“Are Americans More Prone to A.D.H.D.?” is a recent “Room for Debate” question.

ADHD rages as a topic among educators, parents, and researchers. The experts’ responses in “Room for Debate” makes clear that ADHD diagnosis and treatment is far from a settled issue.

Is it a legitimate disorder? Is it even real? How come it skews in populations whose parents can afford a diagnosis? Are some mental illnesses social constructs? Suffice to say there are experts on all sides of the issue.

The NYT frames the discussion this way:

“For some conditions, perhaps wealth explains the disparity: in developing nations, more people are focused on pressing needs like food and shelter, making depression a “luxury disorder” in wealthy nations like the United States.

But are there other factors at play for conditions like attention deficit/hyperactivity disorder, that may be “culture-specific”? Maybe the condition is more common in the United States because the high-energy, risk-taking traits of A.D.H.D. are part of America’s pioneer DNA. Or maybe the same behavior is common elsewhere, but given another label? Some critics would argue that American doctors, teachers and parents are simply too quick to diagnose A.D.H.D. and medicate children. Do the American medical and educational systems inflate the numbers?”(NYT)

The NYT discussion includes views ranging from the true believing (Ned Hallowell), to the skeptic (Peter R. Breggin), to the race, gender and class lens (Donna Ford), to the nuanced (Ethan Watters).

I have to say I’m partial to the work and views of Ford and Watters. I really like the way that Watters works to get at the root of the issue:

“…The really mind-bending fact — the one that Americans can rarely seem to grasp — is that just because these disorders are culturally shaped does not make them necessarily less real. Those Victorian-era women really did faint and experience the paralysis, tics and fainting spells found in their symptom pool. Their unconscious learned, in short, to speak the language of suffering for their time.

In certain historical moments, a given diagnosis will hit such a resonant cultural note that it catches fire. This, I believe, is the story of A.D.H.D. Parents, teachers and mental health healers are critical parts of a feedback loop by which a child unconsciously apprehends their symptom pool. This is not to lay blame at anyone’s doorstep — a similar dynamic is in play with all mental illnesses. We won’t fully understand these illnesses until we add this knowledge to the mix, but that new understanding won’t magically make the disorders disappear.

Unfortunately, the debate about the “realness” or universality of a disorder like A.D.H.D. often distracts from a discussion of what might have given rise to the need for so many children to express distress. The underlying disquiet in the children of our time is more important than the symptom cluster that we declare as legitimate…”(NYT)

Resources:

Boarding School for Students with ADHD

Kim plans to study medicine as his education continues. Right now, he’s a budding software engineer.

Kim appears to have done a nice job- given his young years and amateur status. Schools can find themselves farming out iPhone application development for four figures.

Interestingly (and I don’t know if these are students making jokes or giving Kim a ribbing), I am amazed at the expectation level betrayed in the comments section.

In the short span of a few years, everyone seems to want application that does everything- well and seamlessly- now.

Visit the iRGNS page at iTunes to download their iPhone application.

Boy, if it really were that neat.

That quick description does no justice to the pain and struggles of student and family. In this kind of situation, student and family both find themselves grasping for reasons and solutions where no neat cure exists. In most of these cases, the struggle doesn’t end, but the student learns to adapt and cope. The solution is to learn how to live with the issue.

Donna Dubinsky (Mom) and Marina Dubinsky (Daughter) explore this very kind of situation in their article for doubleX, “The Boarding School Solution: Why I send my daughter across the country for special education.” Ms. Dubinsky and her husband find themselves searching, working with their public school system, and eventually reaching the conclusion that the best school for Marina is cross country in New England.

The article takes readers from Marina’s kindergarten year to the her pending senior at Eagle Hill School. Along the way, we hear about the testing, the struggles, the frustration, the coming to terms with special education, and finally a positive learning environment for Marina.

While I appreciate Marina’s struggles, I most appreciate her mother’s candor. I’m not sure that I’ve heard a parent lay their own struggle on the table so bluntly:

“…I certainly wasn’t happy. I had never imagined my world as a mother being one of special education, extra tutoring, and individual education plans. But that’s what Marina’s life and mine would become…

…Humbled, we returned to the consultant. She told us about a range of boarding schools, all on the East Coast…”

Nothing that Eagle Hill does can make Marina different, but the school has helped her understand and become comfortable with herself.

“…I asked Marina what she would tell a younger student whose family was considering boarding school, where both the parents and the kid were nervous about leaving home. She said, “If you go to a school like Eagle Hill, you will figure out what works for you and how you learn. If you don’t finish your work, the teachers have extra hours when you can go see them both in the morning and after school.” She talked about trying sports like fencing. And about how, among the groups of kids, “There isn’t a group that is better than you.

I still find myself sad every time we put Marina back on United 172 to Boston. But I know now that as hard as it’s been for us to let her go, it would have been very selfish to make her stay.” (dX)

The latest wave of ADD/ADHD dialog now takes the disorder beyond strategy and treatment- repackaging the diagnosis into a positive trait that some argue is a blessing. I’m left scratching my head. Why define, diagnose, and treat ADD/ADHD if it’s such a valuable tool/perspective?

Framed by Michael Phelps, his ADHD status, and his unbelievable Olympic performance, Tara Parker-Pope highlights both sides of issue in her New York Times article, “A New Face for A.D.H.D., and a Debate.“

The two perspectives (as told to Ms. Parker-Pope):

“It’s not an unmitigated blessing, but neither is it an unmitigated curse, which is usually the way it’s presented,” said Dr. Hallowell, who has the disorder himself. “I have been treating this condition for 25 years and I know that if you manage it right, this apparent deficit can become an asset. I think of it as a trait and not a disability.”

From the other side,

“This reframing A.D.H.D. as a gift, personally I don’t think it’s helpful,” said Natalie Knochenhauer, founder of A.D.H.D. Aware, an advocacy group in Doylestown, Pa. “You can’t have a disability that needs to be accommodated in the classroom, and also have this special gift. There are a lot of people out there — not only do their kids not have gifts, but their kids are really struggling.”

Ms. Knochenhauer, who has four children with the disorder, says they too were inspired by the astonishing performance of Mr. Phelps in Beijing. But she added, “I would argue that Michael Phelps is a great swimmer with A.D.H.D., but he’s not a great swimmer because he has A.D.H.D.”

Families oftentimes find it a daunting task to identify the right boarding school for the “special” child. Websites and brochures don’t give enough detailed information for a parent to make an informed decision. Current psychological and academic testing may be inconclusive so parents don’t understand the problems or how to best treat them. Some families seek the counsel of an educational consultant to help them sort through the various options. Whether a family uses a consultant or searches on their own, it is vital to find the school that is the “right fit”; one that can address the child’s unique learning style.

Close to 20% of the school age population are diagnosed with a learning difference. Most of these children have a problem using language and are said to have a language based learning disorder. Others have a non-verbal learning disability and struggle with some of the following: organizational difficulties, poor social skills, visual-spacial weaknesses, conceptual reasoning deficits. Many children have attentional issues and executive functioning deficits. Some LD students just need small classes, academic support and minor classroom accomodations; others whose LD issues are severe and more debilitating, need direct and intense skills-based language remediation. There is a significant difference between academic support and remediation. Boarding schools that offer support usually have a few LD trained teachers in tutorial center. Their role is to help the LD student keep up with what’s happening in the classroom. On the other hand, remedial instruction is a structural approach to helping the child learn strategies to compensate for their weaknesses. Curriculums at these schools use a multisensory approach and experiental teaching strategies. All teachers at these schools are trained in using these techniques. It is very important for parents to understand the difference and to know what a boarding school can and can’t do before placing their LD child.