Is ADHD Really a Brain Condition? Five Experts Debate the Evidence

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From the Teachers Talk Radio podcast. “Is ADHD best understood as a brain condition, a useful diagnostic construct or a label for a collection of behaviours and experiences?

Professor Joanna Moncrieff, Professor Philip Asherson, Dr Lucy Johnstone, Dr Naomi Fisher and Chris Benson debate what the evidence actually shows, whether psychiatric diagnosis provides a meaningful explanation and whether the current system is helping children or locating problems within them that may partly belong to their environment.

This discussion followed Channel 4’s controversial documentary, “The Great ADHD Myth“.

8 COMMENTS

  1. This was a very interesting debate to participate in…. In one corner, two leading advocates for ADHD – one a leading professor of genetics, and one representing the ADHD-UK charity which has made a series of complaints about the programme. In another corner…. critical perspectives represented by Joanna and me. And somewhere in the middle, Naomi Fisher who hosts a podcast which tries to promote debate on all sides. It was heated at times. But I think it did establish that we need to have the discussion, which in the UK is fairly new.

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  2. I wanted to see more focus on the actual question as to whether this is a “brain problem.” Johanna stated clearly at the start, and Lucy reiterated, that no one is saying these issues don’t present difficulties. There was literally zero evidence presented to counter Johanna’s initial presentation, but the moderator allowed the discussion to be derailed into “do they need help?” So I guess the answer is, “No, there’s no evidence of a brain problem.” I’d have liked to see that emphasized. The video cut off, so maybe that was revisited at the end.

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  3. I can’t take the concept of adult ADHD seriously. Of course people have problems. But why put these problems into an amorphous category called ADHD.

    The NYT had an article on this supposed condition (I don’t remember when they had this particular article). The comments indicated people attributed numerous difficulties in their lives to ADHD.

    I kept a record of some of the comments written by people who were finally diagnosed with ADHD. One person said they were talkative, impulsive and easily bored. Another had anger attacks. Someone else had been a daydreaming kid who had to be interested in a subject in order to get involved in it (that person “realized” they had ADHD at the age of 72). Another had overwhelming anxiety when starting a new job. Someone said that they struggled to be on time, was unorganized, and switched from one interest to another. Maybe my favorite is the one who claimed to be a fun conversationalist but had difficulty maintaining friendships (this individual was diagnosed at the age of 83.

    All these people were thrilled to believe that their difficulties could be attributed to ADHD and not a personal failing. A category that is so broad can’t be meaningful.

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  4. I think we have to remember that the diagnostic tools and awareness we have of ADHD today simply did not exist to the same degree in the early 2000s. We are still coming to grips with how often ADHD was missed, particularly in women, whose symptoms may present differently from the traditional stereotype. The more productive debate should be about ensuring the diagnosis is accurate and appropriately verified—not debating whether adult ADHD itself is real.

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    • How can we assure that “diagnosis is accurate” when there is no objective way to determine who qualifies for the “diagnosis?” What “diagnostic tools” can possibly test for something whose criteria include “has difficulty waiting his turn” or “does not seem to listen when spoken to directly?” What are the objective tests for turn-waiting, and what are the threshold criteria for excessive “turn impatience?” The concept is so vague and subjective that the idea of testing for it is laughable for any real scientist. Of course, psychiatry has little to do with science and a lot to do with marketing.

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      • Why do [we] have an urge, a compulsion, a desire to diagnose? Because the Governments’ people and their associates (“experts”, special interest groups, et al.) say so?!

        “The experiences are real”!
        When you or I have an experience that is real, we are told to do a reality check (some level of reflection) and adapt to the situation as seen fit.

        When a teacher, educator has a real experience, they reflect on others’ behaviours, and continue to pursue that line, until the other changes or is changed (medications) or is moved to another class, school, or some other interventions (mostly useless and humiliating for the child) are employed.

        Given that a teacher is in a class with some 20 (give or take) children, is this not an unnatural set-up, in today’s society, given that the 3Rs have been expanded into many more additional domains?

        Teachers now have to fulfil new roles, new topics, new subjects, new technology, new methods, new criteria, new Standards, new legalities, new policies, et cetera, and nothing towards their physical presence has been added to. Surely the addition of a fully qualified and experienced enough education assistant would be in the best interests of the teacher, the children, relevant others, the community, and society?

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  5. ADHD as reflected in preschool and primary school environments is more an indication of the environment and the adults in those environments, along with their attitudes and mindsets that have been influenced to travel down the path of blaming, scapegoating, targeting individual children, individual parents, individual families.

    ADHD has become a financial game.

    Costs of managing a classroom with ADHD inclusion now depends on criteria of getting a diagnosis, the school per se receiving funding, and only then will the child be acknowledged as requiring adjustments and or accommodations.

    As mentioned, years can go by, and the child’s behaviour worsens.

    This is a reflection on the educators, teachers, leadership, and their capacities and capabilities to fulfil their roles as intended.

    To not “differentiate” as required in normal teaching practices, surely is a sign and symptom of ineffective delivery of scope and sequence.

    The OBSERVATIONS OF BEHAVIOURS in children showing ADHD are being clustered into a medical model of symptoms.

    fMRI are meaningless laboratory samples, under unnatural circumstances, that demonstrate what happens under those specifically created conditions. The results cannot be generalised into a classroom with its own population, all of its moment to moment variables, expectations, transitions, and other facets and dimensions.

    It is well known that life is learnt about by mimicking and copying and conditioning and rewarding and punishing. A school environment is the perfect host for contagions. What is fed, grows.

    To watch child/ren being ignored, being left behind, being talked about behind their backs by teachers and staff, being left unattended to, and being given no routine beneficial inputs, is a school climate, school culture, school environment “it” thing.

    To not attend to a child’s learning needs, learning rights, because the school has not received additional funding surely lies outside all Ethical and Codes of conduct and practice and Standards.

    Not only do schools per se refuse to act without additional funding, but once funding is received in the name of the ADHD diagnosed child, that funding is not directed to the child and their leaning needs. The funding can be used in any way that the school per se chooses. The ADHD diagnosed child, may not directly benefit at all.

    ADHD diagnosis also equates to financial allowances for the parent/s.

    The systems should be stripped of additional funding. Educators and teachers need to be inclusive in their methods of teaching.

    Schools should receive funding for qualified teacher assistants to be present with teachers in classes that need more oversight. This will not be entertained as the costs burdens will fall onto the school and its budgeting and the local Education Departments’ willingness to provide more funds for additional staff.

    The ADHD money trail has parents paying for reports, parents paying for and medicating their offspring, parents buying additional resources, parents putting in the effort, which is bizarre, since the ADHD is a school environment thing, and the school receives the funds, which are spent (usually) elsewhere. What the child receives is a “behaviour plan” that is prepared by the school’s counsellor, class teacher.

    What has been achieved? Money for the school.

    What changes in the teacher?
    What changes in the classroom?

    Subduing a child with known mind-altering drugs that are known to cause unnatural brain adaptations that are not normal ought to be seen for what it is – poisoning.

    fMRI is nothing more than a tool for furthering confirmation biases.

    Teachers, educators, are not a given, that they are loving and kind and nurturing and interested and genuinely concerned; and school principals, are now holding degrees in Business Administration and Management.

    It is ridiculous to put on children and families the lack of control per se, that happens in school environments. Why not openly say that the child’s unruly behaviour stems from the school environment? It then shows up in homes. It then shows up in other areas of life.

    The origin of ADHD = the childcare (outsourced) setting, the preschool setting, the school setting.

    It’s time to flip the problem and address the true and core source of ADHD.

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