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Marilyn Wedge - A Disease Called Childhood: Why ADHD Became an American Epidemic

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Marilyn Wedge A Disease Called Childhood: Why ADHD Became an American Epidemic
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A Disease Called Childhood: Why ADHD Became an American Epidemic: summary, description and annotation

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A surprising new look at the rise of ADHD in America, arguing for a better paradigm for diagnosing and treating our children
In 1987, only 3 percent of American children were diagnosed with attention-deficit/hyperactivity disorder, also known as ADHD. By 2000, that number jumped to 7 percent, and in 2014 the number rose to an alarming 11 percent. To combat the disorder, two thirds of these children, some as young as three years old, are prescribed powerful stimulant drugs like Ritalin and Adderall to help them cope with symptoms. Meanwhile, ADHD rates have remained relatively low in other countries such as France, Finland, and the United Kingdom, and Japan, where the number of children diagnosed with and medicated for ADHD is a measly 1 percent or less.


Alarmed by this trend, family therapist Marilyn Wedge set out to understand how ADHD became an American epidemic. If ADHD were a true biological disorder of the brain, why was the rate of diagnosis so much higher in America than it was abroad? Was a childs inattention or hyperactivity indicative of a genetic defect, or was it merely the expression of normal behavior or a reaction to stress? Most important, were there alternative treatments that could help children thrive without resorting to powerful prescription drugs? In an effort to answer these questions, Wedge published an article in Psychology Today entitled Why French Kids Dont Have ADHD in which she argued that different approaches to therapy, parenting, diet, and education may explain why rates of ADHD are so much lower in other countries.


In A Disease Called Childhood, Wedge examines how myriad factors have come together, resulting in a generation addictied to stimulant drugs, and a medical system that encourages diagnosis instead of seeking other solutions. Writing with empathy and dogged determination to help parents and children struggling with an ADHD diagnosis, Wedge draws on her decades of experience, as well as up-to-date research, to offer a new perspective on ADHD. Instead of focusing only on treating symptoms, she looks at the various potential causes of hyperactivity and inattention in children and examines behavioral and environmental, as opposed to strictly biological, treatments that have been proven to help. In the process, Wedge offers parents, teachers, doctors, and therapists a new paradigm for child mental health--and a better, happier, and less medicated future for American children

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Published by the Penguin Group

Penguin Group (USA) LLC

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New York, New York 10014

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Copyright 2015 by Marilyn Wedge

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Library of Congress Cataloging-in-Publication Data

Wedge, Marilyn.

A disease called childhood : why ADHD became an American epidemic / Marilyn Wedge, PhD

p. cm.

Includes bibliographical references and index.

ISBN: 978-1-101-63963-4

1. Attention-deficit hyperactivity disorderUnited States. 2. Attention-deficit hyperactivity disorderSocial aspectsUnited States. 3. Child rearingUnited States. I. Title.

RJ506.H9W432 2015 2014045248

618.92'8589dc23

Neither the publisher nor the author is engaged in rendering professional advice or services to the individual reader. The ideas, procedures, and suggestions contained in this book are not intended as a substitute for consulting with your physician. All matters regarding your health require medical supervision. Neither the author nor the publisher shall be liable or responsible for any loss or damage allegedly arising from any information or suggestion in this book.

Version_1

For Jess, Dan, and Jay, with love

CONTENTS
AUTHORS NOTE

In order to uphold therapist-client confidentiality, I have changed the names and identifying features of the clients mentioned in this book. The processes and outcomes of the therapy sessions are real. Family therapy relies for its integrity on the accuracy of case studies. The people and conversations I relate are composites that I have adapted conceptually from a number of individual cases from my twenty-five years of practice. Any resemblance of the composite characters or therapies to any actual person is entirely coincidental.

INTRODUCTION
A Season in Childhood

In 1988, when I started my practice as a child therapist, I had barely heard of attention-deficit/hyperactivity disorder, or what is typically called ADHD. The diagnosis had arrived on the scene a year earlier, in the third revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R), the book doctors use to diagnose mental disorders in children and adults. Previous iterations of the manual had identified various types of hyperactivity and attention problems in children, including attention deficit disorder (ADD), the precursor to ADHD, in 1980. But this was the first time the term ADHD as we know it today appeared. According to the DSM, to warrant a diagnosis of ADHD, a child had to exhibit eight symptoms of hyperactivity, inattentiveness, or impulsivity (from a checklist of fourteen) for at least six months. The checklist included things such as is easily distracted or often interrupts or intrudes on others.

Despite its codification in the DSM, at the time ADHD was not widely discussed among child therapists, let alone parents, teachers, and pediatricians, as it is today. Psychoanalytically minded child therapists (those inspired by the work of Sigmund Freud) saw childrens problems as the expression of inner conflicts, while family systems therapists like me considered kids problems responses to stressful situations in their social context: at home, at school, or with their friends. We saw no reason to formalize a diagnosis for behavior that child therapists had been successfully treating for years. So we ignored it.

For a while, that was fine. From the time I started my practice until the middle of the 1990s, not one mother or father ever asked me if I thought their child had ADD or ADHD. If their childs behavior changed, parents assumed something was worrying or stressing their child. They came to me to discover the source of stress.

From my point of view, behavioral problems such as aggression, disobedience, or other behaviors commonly associated with ADHD, such as inattention and hyperactivity, are signs that something is wrong in a childs lifeeither extreme trauma, like abuse or poverty, or something more typical, like a lack of discipline or a difficult family transition. Children are not fully developed mentally or behaviorally. Negative emotions that arise from lack of structure or difficult circumstances in their environments usually manifest themselves in their behavior, since children are not equipped to express themselves directly. I was used to treating childrens symptoms as responses to rough patches in their family life or troubled relationships with friends or at school. I helped children cope with sadness or anxiety, compulsive behaviors or aggressiveness, inattentiveness at school or moodiness at home by discovering the cause of the childs distress.

Of course, I saw plenty of children who were jumpy, disruptive, fidgety, oppositional, or uninterested in school. In these cases, parents generally came to me to ask if I could help them keep the behavior in check, sometimes after a teacher had complained that a child was interrupting class or refusing to do assignments. I typically came up with behavioral solutions for these kids. I advised parents to create a solid plan for discipline, to stay calm, not to yell, to give their child time to mature, to reward good behavior, to invoke consequences for mischief, and so forth. At times, I attended a meeting at the childs school and worked with the childs parents, teacher, and school counselor to find specific ways to help the child in the classroom. For particularly active kidsmore often boys than girlsI recommended that parents enroll them in a sport or encourage them to ride their bikes as an outlet for their extra energy. Even in cases where something specificsuch as divorce, a parents injury or illness, or another disruption in the childs lifewas causing the distress, I could usually work with parents and children to address the problem, talk to the child, and figure out a way for them to move past it. These techniques usually worked.

Not every misbehavior was rooted in a troubling situation at home. In those days, some degree of naughtiness and wildness was tolerated and even expected in children, especially in boys. If parents had a little Dennis the Menace at home, well, that was just boys being boys. Impulsive, distractible kids who occasionally rebelled against the authority of adults were considered naughty but normal. Nobody would have suggested that Dennis the Menace or Beaver Cleaver had a mental disorder that required medication. Nobody would have suggested that Huck Finns chronic truancy was the sign of a mental illness. A teaspoon of discipline, not a dose of psychiatric medication, was the cure for naughty children. Most people thought the only disease that afflicted kids like that was called childhood.

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