ADHD is not always about deficit

David was in grade 9 at the Middle School. He had been referred by teachers because they found him unable to concentrate and sit still in class whilst they were teaching. So he was psycho-educationally assessed very thoroughly, referred to a medical specialist and came back with a diagnosis of ADHD.

I remember having a conversation during handovers with the principal of the High School. He was nothing short of outraged that such words, ADHD, were used when describing David in the classroom. “I have seen him concentrate without any problem at all!”

He was utterly correct and his advocacy was critically important to David’s life and self-esteem.

Let me make a statement about diagnosis and medication of ‘ADHD’.  I have no problem with diagnoses as long as they are made by psycho-educational and medical specialists. I also have no problem with the use of methylphenidate if it is prescribed after extensive assessment and is appropriate for each child (some kids react with heightened anxiety to the medication), differential diagnosis and is not being used solely as a measure of control for teachers or parents exasperated by the child. Psychologists and teachers for that matter, in terms of their interventions should in my view not rely on the medical/illness/disease model but should rather take a phenomenological approach to a person’s ‘manifestations’; their liquorice allsorts; understand and document the fullest range of the child’s strengths and weaknesses with regard to all their abilities beyond the standard IQ test. Be on the ‘look-out’ vigilant to those aspects of the child that are amazing.

You see I believe that ADHD is wrongly understood and accepted as a deficit condition. I dispute this notion, not in every instance but in virtually every instance I experienced in nearly twenty years in school education.

Like the High School principal I too have repeatedly seen kids diagnosed with ADHD exhibit the capacity to focus mentally and physically with no problem at all; simply indistinguishable from any other so called ‘normal’ child.

Let me explain.

I don’t particularly find traditional IQ tests very useful. They are useful in that they pick up some areas of ability useful in a sit-down, sit-still classroom context that are either poorly developed or absent in extreme cases. The thing is that the importance and worth of any ability should be linked to the specific context in which the specific demands on the child are being made. Sadly IQ’s do not always pick up on other abilities that the child might possess. Why believe that there is a narrow range of ‘legitimate’ and ‘real’ abilities to the exclusion of others. My own view is that there are unlimited abilities available to and manifested by people; I share the position of Howard Gardiner in this vein.

I have seen a child who literally never passed a normative, age-level exam in his entire school career, who could barely read; build a go-kart that was simply mind-blowing in its beauty and sophistication; it was nothing short of a genius intelligence, a genius ability for a child who on the standard IQ test would have measured as developmentally delayed.

So too with a child diagnosed with ADHD; the really important work is not to simply or only measure how well the meds are working to ‘subdue’ the child but to create opportunities and be comprehensively open to discovering the beauty and abilities of the child.

The first question is to ask where the child does concentrate, in which context, doing what and what seems different about the child’s demeanour or attitude towards himself; far more males are diagnosed than females.

You see I do not believe that there is much merit or fairness in measuring a child’s worth by the things that they can’t do, we need to look for, acknowledge and encourage with vigour those things that the child can do. At school we would never ask the Head of subject A to organise the school timetable; she couldn’t do it. In the same breath we would never ask the Deputy Manager to organise a party; he couldn’t do it. But swop the roles and you were guaranteed the best most efficient timetable and a humdinger of a party!

I firmly believe in remedial interventions, at the earliest age possible. But there are often limits to what can be repaired or compensated for. Sometimes we have to thank the heavens for what we do have and accept gracefully what are not our apparent strengths.

ADHD might usefully be understood as a phenomenon comprising issues in the modulation of motivation and attention wherein motivation is intricately linked to issues of self-esteem experienced by the child required to undertake specific tasks and have particular levels of motivation in specific contexts.

So don’t see a deficit; accept that in specific contexts and with specific demands some kids will struggle. Look for and create opportunities for kids to find their power, passion and skills; their worth and direction in life! Remember you won’t always find them at