Each year, doctors diagnose an average of nine percent of children between the ages of five and seventeen with attention deficit hyperactivity disorder, or ADHD. One of the most common childhood disorders, it is also one of the most controversial—since first identified in the late 1950s, everyone from medical professionals to politicians have debated its causes, its treatment, and its implications for children. Today, physicians believe it is an inherited neurological disorder best treated with stimulants.
Hyperactive provides the first history of ADHD, addressing why children were first diagnosed with the disorder, why biological explanations became predominant, how powerful drugs became the preferred treatment, and why alternative explanations have failed to achieve any legitimacy. Contending that hyperactive children are also a product of their social, cultural, and educational environment, Matthew Smith demonstrates how knowledge about the history of ADHD can lead to better choices about its diagnosis and treatment. A revealing and accessible study of this controversial subject, Hyperactive is an essential book for psychologists, teachers, policymakers, and parents.
My first reaction to this 2012 book by Matthew Smith, a chaired faculty member of the University of Strathclyde in Glasgow Scotland, is loathing. Dr. Smith's two basic premises are: (1) because CIBA (now Novartis) encouraged the potential over-prescription of Ritalin as a medical treatment for ADHD when Ritalin was first commercially available; (2) because the medical community's understanding of, and therefore terminologies for, ADD/ADHD have evolved over decades, there must not be such a neurological condition as ADHD. The astonishing callousness of these "conclusions" is monstrous: within his own Introduction: Why the Hype?, page 12, paragraph 1, he writes:
"Hyperactivity is all around us. If current estimates are to be believed, anywhere between 2 and 18 percent of children in the United States, for example, have hyperactivity or Attention Deficit/Hyperactivity Disorder (ADHD). A recent survey of worldwide prevalence suggested that 5.29 percent of the world's children had the disorder. Most of us know a hyperactive child, or, increasingly, an adult diagnosed, and even if we do not, we could probably describe one quite accurately. Hyperactive children tend not only to be overactive, but also inattentive, impulsive and often defiant and aggressive as well. They have difficulty at school, have problems in their relationships and may eventually struggle in the world of work. The disorder is also associated with higher rates of imprisonment, drug and alcohol abuse and other mental illnesses, particularly depression."
He blithely forgets that paragraph immediately. The tortured logic and scant research he uses to arrive at his opinions are blinding. There is not one mention in this book of world-renowned clinicians such as Dr. Edward Hallowell, complete disregard for dozens if not hundreds of documents providing detailed analyses of every aspect of ADD/ADHD, from compilations of case studies, to its potential origins to the biochemical and physical differences evident in the brains of ADD-abled and non-ADD-abled individuals.
Physicians' understanding of cancer has undergone drastic changes over millennia. It was once thought to be contagious. Early humankind thought illness came from the gods: Antony Leeuwenhoek discovered bacteria in the 1670s and slowly knowledge of the inextricable connection between "germs" and disease developed. The naming of Bipolar Disorder has a long, and almost colorful, history. To condescend to disavow an illness because science, as a mandated part of its procedures, refines itself over time, is unforgivable. To invalidate an illness because American laws around marketing medicines are obscene is equally unforgivable.
I work with people with ADD/ADHD. People who've lost jobs because of their ADD. People who have confessed to using speed before their diagnosis, because it was the only effective tool they had for some kind of focus. People who have divorced, who are estranged from their children, because the chaos caused by their undiagnosed ADD/ADHD wrecked havoc in their lives. Deliberate disinformation leaves me livid.
Equally disheartening? There is, buried in the dreck, Dr. Smith's compelling plea for a much more profoundly humane, child-centered approach to teaching American children, which Cold War politicians who had no business pretending they understood anything about teaching dispassionately forced American educators to abandon in response to Sputnik. And, equally worthwhile, he synthesizes decades of research that our larger environment(s) - home, school, community - have almost immeasurable influence over our lives, so that it can be argued that strong safety nets - addressing malnutrition, for example - may well have tremendous impact to eliminate learning and behavior challenges.
Interesting from a historical perspective but the tone seems biased towards one side of thinking about the disorder over the others. Despite attempting an unbiased look at the history and treatment of the disorder, it is evident that the views of the author are presented throughout the narrative.