By Hwaa Irfan
One of the concerns expressed by American parents this summer is the extent to which their children are being diagnosed with Attention Deficit/Hyperactive Disorder, ADHD, and being forced to put their children under drug therapy by teachers and doctors. The parents are not within the low income bracket that has been included as one of the key factors with ADHD children, and neither are their professions. The fact that these parents express concern indicates that they have a difference of opinion about their children, negating the history of the number of parents in the U.S. who have contributed significantly to understanding the nature of a childhood disease from deaf and blindness to autism. But what is ADHD!
Attention Deficit/Hyperactive Disorder
According to the World Psychiatric Association:
- “Attention Deficit/Hyperactive Disorder is a behavioral disorder that affects up to 1 in 20 children in the U.S.”
The characteristics include:
• Inattention and/or impulsivity and hyperactivity
The definition by the American Psychiatric Association, APA “as it is now defined” according to the World Psychiatric Association has led to the understanding of this illness. APA definition found on their website is:
“ADHD, or attention-deficit hyperactivity disorder, is a behavioral condition that makes focusing on everyday requests and routines challenging.
“People with ADHD typically have trouble getting organized, staying focused, making realistic plans and thinking before acting. They may be fidgety, noisy and unable to adapt to changing situations.
“Children with ADHD can be defiant, socially inept or aggressive.
“Families considering treatment options should consult a qualified mental health professional for a complete review of their child’s behavioral issues and a treatment plan”.
As stated on their website, this definition is taken from the Encyclopedia of Psychology. However in the World Psychiatric Association, WPA, overview of the problem, consistency in definition is not reflected throughout the profession, in their attempt to ascertain whether ADHD is “… largely an American disorder”.
In looking at the landscape around the world, WPA have found disparity in definition despite 40 years of American research. The World Health Organization, WHO, use the term “hyperkinesis.” In the U.K., Australia, Canada, and New Zealand the problem is referred to one as “hyperactive”, with hyperactive meaning restless and distractable being distinct from antisocial, defiant and aggressive behavior. In the U.K. children who are hyperactive are diagnosed as having “conduct disorder”, and in the US, ADHD. Taking into consideration the differences in method of diagnosis, WPA found that ADHD is not peculiar to the US, however there is difference in degree. A child is forced to keep too still without any experiential imput is bound to become agitated, and from what can be seen by the definitions used can fall under the WPA/APA definition of ADHD. However, there seems to be a more cautious definition in European countries in an attempt to avoid those who may fall within the false-positive margin. In Europe, the hyperkinesis, HKD, is used for children who are deficient in attention span, motor control and perception i.e. DAMP though WPA defines this as a severe form of ADHD; yet WPA admits:
- “… the absence of adequate recognition of the disorder by the medical community, the teaching profession, and the public in general…”
What is apparent, is that the diagnosis of ADHD if considered a genuine disorder is higher in boys than in girls. Many of the studies around the world looked at by the WPA confirms the APA findings in the US. In addition, those studies that included the parents, and the children themselves in terms of diagnosis, report a significant difference between professional (medical-teaching) assessments and that of the parents and children. In all of this, there seems to be a widening gap between what is expected of a child developmentally, and what is expected socially. It has long been established, though not implemented, that boys need to have a more experiential learning experience, even into their late adolescence than girls. The nature of the gap between cognitive, and social developmental needs show quite clearly that the process of puberty as a social drive, and therefore becomes a greater arena of attention for young people, than the cognitive, and begins to level out towards late adolescence, and early 20s, yet schooling demands of them the opposite – ready or not! In any given country, one can see the difference in development, self concept, and maturity between a child raised in the countryside, and those raised in the city. Particularly for boys, being raised in the city, is less likely to provide suitable medium for self awareness, a developed self concept, and the ability to take on the responsibilities of adulthood. This marked difference becomes heightened once again when comparing cultures markedly different in that some cultures do not perceive adolescence in the same way as the West. Looking at the rites of passage that still takes place in some parts of Africa, Professor Manu Ampim points out the following:
- “Adulthood rites are usually done at the onset puberty age (around 12-13 years of age in many cultures) and they are to ensure the shaping of productive, community-oriented responsible adults. There is nothing automatic about youth being productive members of society, nor is there anything particularly difficult about transitioning from a child to an adult. This transition to adulthood is exceedingly difficult in Western societies because there are no systems of adulthood rites to systematically guide and direct the young person through this important stage in his or her life cycle”.
As such, taking into consideration the pertinent natural developmental needs of a:
9-12 Year Old
– Fairness – justice – honesty – adventure – adaptability – trust-reciprocity
13 – 17 Year Old–
Challenges-adventures-personal space-opportunity to explore ideals-autonomy-interconnectedness-humility-personal power.
18 – 21 Year Old–
How much of the above developmental needs are undermined/oppressed by schooling today, and how much of what they are being forced to learn matches their developmental needs?
The Learning Environment
An example of established natural learning methods that work is that of Waldorf Education developed by Rudolph Steiner, who was revolutionary therefore controversial offering a real alternative to the damage caused by factory education. Waldorf Education contributed greatly to the understanding that child’s full potential can only be fulfilled by observing and facilitating the natural way in which children learn, which would enable them to meet their own potential the unification of the spirit, body and soul via the true understanding of human nature.
At age 7 in Waldorf education, a child’s imagination is the medium through which learning takes place. This isn’t the limited understanding of imagination through books etc, or in the case of T.V. which robs a child of their imagination, and replaces it, but the imagination that comes with one’s relationship with the world, i.e. experiential: constructive and creative play, art, linguistic development, storytelling, and gardening for example.
- “…if we want to stimulate the child pedagogically during the first seven years, then we
don’t train its thinking but we support its imagination, its powers of imitation—especially if we give space for real activity of will” – Michaela Glockler, M.D.(teacher in the Waldorf method).
Ages 7 – 14, the desire to belong is the medium through having the same teacher throughout the course of a school day/week etc., class mates, and as a collective experience explore the world. The curriculum is more structured with a multisensory approach with the aim of developing expression and memory. Text is not provided, but created by the children as a means for them to reinforce, and affirm what they have learnt experientially i.e. literature, through storytelling, eurythmy, practical crafts, the natural sciences, foreign languages, art, outdoor activities and music.
- “Our ego is our purest agent of spiritual intentions. I am not referring to the sort of willfulness arising from the drives and instincts of our body, but the sort of will coming from our ego intentionality, our ego organization. When we can observe in the youngster this sort of will in the thinking, then puberty is over because idealism is born.” – Michaela Glockler.
The high school years are focused on developing the intellect through rationale, ethics, social responsibility, and handling of complex issues.
- “… when the ego organization becomes free in the middle sphere and feeling appears in thinking. Then a sense for what is true, what is authentic, is born along with a tremendous feeling of powerlessness, of feeling insufficiently grown up to meet the world. So it is that at this age we have a high incidence of suicide. Feeling enters into thinking as the ego organization becomes free in this realm. So first we learn to bring will into our thought; then into our emotional lives as we struggle with our emotions including the danger of suicide. Then in the last phase of this period—from around 18 2⁄3 to about 21—this free will enters into our physically orientated will. One can say that “the will enters into the will.” We acknowledge these changes in the feeling life and later in the will by allowing our youngsters to vote at 18 (at least in some countries). With this right we recognize that young people have reached a stage of maturity at which they can think independently and, yes, handle their emotions.” – Michaela Glockler.
In the Waldorf approach to learning, a child is allowed to grow developmentally aligning the child physical, emotionally, mentally and spiritually, i.e. according to their developmental needs, which allows them to be fully prepared for their next developmental phase. The whole child is involved in the process of learning what they experience, rather than the brain only absorbing information rather than knowledge, which is experiential in nature. This is antithetical to what happens in schooling whereby knowledge is reduced down to being an endless stream of information because it is second hand, and not experienced; and what one does experience/one’s world may or may not form a part of one’s understanding of the world in balance!
In the more widely “accepted” Montessori approach to education, the adult-teacher plays a directors role, which began life with children who had disabilities in the slums of Rome, working with a child’s natural intelligence, developing a child’s confidence, and inner discipline until there is less need to interfere.
In both the Waldorf, and Montessori method children end up being more balanced, have greater self esteem, and able to express a more intelligent relationship to their environment.
The research in the U.S. over 40 years runs parallel with the standardization of schooling in the West becoming widespread, and as the formal means of education at a time when urban living and a less open environment becomes the norm for children growing up. In this period, we have become accustomed to the world of a child being confined within the four walls of a school from ages 5 – 18. Increasingly, the child’s world is decided by the adult, without the willing involvement of the child. Though seemingly willing, a child becomes increasingly imbalanced as aspects of their self development go unaddressed.
Man-Made Chemical Factor
Today we find ourselves in a situation whereby we have to be concerned about everything form of “food” our body ingests, that is external factors that feed either the body physical as in the food we eat, the physical environment as in the “foods” we absorb either indirectly or directly through various media including the air we breathe, and spiritual foods which nourish us or harm us. With a vast onslaught of man-made chemicals to add to the ADHD agenda we find that there are certain foods that children are sensitive too. Now there are some widely used compounds in our environment which has been linked to ADHD. Looking at 571 children aged 12 – 15 from the data of the U.S. National Health and Nutrition Examination Survey (NHANES), a higher level of polyfluoroalkyl chemicals, PFCs was found in their blood by the Boston University School of Public Health. PFC’s can be found in stain-resistance coatings, food packaging, and fire-fighting foams.
Perth’s Telethon Institute for Child Health Research, Australia in 2010, have found a direct relationship between ADHD in teenagers and the Western diet. Looking at the diet of 1,800 teenagers, they found the Western diet doubled the risk of ADHD.
A “healthy” pattern is a diet high in fresh fruit and vegetables, whole grains and fish. It tends to be higher in omega-3 fatty acids, folate and fibre. A “Western” pattern is a diet with a trend towards takeaway foods, confectionary, processed, fried and refined foods. These diets tend to be higher in total fat, saturated fat, refined sugar and sodium.
- “When we looked at specific foods, having an ADHD diagnosis was associated with a diet high in takeaway foods, processed meats, red meat, high fat dairy products and confectionary,” Dr Oddy, leader of the study said.
Yet still, it has been generally accepted that there is a direct link between the food colorings and additives in foods and ADHD, but addressing this problem continues to go ignored. Professor Andrew Kemp of the University of Sydney points out:
- “Of the three main treatments for ADHD in children–drugs, behavioral therapy, and dietary modification–only drugs and dietary modification are supported by data from several trials. Yet, behavioral therapy, which has no scientific evidence base, is still thought of as necessary for “adequate treatment.”
There are many contributory factors which may indicate that susceptibility to one makes one susceptible to other(s), however it is only by looking at the whole child development process honestly and opening can we see how far current systems that are obliged to grow up in impacts on them as people. Maybe one day rather than try to change a human being, a gift of nature, into something unnatural according to man-made codes of what is considered to be normal, we can change the systems to becoming more natural for the development of man. As parents, if we are concerned about our children in the coming new school year we might want to take this time to review what it is we are providing for our children.
o Is your child happy at the school they have been attending? If you can’t tell or if you have been too busy to tell, try observing your child in different learning environments both conventional and unconventional. Observe what kind of information/knowledge they are able to share with you.
o If for reasons of income, you are not in a position to reflect on what your child learns everyday, make a point at least half an hour before bedtime, to share, and listen.
o Reduce the impact of the environmental challenges that your child might be struggling with by not buying processed foods or eating out
o Buy wholefoods, fresh foods, and when possible buy in bulk foods that keep well.
o Take the opportunity to have days out at local farms, where you can buy direct fresh fruits and vegetables. This would also provide a learning experience for your child.
o When possible buy organic, there is no better alternative despite all the counter-campaigns. The counter-campaigns are only half truths because there are those who will exploit for profit, equally as the food and agricultural industry are frightened of losing their profit-margin.
o Reduce information overload, as a child is faced with a constant bombardment of contradictory “dos” and “don’ts”. This can be done by only watching valid programs on T.V. only listening to forms of media that contribute to self understanding, getting to know the friends (and their parents) of your child, and participating more in their life outside the home, including school. This might mean a lifestyle change, but it might provide the window of opportunity towards leading a more fulfilling life!
o Make time for acts of worship, and appreciate life as a whole!
Amber L. Howard, Monique Robinson, Grant J. Smith, Gina L. Ambrosini, Jan P. Piek, and Wendy H. Oddy. ADHD Is Associated With a ‘Western’ Dietary Pattern in Adolescents. Journal of Attention Disorders, 2010; DOI: 10.1177/1087054710365990
Ampim, M. “The Five Major African Initiation Rites.”http://www.manuampim.com/AfricanInitiationRites.htm
APA. ADHD. http://www.apa.org/topics/adhd/index.aspx
Faraone, S. V. et al. The Worldwide Prevalence of ADHD: Is It an American Condition?. World Psychiatry. 2003 June. 2(2): 104 – 113
BMJ-British Medical Journal (2008, May 23). A Trial Of Removing Food Additives Should Be Considered For Hyperactive Children, Experts Suggest. ScienceDaily. Retrieved August 4, 2010, from http://www.sciencedaily.com¬ /releases/2008/05/080522210010.htm
Glockler, M. How Does the Middle School Meet Puberty? AWSNA Teachers’ Conference 2002.
Kate Hoffman, Thomas F. Webster, Marc G. Weisskopf, Janice Weinberg, Verónica M. Vieira. Exposure to Polyfluoroalkyl Chemicals and Attention Deficit Hyperactivity Disorder in U.S. Children Aged 12-15 Years. Environmental Health Perspectives, 2010; DOI: 10.1289/ehp.1001898
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