ADHD as normal result of evolution?
Mar. 7th, 2006 02:19 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
semiotic_pirateAttention Surplus? Re-examining a Disorder
By PAUL STEINBERG, M.D.
Published: March 7, 2006 - NYT
The recent recommendation that Ritalin and other medications for attention-deficit disorder carry the most serious allowable warning will certainly slow the explosive growth in the use of those drugs.
That was the intention of some members of the Food and Drug Administration advisory committee that called for the packaging alert, known as a black-box warning.
But the recommendation and concerns about growth in the use of these drugs may force us to think about the disorder, known as A.D.H.D., in new and different ways, from an evolutionary and contextual standpoint.
Every generation likes to believe that it is witnessing the most dramatic epoch in history. In the case of the current Western world, that belief may indeed be accurate, particularly in light of the striking changes of the last 30 years.
As the business writer and consultant Peter Drucker pointed out, most people in the United States, Japan and parts of Europe are "knowledge workers." We live in an information age, in a knowledge-based economy.
For those of us who have "attention-surplus disorder" — a term coined by Dr. Ned Hallowell, a psychiatrist in Boston who has A.D.H.D. — this knowledge-based economy has been a godsend. We thrive.
But attention disorder cases, up to 5 to 15 percent of the population, are at a distinct disadvantage. What once conferred certain advantages in a hunter-gatherer era, in an agrarian age or even in an industrial age is now a potentially horrific character flaw, making people feel stupid or lazy and irresponsible, when in fact neither description is apt.
The term attention-deficit disorder turns out to be a misnomer. Most people who have it actually have remarkably good attention spans as long as they are doing activities that they enjoy or find stimulating. As Martha B. Denckla of the Kennedy Krieger Institute in Baltimore has noted, we should probably be calling the condition something like "intention-inhibition disorder," because it is a condition in which one's best intentions — say, reading 50 pages in a dense textbook or writing a 10-page paper in a timely fashion — go awry.
Essentially, A.D.H.D. is a problem dealing with the menial work of daily life, the tedium involved in many school situations and 9-to-5 jobs.
Another hallmark, impulsivity, or its more positive variant, spontaneity, appears to be a vestige from lower animals forced to survive in the wild. Wild animals cannot survive without an extraordinary ability to react. If predators lurk, they need to act quickly.
This vestige underscores the fact that human genetic variability, the fact that we are not all simply clones of one another, has allowed us to survive as a species for 150,000 years in a variety of contexts and environments.
In essence, attention-deficit disorder is context driven. In many situations of hands-on activities or activities that reward spontaneity, A.D.H.D. is not a disorder.
Ultimately, if studies show convincing evidence that children and adults have been harmed by medications for attention disorder, cardiologists will have every obligation to tell us to halt their use.
But a more fundamental societal accommodation would be highly beneficial — to recognize that each child and adult learns and performs better in certain contexts than others.
As Arthur Levine, president of the Teachers College at Columbia University, has noted, future teachers will be able to individualize and customize the education of students.
Some children and young adults with attention disorder may need more hands-on learning. Some may perform more effectively using computers and games rather than books. Some may do better with field work and wilderness programs.
If it is indeed a context-driven disorder, let's change the contexts in schools to accommodate the needs of children who have it, not just support and accommodate the needs of children with attention-surplus disorder.
For those with attention disorder who wish to be full participants in a knowledge-based world, medications equalize their opportunities. The drugs should and can be used only as needed in the context of dealing with the tedium of school or the drab paperwork of some jobs.
Cardiologists, biostatisticians and consumer advocates may clamor, appropriately or inappropriately, to reduce the use of the medications. But unless we go back to the caveman world, some people will find the drugs increasingly necessary to succeed as knowledge workers in a drastically transformed modern world.
Paul Steinberg is a psychiatrist and writer in Washington.
The Claim: TV Shortens Children's Attention Spans
By ANAHAD O'CONNOR
Published: March 7, 2006
THE FACTS For about as long as television has been around, people have speculated that too much exposure to it can harm children's brains. So it was perhaps no surprise when a large study two years ago found that children who watched the most television also had the shortest attention spans. In some cases, all it took was an extra hour of television viewing a day to increase the odds of developing concentration problems by 10 percent, the researchers found.
But parents who cringed at those findings can breathe a little easier.
In the last two years, two other studies have failed to find any link between television exposure and symptoms of attention-deficit disorder. The most recent, published this month in the journal Pediatrics, based its findings on a group of 5,000 American kindergartners who were followed for two years.
The researchers found that children who watched the most television were no more likely to develop attention problems than those who watched the least television. The other study, in the Netherlands, also found no relationship. But researchers say more study is needed.
THE BOTTOM LINE The link between exposure to television and decreased attention spans in children may not be as strong as once thought.
By PAUL STEINBERG, M.D.
Published: March 7, 2006 - NYT
The recent recommendation that Ritalin and other medications for attention-deficit disorder carry the most serious allowable warning will certainly slow the explosive growth in the use of those drugs.
That was the intention of some members of the Food and Drug Administration advisory committee that called for the packaging alert, known as a black-box warning.
But the recommendation and concerns about growth in the use of these drugs may force us to think about the disorder, known as A.D.H.D., in new and different ways, from an evolutionary and contextual standpoint.
Every generation likes to believe that it is witnessing the most dramatic epoch in history. In the case of the current Western world, that belief may indeed be accurate, particularly in light of the striking changes of the last 30 years.
As the business writer and consultant Peter Drucker pointed out, most people in the United States, Japan and parts of Europe are "knowledge workers." We live in an information age, in a knowledge-based economy.
For those of us who have "attention-surplus disorder" — a term coined by Dr. Ned Hallowell, a psychiatrist in Boston who has A.D.H.D. — this knowledge-based economy has been a godsend. We thrive.
But attention disorder cases, up to 5 to 15 percent of the population, are at a distinct disadvantage. What once conferred certain advantages in a hunter-gatherer era, in an agrarian age or even in an industrial age is now a potentially horrific character flaw, making people feel stupid or lazy and irresponsible, when in fact neither description is apt.
The term attention-deficit disorder turns out to be a misnomer. Most people who have it actually have remarkably good attention spans as long as they are doing activities that they enjoy or find stimulating. As Martha B. Denckla of the Kennedy Krieger Institute in Baltimore has noted, we should probably be calling the condition something like "intention-inhibition disorder," because it is a condition in which one's best intentions — say, reading 50 pages in a dense textbook or writing a 10-page paper in a timely fashion — go awry.
Essentially, A.D.H.D. is a problem dealing with the menial work of daily life, the tedium involved in many school situations and 9-to-5 jobs.
Another hallmark, impulsivity, or its more positive variant, spontaneity, appears to be a vestige from lower animals forced to survive in the wild. Wild animals cannot survive without an extraordinary ability to react. If predators lurk, they need to act quickly.
This vestige underscores the fact that human genetic variability, the fact that we are not all simply clones of one another, has allowed us to survive as a species for 150,000 years in a variety of contexts and environments.
In essence, attention-deficit disorder is context driven. In many situations of hands-on activities or activities that reward spontaneity, A.D.H.D. is not a disorder.
Ultimately, if studies show convincing evidence that children and adults have been harmed by medications for attention disorder, cardiologists will have every obligation to tell us to halt their use.
But a more fundamental societal accommodation would be highly beneficial — to recognize that each child and adult learns and performs better in certain contexts than others.
As Arthur Levine, president of the Teachers College at Columbia University, has noted, future teachers will be able to individualize and customize the education of students.
Some children and young adults with attention disorder may need more hands-on learning. Some may perform more effectively using computers and games rather than books. Some may do better with field work and wilderness programs.
If it is indeed a context-driven disorder, let's change the contexts in schools to accommodate the needs of children who have it, not just support and accommodate the needs of children with attention-surplus disorder.
For those with attention disorder who wish to be full participants in a knowledge-based world, medications equalize their opportunities. The drugs should and can be used only as needed in the context of dealing with the tedium of school or the drab paperwork of some jobs.
Cardiologists, biostatisticians and consumer advocates may clamor, appropriately or inappropriately, to reduce the use of the medications. But unless we go back to the caveman world, some people will find the drugs increasingly necessary to succeed as knowledge workers in a drastically transformed modern world.
Paul Steinberg is a psychiatrist and writer in Washington.
The Claim: TV Shortens Children's Attention Spans
By ANAHAD O'CONNOR
Published: March 7, 2006
THE FACTS For about as long as television has been around, people have speculated that too much exposure to it can harm children's brains. So it was perhaps no surprise when a large study two years ago found that children who watched the most television also had the shortest attention spans. In some cases, all it took was an extra hour of television viewing a day to increase the odds of developing concentration problems by 10 percent, the researchers found.
But parents who cringed at those findings can breathe a little easier.
In the last two years, two other studies have failed to find any link between television exposure and symptoms of attention-deficit disorder. The most recent, published this month in the journal Pediatrics, based its findings on a group of 5,000 American kindergartners who were followed for two years.
The researchers found that children who watched the most television were no more likely to develop attention problems than those who watched the least television. The other study, in the Netherlands, also found no relationship. But researchers say more study is needed.
THE BOTTOM LINE The link between exposure to television and decreased attention spans in children may not be as strong as once thought.
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Date: 2006-03-08 01:28 am (UTC)So yeah, multitasking is easy and I at least can process and connect lots of information- I'm really good at synthesizing, say, the results from six tangentially related papers into a cohesive piece of information. But it's like the thing says, when I'm in the lab and it's time to mix little bits of chemically distinct clear liquid with each other, and put those through a set of temperature changes, all with the intended end purpose of getting different colored bits of water six hours later?
It gets hard to focus. Sometimes a boy wishes he had some legos.
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Date: 2006-03-08 01:29 am (UTC)