose a leg when you trip on one.

bayesian_horse 8y ago

They don't really talk about the harm that could be done by "overtreating". Between treatment options being quite safe and there being a continuum of maturity/impulse control I would guess it is relatively low. Especially compared to the consequences of ADHD not being treated (lower academic success, lower social abilities, more violence, maybe even addictions later on).

sudosteph 8y ago

It's interesting because one thing about ADHD, and Autism Spectrum disorders too, is that diagnosis is very dependent on people having a base point to compare against. That's why for most of these disorders, you're more likely to be diagnosed if you're 2nd born and 1st born doesn't have it. The parents are familiar with how the first child developed and can see the discrepancy sooner. Meanwhile, in cases like my family, where me, my sister, my Dad, some cousins, and probably my mom's siblings too all fit the criteria for ADHD (we're a family of troublemakers) - my parents couldn't tell anything was off. When my cousins got a diagnosis through school, my parents were skeptical of the whole thing. But the treatment they got for it early on helped a ton and those cousins turned out better adjusted in many ways than my sister and I who didn't get diagnosed til adulthood. It's funny though because now I have a step-niece (no biological relation) and my mom keeps commenting on how crazy well behaved she is, because she doesn't run around every time they go to a restaurant or talk incessantly or constantly run into things... So from her perspective, children without ADHD-behaviors are the abnormal ones. Go figure.

WeAreGoingIn 8y ago

There has always been ADHD around. When my normative group were kids, we climbed trees, played Indian and cowboys and had a lot of outdoor fun. There were some kid or two who was more risky or over the edge, but hey, we had fun. Today, looking back, I would consider some of my childhood friends to have ADHD or some kind of other diagnose. Yesterday, these ADHD-kids, was not a great deal. There were also a lot of local jobs and other opportunities as well that didn’t demanded a high education. Now kids don’t play outdoor and it’s easier to single out the ones with ADHD. Further more people have moved to the cities and there is a greater pressure to study. Today it’s hard to find a decent job for a supporter of a family without a good education. Hence, without a diagnose, these kids would not stand a chance. They need all the help, support and understanding they could get.

jonhendry18 8y ago
Even in the old days when there were good jobs for people without high school educations, I'm sure the jails were full of people with ADHD. As they probably are today.
- ts1543636885 8y ago
  Indeed. https://add.org/undiagnosed-adult-adhd-a-high-cost-for-society/ https://add.org/undiagnosed-adult-adhd-a-high-cost-for-socie...

baryphonic 8y ago

I'm a bit surprised I haven't seen any comments (admittedly, I got too distracted to read them) about the decline of children's free play and the increase in adult-guided activities in America over the past 50 years. I was diagnosed with ADHD when I was 15 and have intermittently suffered through it over the years. I took meds for a while, but I felt like an amped-up zombie and stopped some time during college. Kids have not always gone to school for full 7 hour days starting at age four or five, where they have been subject to strict rules that emphasize obedience to adults and "sitting still." In fact, some research indicates that children at a young age learn best how to regulate themselves through play with other kids, including through games (that they themselves create) and role-playing. Kids figure out how to regulate themselves from each other, not from adults. (This could explain why increases in ADHD, bullying and teen suicide seem to be happening at the same time.) I look back and think that at least in my case, this might explain a bit of my issues. In my case, I think there are probably underlying causes that are only now, years later, being looked at, including pretty serious trouble sleeping and some hormone problems. But I also think that I lacked the child-oriented play that kids really need, and was wound up in adult-guided activities where I didn't learn to govern myself. I'm not anti-schooling, but I do think that the schools have gotten too high-stakes at earlier ages, and we should probably limit younger kids to shorter school days and allow them to engage in relatively hands-off free play with each other. (Of course, this is much easier said than done - teachers unions and the lawyers' guild are quite powerful, and we moms and dads love the free babysitting we get at the public expense.)

eatitraw 8y ago

I am really surprised at all the skepticism about ADHD in this thread. 1) Attention (or executive functioning in general) is normally distributed, just like a lot of other human traits. If you don't doubt that intelligence is normally distributed (and that some people are smarter than other), what makes you think that there is no variability in executive functioning / attention? Executive functioning also improves as brain develops, and that's why problems of younger kids are probably more noticeable. 2) Re: diagnosing using checklists and interviewing. That's literally how every other psychiatric disorder is diagnosed. Depression? Checklists and interviewing. Anxiety? Checklists and interviewing. Schizophrenia? Also checklists and interviewing. Studies show that there are measurable differences between ADHD brains and normal brains. People complain that these are not used for diagnosis. The reason these scans are not used for diagnosis is because the resolution of common brain scan methods is not high enough, and these differences are seen on the population level. 3) Some graphs on brains differences: https://adhd-institute.com/burden-of-adhd/aetiology/neurobiology/ https://adhd-institute.com/burden-of-adhd/aetiology/neurobio...

devoply 8y ago
Maybe the ADHD brain is the normal brain and there is something abnormal about domesticated human brains, the ones that conform to the needs of modern corporations and the schooling system that supports them. Maybe the ADHD brain is a better hunter gatherer / forager brain.
- eatitraw 8y ago
  There is a 'hunter vs farmer hypothesis'. It is certainly a cute idea. But even if it is true, the society isn't going back to back to persistence hunting. There is some real human suffering right now (simply by definition from DSM - if there is no impairment, it is not ADHD). "I guess I picked the wrong time to be a human being".
  - devoply 8y ago
    So we eliminated the ADHD brains only to found most of our jobs automated and most of our schooling irrelevant.

crazy1van 8y ago

This first part of this article about the realities of diagnosing ADHD is worthwhile reading: http://slatestarcodex.com/2017/12/28/adderall-risks-much-more-than-you-wanted-to-know/ http://slatestarcodex.com/2017/12/28/adderall-risks-much-mor... One particularly interesting quote: "Trust me, no matter how unsuitable a candidate you are, no matter how bad a liar you are, somewhere there is a psychiatrist who will give you Adderall. And by “somewhere”, I mean it will take you three tries, tops."

roguecoder 8y ago
Ironically, having ADHD makes it much harder to do all those things required to get Adderall.

agigao 8y ago

https://m.soundcloud.com/instituteofartandideas/e123-minds-madness-and-medicine-lucy-johnstone-david-nutt-david-healy https://m.soundcloud.com/instituteofartandideas/e123-minds-m...

roguecoder 8y ago

It is surprising to me that people are so dubious of ADHD when for people with the disorder who metabolize caffein normally diagnosis is remarkably simple: give a six year old a cup of coffee. If they settle down or go take a nap, they quite likely have ADHD. Give a neurotypical kid a cup of coffee and then live with the results because no way are the parents going to thank you for helpfully demonstrating how normal their child is.