A Disease Called Childhood: Why ADHD Became an American Epidemic

by Marilyn Wedge

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 child's 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 Don't 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

Genres: Nonfiction, Psychology, Parenting, Education, Adhd, Medicine, Mental Health

269 pages, Kindle Edition

First published March 24, 2015

About the author

Marilyn Wedge, Ph.D., lic. MFT, is a family therapist and author of three books and numerous professional articles in the field of family therapy. She has a Bachelor's Degree and a Doctorate from the University of Chicago, and was a post-doctoral fellow at the Hastings Center for Bioethics in New York. She has taught at the California State University, East Bay, the College of the Art Institute of Chicago and the University of Chicago Extension.


Dr. Wedge has popular blogs on the Huffington Post and Psychology Today. Her blog titled "Why French Kids don't have ADHD" has more than 13 MILLION readers. She is a respected presenter at national and international conferences and has a private practice in Westlake Village, California, where she sees children, teens, couples, and individuals.

She has been married for thirty-four years to her husband Gene, and has three grown children and three grandchildren. She lives in Oak Park California.

from http://www.marilynwedgephd.com/AboutM...

Reviews

[Shannon · Rating 3 out of 5]

I really liked the second half of the book as she gives really helpful parenting tips for all children, not just those with ADHD.

However, I wish she wasn't such a firm believer there is no biological link to ADHD. I have seen the connection across generations in my own family. That doesn't mean you must medicate. It just shows the relationship is there.

[Laura Hoffman Brauman · Rating 3 out of 5]

This was an interesting read, although it was clear that the author had a very specific opinion/perspective. Some good things to think about -- particularly some of the differences culturally between the US and other countries. The book also gave some solid behavioral recommendations to reduce concerning behaviors, although none of them were innovative or unusual. Ultimately, I think the book might have been more effective if it had presented both sides of the diagnosis coin as well as both sides of the medication issue and then moved forward from there.

[Cyndee · Rating 3 out of 5]

The most interesting part of this book is how it goes into the history of what is now known as ADHD and how our conceptions of it have changed over time, and the rise of stimulant medications as treatment, beginning with a group of children who had brain injury.

The author has a clear and obvious bias: that what we know of as ADHD has no biological or neurological origin and is simply a cultural construct that labels behaviors, some of which are a variation of normal childhood, and others of which are caused by the home environment. Perhaps I might be able to find this argument convincing if I did not have a child with ADHD myself, but I clearly see the ways in which his brain works differently, his struggles with executive function and focusing. His home environment is the same as my daughters; there is clearly something different going on in his brain.

The chapter on food mainly focuses on artificial dyes. What I found particularly interesting about this chapter is when discussing the study on artificial dyes, she mentions that the elimination diet eliminates not just artificial dyes, but all salicylate containing foods, which include: apples, strawberries, tomatoes, grapes, peaches, plums, raspberries, oranges, almonds, and cucumber. Eliminating artificial dyes is one thing...eliminating practically all the fruits my son will eat is QUITE another. But then she goes back and laments processed foods that contain dyes, to me eliminating apples is a bigger struggle.

Some of the parenting tips are helpful but a lot of it are things you've already heard and if you have a particularly defiant child, they are quite hard to implement effectively. As someone who is medication hesitant I'm sympathetic to some of the arguments used in this book. Obviously I'm interested in non-medical solutions, but I also think it's an over simplification to say that ADHD is all environmental. I tried so hard to implement best parenting practices from birth. I fed my kids healthy, unprocessed foods as much as possible. I tried to limit sugar. I severely limited screen time. I try to encourage outdoor activity and exercise. I provide structure. A regular bedtime. My kids are not abused or traumatized. And yet I still have a little boy with ADHD. And it's truly an uphill battle in a system such as ours where finding behavioral help is hard. Finding ANY child therapist taking new patients is hard. We can't be picky. We can't keep looking for a better one. There are none. The school provides little in the way of support. The expectation is that you will medicate your child.

[Lindsey · Rating 4 out of 5]

Written by a family therapist, this book approaches a diagnosis of ADHD in a way that makes more sense to me. Instead of just putting a kid on stimulant drugs to improve behavior, this author explains the reasoning behind dietary, environmental and family changes that should be tried first. I am honestly upset that Europe seems to have their act together in terms of health and safety while the US caters to corporations first. I really want the option to buy those European M&Ms with natural food dyes. Highly recommended reading for parents, with or without an ADHD child.

[Edina · Rating 5 out of 5]

This book was incredibly insightful.

[Christine Barkey · Rating 4 out of 5]

Very informative and eye opening.

She is firmly in the camp of "ADHD has no biological cause". She discloses this bias and presents sound evidence. Even if you disagree with this point it is a good read and provides perspective.

Practical parenting tips and advice at the end as well.

[Jen · Rating 4 out of 5]

Good book on the current state of ADHD diagnosis and treatment. Although I do think there are specific instances where ADHD is definitely a medical problem requiring medication, I agree with the author that in a large number of cases the underlying cause of hyperactivity/inattention has an emotional or behavioral cause requiring different intervention both at home and at school. I was surprised to learn that there are not a lot of good research studies on the benefits of ADHD drugs. Yes, they make kids more attentive-but apparently they will make any kid more attentive for the short term. If underlying causes of inattention and hyperactivity are not addressed then how are these kids doing long term? We don't know. Not surprised that the US as a nation is way above the norm in the world for ADHD diagnoses. After reading this I get the sense that we as a society have lost all common sense. My reaction to her advice on how to intervene for these kids was "well, duh". Make sure kids have a solid structure with appropriate discipline at home, provide healthy food, limit screen time, allow for exercise...All stuff we know, but some kids are more sensitive than others, and will respond way outside the realm of normal if these things are out of whack.

[Celest · Rating 3 out of 5]

I have really mixed feelings about this book. On the one hand, it provides a reasonable alternative approach to supporting children with ADHD symptoms without medication. On the other hand, it's full of myths such as "boys have more energy, curiosity, and impulsivity than girls" from page 123.

How do you write a book critical of psychiatrists for prescribing medication for an illness they can run a medical test for, when primary care physicians do it all the time for almost every medicine they prescribe? I can't be mad at a psychiatrist for prescribing Ritalin when my pediatrician is constantly pushing antibiotics on us for every single head cold that pops up "just incl case".... Additionally, there are a number of other medical conditions that can really only be diagnosed by client/family report of symptoms and medication prescribed by that report instead of by a blood test or imaging (depression, bipolar, anxiety, idiopathic sleep disorders, addiction, etc.).

I think the idea behind this book is awesome, but needed to be more consistently and accurately developed.

It is still worth a read if you, your children, or family members have symptoms that could land you into ADHD territory.

[Sarah Briel]

Read this for school. Some interesting things but I disagree with her overall stance that there's no biological basis for ADHD and it's entirely a social construct. I think some of her other values (exercise, reworking school expectations, limiting sugar, and especially taking a look at the family system and environment) have some merit to them, but I do believe that medication could be beneficial or even necessary for some individuals. Additionally, I believe there is some physiological component as we can see in low dopamine activity in the brains of individuals with ADHD symptoms, and some biological component, however small, that can lead to it being "passed on." Some parts of Dr. Wedge's argument in this book were frustrating, especially her value-laden judgments on the topic, but there were some interesting factors she described. Additionally, the history of the disorder is alarming. Even if ADHD is a biological disease the rapid pipeline for young children to be put on drugs is not the approach that I would like to see.

[Whitney · Rating 3 out of 5]

I had higher hopes for this book. The author argues that there are 3 main beliefs about ADHD: that it is a biological disorder that needs to be treated with medication, that it is a combination of genetic/biologic risk factors and a child's environment, or that it is a set of behaviors completely caused by the child's environment. The author firmly believes it is the last of these. I tend to believe it is the middle option. She makes great points annoy the risks of medicating young kids, the need for increased play time, the stress our society puts on kids, and the impact of screen time. But none of it was new or revolutionary to me. Although she had good tips for setting limits with kids and focusing on parents' mental health to reduce stress in the child's life, I'm not sure that is always the answer to kids with attention or behavior problems.

[Cat]

This book really spoke to many of my personal experiences with "ADHD" children, both in my martial arts classes and working as an ESL teacher in the public school system. The author added nuances to my understanding of ADHD by addressing "psychosocial & situational" factors that deeply affect children's behavior. Great information for educators, but also left me feeling overwhelmed by the many places where things go awry for today's children.

[Kimberley · Rating 2 out of 5]

Well written, but same old stuff - don't eat artificial foods, don't take medicine, go to therapy. Have you tried to get a teenager to stop eating junk food and go to therapy?

[Abby · Rating 4 out of 5]

In a nutshell: According to Wedge, data do not support the classification of ADHD as a biological illness. Rather, it's a cluster of related symptoms that can improve when environmental factors change (e.g. parenting style, educational mismatch). In the 1970s, a shift occurred in psychiatry away from psychoanalysis/a more “psychosocial” approach and toward a biological one. Doctors wanted to be able to diagnose psychiatric problems more uniformly, so diagnostic criteria that simplified the process were developed, and the DSM was revised to reflect this biological approach--which over time was (of course) buttressed by both pharmaceutical companies and insurance companies. The biological view was attractive to parents because it absolved them from examining parenting strategies/family problems that might be contributing to undesirable behaviors.

A quick history of stimulants: In the 1930s, Smith, Kline, etc. started marketing Benzedrine as a performance enhancer (it improved mental alertness and concentration). Dr. Charles Bradley verified these effects but believed that in children without biological brain conditions, hyperactive behavior was due to stress/psychosocial factors, and medication should neither be a first-line treatment nor replace talk therapy. Smith Kline ignored his work because they wanted to market the drug to healthy kids. *rolls eyes* The doctor who took over for Bradley published an influential article in Journal of Pediatrics recommending the stimulants for “hyperkinetic disorder of childhood,” and that’s all she wrote. “If a child responds to stimulants, then a child must have ADHD” became the norm, even though stimulants improve concentration for almost everyone.

Interesting tidbit: The Conners scale is from 1969, and Conners admitted in 2013 that such scales and checklists “reinforce” the tendency to overdiagnose ADHD. So why are we still using them??

"Amen" quote: “Research shows that behaviors associated with giftedness--like poor attention and low tolerance for tasks that seem to the child to be boring or irrelevant--are associated with diagnoses of ADHD.”

My takeaway: I am not convinced that there ISN'T a biological basis for attention and focus issues. But we haven't found it yet, and given Wedge's argument, I would be very hesitant to medicate a child. I would try EVERYTHING else first--even changing the way the child is being educated. In fact, as a teacher, I've seen enough of this over the years to think that we are failing these bright, active, scattered (usually male, but sometimes female) students. What needs to change?

[Annie Feng · Rating 5 out of 5]

Great overall look into how much big pharma and policy has influence the way we look at and treat mental illness. This book is informative, educational, and contains some hard truths about parenting and taking responsibility.

Though I really was hoping for more case studies, I did appreciate the history lessons on the development of psychiatry. There is so much in there that is just plain WRONG, and we've gotten to the point where you need 12 years of schooling to even try to correct the course. There are bits in there that I don't agree with, like modern cartoons being too fast-paced (I have literally NEVER met a single person who regarded Caillou with anything but pure loathing and contempt). It's a grandmother's lens on childrearing, and I'm sure if I had kids my mother would say some of the same things. The overall overdrugged narrative stands though, and it's incredibly eye-opening to reconceptualize what is diagnosed as a biological illness to really be our bodies' natural responses to adverse environments.

Overall an enlightening read, and would recommend this to everybody, kids or no kids, ADHD or no.

[Jeanette · Rating 5 out of 5]

Holy Cow!! This was a huge eye opener as to the money and power that is driving the ADHD culture. At the time of publication there was no good science to back up the alleged biological cause of ADHD. Many doctors, medical journals, and support groups are generously financially compensated by drug companies to educate the rest of us about their miracle meds. Childhood traumatic events elicit the same behaviors that would qualify a child to have ADHD, but the meds don't address the problems. Divorce, abuse, substance abuse etc is rampant in our society, but rather than dealing with that we give children the most addictive drugs that fall into the same schedule as cocaine and morphine. Shoddy flawed research that doesn't hold up under examination isn't reported to the public because that isn't considered newsworthy. This is a case of "The Emperor's New Clothes."

[Sharon Bodnar · Rating 5 out of 5]

Well written and informative; I totally agreed with her premise. My son’s elementary school teachers suggested we see a psychiatrist for ADHD which we did for a while but I disagreed with the diagnosis and didn’t like keeping him on drugs. My husband actually has it and his behavior and habits were way more in line with that diagnosis.

My son is a creative, imaginative person and has done well.

That said every parent should do research, consult with perhaps more than one doctor and then decide what’s best for their family.

[Nicole Miller · Rating 5 out of 5]

As a middle school teacher I often wondered why SO MANY of my students were on ADHD medications. I often told myself “It wasn’t like this when I was in school” and this book confirms, indeed, it was not. Marilyn Wedge gives interesting insight and history to how American Psychiatry, Big Pharma, and American culture has contributed to the (recent) rise in ADHD diagnosis and medical treatment in American children. Eye opening book that also gives practical advice on how to save our children from this epidemic.

[Kris Zeller · Rating 3 out of 5]

Enjoyed this book, learned a lot. The only frustrating part was that it seems like every other paragraph says, ".... but we'll get into that in Chapter Seven..." or "As I'll discuss later in Chapter Eight..." and it made it sound a little like it was constantly starting things and then saying, "never mind we'll go back to that". Still a very interesting book, just a little disjointed.

[Melissa · Rating 5 out of 5]

Fabulous book. Author does a great job of focusing on skepticism and encouragement of alternative treatments instead of creating an "I'm right, they're wrong" argument concerning ADHD. The history she provides as well as stories of patients, physicians, amd researchers creates the tale surrounding ADHD throughout the decades. highly recommend this book.

[Rajan Desai · Rating 4 out of 5]

Fast/easy read. Author does a good job of recounting the evolution of ADHD in the USA versus other countries. Some statistics were a little misleading in phrasing like comparing 54 kilobits to 20 million bits. Provides great insight into other factors to consider instead of or before reaching for a cure in a bottle.

[Fry Morgan · Rating 4 out of 5]

Love the content and premise - ADHD is disturbingly overdiagnosed at best, a questionable diagnostic entity at worst. I found the writing style a bit loose and fragmented. The "case reports" seemed pointless to me, particularly from a PhD author. I would have preferred a deeper focus on the date that is swept under the rug in favor of the stimulants-for-ADHD narrative. Recommended read, overall.

[Alexis · Rating 3 out of 5]

While the author offers plenty of practical advice for all parents, regardless of their child's diagnostic status, I could not stand the all-or-nothing mentality. Yes, many children with ADHD are probably experiencing a reaction to their environment, however, there are also children who have inheritable and biological brain conditions that yet to be diagnosed.

[Hella Smella · Rating 5 out of 5]

Should be required reading for all parents and teachers in the US. Wedge unearths alliances between child psychiatrists and drug companies who produce stimumants, plus airs buried data about the proven relationship between artificial food dyes and hyperactive behavior.

[Bethzaida E Adorno · Rating 5 out of 5]

Insightful

Great read for those trying to understand inventiveness. Highly recommend before you take a drastic medication approach that may hurt your child in the long run. Remember that education is a lifelong marathon and not only measured by good grades.

[Arwyn · Rating 3 out of 5]

I don’t agree that there is no biological cause for ADHD. Just because we haven’t found it doesn’t mean it isn’t there.

Would I still try everything else first for my child before reaching for medication? Absolutely.

[Alexis · Rating 5 out of 5]

I loved this book. It is very heavily biased because the author has made up her mind and is defending that argument, but I guess that's kind of the point. Otherwise, I thought it was really easy read with really good information!

[Karen · Rating 3 out of 5]

The pharmaceutical industry and current medical practice would have everyone believe that all indications of ADHD arise from a chemical imbalance that should be treated with various levels of powerful drugs. The author points out that rates of diagnoses of ADHD in other similar Western societies are less than half of the ever increasing numbers in the United States. The knee-jerk reaction in the US to medicate hyperactive children rather than to try other strategies that she has successfully pursued with her patients. Strategies include uncovering an emotional trauma the child may be experiencing and provide family therapy to mitigate the effect on the child; working with teachers and schools to understand that maturity level plays a role in how children act and perform in school; change the diet to eliminate toxins and sugar to gauge effect on behavior; limit excessive screen time, have parents exert more authority over children's choices and set clear rules for behavior.

It is worth a try, at least for non pharmaceutical choices, to avoid medicating children with drugs that have the potential to change their developing brains, and ultimately make them believe that they cannot get through life without taking drugs every day.

[Mama K · Rating 5 out of 5]

BREEZED through this book and I LOVED it. this book exposed, with detailed and valid research, EVERYTHING I have long believed about the ADHD epidemic in the U.S. This book details the hoax that Big Pharma and paid off doctors have perpetrated on the American Public. WEdge uses case study after case study after case study, and even Big Pharma's own records, to expose how the ADHD disagnosis has become BIG Buisness for the pharmaceutical companies but also BIG trouble for the future our our nation's children. But Wedge not only exposes the unethical doctors who have their hands in the coffers of Big Pharma in exchange for promotiong ADHD drugs, she also lays out the ROOT causes of ADHD symptoms and gives practical methods for parents who actually want solutions other than just drugging their children. In addition, WEdge points out the excessive side effects, and lack of data on the long-term effects, of the drugs American parents are dispensing to millions of children every day. It's time we Americans wake up and do better for our children.

[Jane Lack · Rating 4 out of 5]

Very interesting read for anyone with kids.

[Christina Dudley · Rating 4 out of 5]

Fortunately I haven't had to deal with this with my own kids, but I was interested in the rise of this previously unknown diagnosis. Author Wedge is a longtime family therapist who is pro-therapy and dealing with causes, rather than going straight for the drugs. She covers how Big Pharma is intertwined with the journals publishing pro-drug articles, the different philosophies toward inattention and hyperactivity that France and Finland take, and even the possible connections to diet and processed foods (artificial food colorings and sodium benzoate).

Very interesting, quick, informative read. If someone is telling you your kid needs to settle down in class or be drugged, read this first.