Twitter was writhing again this week in response to Tom Bennett’s latest TES piece in which he linked the recent fidget-spinner craze to “crypto-pathologies” in education. The two examples offered were Attention Deficit Hyperactivity Disorder (ADHD) and dyslexia.*
It’s an interesting piece because – like many pieces by teacher-blogger/edu-celebrities – there is a vein of truth in what Tom says and I have sympathy for what I think is his main argument. But, his overall treatment of a really serious issue is ham-fisted and I fear it will do more damage than good.
Unfortunately, this is not the first time I’ve felt concern that research about over- and mis-diagnosis is in danger of being misinterpreted. I also received a request to blog on this issue from a concerned mum, so here goes!
Diagnosis and ADHD
I’ve spent much of my life in close orbit to ADHD and have always been scrupulously careful to stay away from the myth or reality debate. My research focus has always been the function the diagnosis serves and the implications it has for the education of kids who fit the diagnostic criteria.
There is legitimate concern in education research that ADHD will be held responsible for any and all issues a child experiences at school, perhaps detracting attention from the quality of education that child is receiving.
By the same token, quality teaching – in the form of clear and explicit instruction, with liberal doses of structure, routine and repetition – can help children with ADHD focus and retain what they learn. On this, Bennett is right.
However, rates of ADHD diagnosis have levelled off in many Western countries and it is no longer the “blink twice and there’s another kid diagnosed” disorder that it once was. The UK has always had lower rates of diagnosis and medication than the United States, Australia and Canada, so it does feel a little like ADHD is being used as a strawman in this case. That’s not very helpful to the kids and families involved.
The other thing that has interested me in this latest UK debate has been the framing of parents. In the various articles I’ve read, parents are being positioned as too stupid to be able to see through sham diagnoses and/or sham products, or looking for medical excuses for why their child can’t or won’t behave/learn rather than looking at their own parenting.
That’s just parent-bashing, to be frank. There is a very broad spectrum of parents out there with some who refuse to acknowledge their child is having any difficulties and others who see everything through the prism of the DSM.
Most are in the middle ground and most just want to find answers so that they can help their child make it through 13 years of school, so that they can get a decent job and live a happy life.
Yes, some will cop a bum steer [sorry for that Australianism… it’s Mother’s Day here and I’m too full of Yum Cha (thanks kids!) to think of an English alternative] and may latch on to fidget-spinners or wobble chairs or fish oil or brain training in the hope that it will help, but they don’t deserve derision for the effort.
None of these things are going to “cure” ADHD and I’ve yet to meet a parent who truly believes that. Teachers and parents are right to be cautious about the claims of these or any other gadgets sold on a promise.
Speaking of which, an excellent book to help parents and teachers navigate this minefield is Caroline Bowen and Pamela Snow’s Making Sense of Interventions for Children with Developmental Disorders.
The one caution that I would add is that research always lags reality by several years and only certain types of research get funded. Pharmaceutical research is where the big bucks can be found, so it’s not surprising that the majority of research relating to ADHD is pharmacological.
The point to note here is that medication doesn’t cure ADHD either and the side-effects can be significant enough to persuade many parents to try other options. At the end of the day it is the parent’s prerogative and whether they diagnose or not, medicate or not, or buy their kid a fidget-spinner and dose them in krill oil, is no one else’s business.
Happily, teaching and learning IS teachers’ business and, whilst a diagnosis can guide teachers’ sense-making, as Jules Daulby put it in her excellent blog post on this topic, at the end of the day:
It doesn’t matter if the child has ADHD or not… recognising behaviour traits and responding is the same, label or no label.
This is just one reason that I have recommended education systems move away from categorical SEN funding models.
A diagnosis is only ever a starting point and children with the same diagnosis can have very different support needs. Similarly, some children with different diagnoses (e.g., ADHD and Developmental Language Disorder) can have very similar support needs.
What matters at the end of the day is the interpretation of the presenting behaviour and the adjustment required. Get those two things right and everyone wins.
This is what I fear will be missed if teachers are influenced by well-meaning but naive interjections that associate very real problems like ADHD with the term “crypto-pathologies”.
These children don’t receive enough support as it is. A more positive contribution would be to address the reasons they don’t because that is what will make a difference to educational outcomes.
Anything else is just noise.
* I will restrict my comments to ADHD because that’s my area of research. For experts in dyslexia, visit the pages of Macquarie University’s Centre for Human Cognition and its Disorders. They have published a statement on what they mean when they use the term.
Bowen and Snow (2017) also cover the dyslexia terminology debate in their book, Making Sense of Interventions for Children with Developmental Disorders, see p. 231 (excerpt below).