The New York Times is once again trying to be relevant and cutting edge in the ADHD discussion. The latest article is another confusing, unhelpful disappointment.
The article is entitled “A Natural Fix for ADHD”. You might be forgiven for thinking that the author, Dr. Richard Friedman, a psychiatry professor at the Weill Cornell Medical College, had a promising new treatment to share. I certainly did. He doesn’t. On the plus side, he doesn’t bash the parents who choose medication in their battle to help their children.
1900 words into this 2000 word article, he finally suggests the “natural fix”:
“we should do everything we can to help young people with A.D.H.D. select situations — whether schools now or professions later on — that are a better fit for their novelty-seeking behavior…small classes that emphasize hands-on-learning, self-paced computer assignments and tasks that build specific skills.
That’s it? You don’t need to wade through the neuroscience he relates in the body of the article to come up with these recommendations. Educators have been recommending exactly this method for at least some students for decades.
You might guess that a lot of the previous 1900 words laid out the case that “novelty-seeking” is part of ADHD, and that people seeking novelty have done some very important things over the millennia such as leaving Asia to populate the Americas and leaving boring corporations to write smartphone apps. You would be right. (And ignore for a minute the observation that a sizable minority of people with ADHD have little or no novelty-seeking tendencies.)
You would also be correct to guess that he pulled out the tired old hunter-gatherer paradigm to show how novelty-seeking ADHD brains are just right for 15,000 years ago:
“In short, having the profile of what we now call A.D.H.D. would have made you a Paleolithic success story.”
Really?!? I shouldn’t think myself a misfit, since I actually fit perfectly well in a different time and place? Even though that time and place doesn’t exist anymore? A time, incidentally when the infant mortality and murder rates were 25% and 15% respectively. That’s my people, my home?
The implication is cruel. Not everyone has evolved enough to attend a modern school. Let those advanced kids exercise their prefrontal cortices. The misfits will be in separate room being entertained on the same computer screens that ruined our attention back home. (Yep, Professor Friedman said both that the digital world is driving ADHD diagnosis and that digital learning is the cure.)
If you lack a genome-wide adaptation, find a societal niche where everyone is equally impoverished. Instead of those invasive growth hormone shots, short-statured kids could just hang out in the kindergarten. Kids with dyslexia just need a tribe without a written language. (“Don’t be sad, young Cyclops. In the Land of the Blind, you would be king!”)
See how simply the ADHD problem is defined away? People with ADHD who struggle to learn, manage time, follow rules and live substancce-free just need to find a spot in in the world where ungoverned, pre-literate, herb-enlightened people measure time by the moon. I and my 350 million friends worldwide with ADHD will now rejoin the Neanderthal people.
Humans have populated the globe and become its dominant species largely because the prefrontal cortex allows us to collect experience, modify our environment, plan the future, adapt to new and varied situations, and decrease risk and uncertainty. People with ADHD don’t have the rich interconnections from the prefrontal cortex to the rest of the brain that the majority enjoys. Either we find people with ADHD a place where those connections aren’t needed—federal prisons come to mind—or we find a way to enrich those connections and let people with ADHD in on the progress.
Medications for ADHD enrich those connections. Nothing else in the treatment manual is known to do that. We desperately need more options with similar or better effect. Natural or man-made is fine by me.
Redefining the problem, though, is not a treatment, and the New York Times still lacks useful contribution to the ADHD discussion.