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I hear students, parents, and -- some -- teachers pull this claim all the time: standardized tests causes a rise in ADHD in children. I know Sir Ken Robinson mentioned something like that in one of his presentations.

Are there any studies to back this up?

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    I had never heard this claim, interesting. My wife is a teacher, I'll have to ask her if she gets this one. She likes to blame the fact that tv and movies have so many cut sways per scene. – Dogmafrog Mar 17 '11 at 23:46
  • He's mentioning the exact opposite, in fact. – Sklivvz Mar 18 '11 at 22:21
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Sklivvz is right in pointing out that Robinson does not claim that tests cause ADHD. Robinson questions the diagnosis in the first place. Since Robinson is the only source you've cited for your claim, this is the view that my response is aimed at.

Robinson frequently claims that ADHD is invented (in this TED talk, among other places). What we know for sure is that he doesn't know that for sure.

Robinson is making very bold claims outside of his own comfort zone (his PhD is in drama and education) and contradicts the consensus in medicine and psychology, where ADHD is treated as something very real. More than anything, his claims are emotional, anecdotal, and to me seem to reveal a gross missconception of what ADHD even is. Robinson will often say that children are different in several ways and that this should be encouraged. ADHD doesn't contradict that. ADHD is very specific. Although diagnosis is based on subjective judgement and there is no simple lithmus test to decide whether or not it is present in a given individual (much like most other psychogenic conditions, a line of argument I elaborated on in the question about addiction), it isn't enough to be fidgety and impatient, which are completely natural traits in children. In order to be diagnosed with ADHD, a child must meet several criteria on inattention and hyperactivity.

For Robinsons argument to have any bearing on the validity of ADHD at all, given how specific the diagnosis is, the argument should not simply be that children are different, but he'd have to argue that a subset of children are for some reason different in a very specific and uniform way. It is easy to understand that conformity of behaviour if you consider a psychogenic disorder (the mechanics of which are not at this point entirely understood) to be the common cause in all these children. If Robinson is to dismiss that explanation, he would have to provide another one, or at the very least a plausible reason for this dismissal. I have not seen Robinson put forth either, and as far as I can tell, his criticism is rooted in ignorance of the disorder at hand.

Given that ADHD does exist, is medication the proper way to deal with it? I'm not qualified to say. Are we currently over-diagnosing the condition? Possibly. A study I don't have access to apparently claims (according to Wikipedia) that diagnosis based on the DSM-IV criteria, which are used in the USA, will be 3-4 times more likely to positively diagnose ADHD, compared to the DCI-10, used in Europe. From this, we must deduce that either over- or under-diagnosis must reasonably be going on. I wouldn't debate Robinson if those were his focal points, but his broader claims that ADHD is invented are very controversial, and in stark contrast with the current consensus among those who are actually educated in the subject.

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I watched the video you linked and it does not make that claim. What he claims is something completely different. He claims that, in education, we expect all students to conform to a certain standard (hard working, attentive and so on). The extreme example of this, he says, is that we have started to classify unconventional, different behaviours as new pathologies.

He furthermore argues that this is incorrect: pathologies like ADD should be considered simply differences in behaviour which are a positive thing. He argues that we should not medicate people into becoming something they are not.

So, he doesn't make this claim at all - but he expresses a potentially valid subjective opinion that cannot offhandedly be verified or denied: it's mostly a matter of definitions.

  • A true diagnosis of ADD/HD takes more than just brief observation. The current understanding of the condition is that the brains of people with ADD/HD are unable to process dopamine and other chemicals the way that 'normal' brains do. Unfortunately, you cannot test the brain for this without extracting it from the body, which would kill the patient. Dr. Amen has done a fair amount of work linking the various ADD/HD subtypes with measurable brainwave activity, but claims a full EEG or PET scan is not necessary to make a diagnosis. – oosterwal Mar 28 '11 at 14:51
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I think (not scientific) that the vast majority of children diagnosed with ADHD are just active children. The expectation that every child is predisposed to sit in a chair and accomplish tasks is flawed at its basis. Sure some actually have an imbalance, but not nearly as many we seem to think. I am looking for data now from other places (Europe and Japan specifically) to see if their children seem to be afflicted as well. Their not being would be a telling comment on our society's predisposition to medicate...

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    FWIW I'm from Europe and I've never met anyone with ADHD. – Sklivvz Mar 18 '11 at 22:08
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    @Sklivvz: what is that meant to be worth? I'm from Europe and I've met several people with ADHD. But this is not the place for anecdotal evidence. – David Hedlund Mar 19 '11 at 15:09
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    Thinking that ADHD is "just active" is similar to thinking that depression is "just sad", schizophreny "just confused". – Suma Mar 28 '11 at 7:59
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    no Suma, but it does appear that the mass increase in ADHD diagnoses over the last decade or so is caused by parents and teachers not wanting to deal with active kids. Drug them into a stupor and they're nice and pliable. Doctors and pharmaceutical companies make quite a nice income from that so aren't going to complain. Is this the cause? I don't know, but it's more than likely to be a factor. The marked increase in families where both parents work fulltime jobs in the US probably causes parents to want kids to be inactive, as active kids need more parenting. – jwenting Mar 28 '11 at 10:39
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    in other countries, where a larger percentage of mothers (and sometimes fathers) stay at home, there are far fewer ADHD diagnoses as well. I'm pretty sure that were I a kid in the US today I'd be drugged myself. I liked running around, getting dirty playing in the garden, behaviour now (in the US at least) considered bad and ground for putting the kid on Prozac to keep them quiet, using ADHD (which is indeed a real disease) as an excuse. – jwenting Mar 28 '11 at 10:42
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Observationally, ADHD is generally diagnosed prior to any standardized tests being issued (at least in the educational world (again, from personal observation, those diagnoses are frequently made between 4 and 7 years old)). In most locales, standardized tests are not issued until grade 4, or approximately age 10.

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