Comment by zeteo | Hacker News Reader

Comment by zeteo | Hacker News Reader

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Well, considering the criteria used to diagnose ADHD, pretty much any kid who fails to be in exact lockstep with the rest of his/her class runs the risk of being forced into conformity with psychoactive drugs. Below are the currently official criteria (from http://www.neurosurvival.ca/ClinicalAssistant/scales/dsm_IV/...; note that these criteria are the ONLY means of diagnosis). I think personally I failed more than half the things on the list back when I was 6; thank Goodness they didn't have ADHD diagnostics back then.

-Fails to pay close attention to details or makes careless errors in schoolwork, work or other activities

-Has trouble keeping attention on tasks or play

-Doesn't appear to listen when being told something

-Neither follows through on instructions nor completes chores, schoolwork, or jobs

-Has trouble organizing activities and tasks

-Dislikes or avoids tasks that involve sustained mental effort (homework, schoolwork)

-Loses materials needed for activities (assignments, books, pencils, tools, toys)

-Easily distracted by extraneous stimuli

-Forgetful

-Squirms in seat or fidgets

-Inappropriately leaves seat

-Inappropriately runs or climbs

-Has trouble quietly playing or engaging in leisure activity

-Appears driven or "on the go"

-Talks excessively

-Answers questions before they have been completely asked

-Has trouble or awaiting turn

-Interrupts or intrudes on others

You left out some qualifiers, though:

- "Persisting for at least 6 months to a degree that is maladaptive and immature..."

- "The disorder impairs school, social or occupational functioning."

While all kids are going to exhibit many/most of the items on the list, most don't do so in a maladaptive way that's immature relative to their peers and that impairs their function. So while I'm certain there are inappropriate diagnoses of ADHD (perhaps disproportionately many, I don't know), I don't find the list you posted to be an indictment of the DSM-IV criteria.

After you start to hit many items on that list, though, some people box you in and hear impairment without objective evidence of it. I was seen by a counselor a few times for a witches brew of issues, mostly synonymous with being shy. She gave me the usual battery and picked up on my pervasive disorganization -- loses pencils, check, routinely avoids doing homework, check, not looking intimidating counselor in eye, check. She became convinced, quote, I would have no academic success without addressing my ADD. My mother explained that I had had straight As for my entire life and she wrote that off to "unusually good coping skills for his ADD"

I have one or two friends whose lives were very improved by medication, but the use of this diagnosis to label and crowd control scares me. And once you get it, that is the scarlet A. God bless my mother for keeping it out of my record. Otherwise, every paper I delivered late would have been because I was ADD. Bored in pre algebra because I had already solved systems of equations in two variables? ADD. Prefer reading books to group work? ADD.

In the old days, naughty kids would get a spanking, and shy kids would be lectured by parents. These days, society has decided to go "Clockwork Orange" on such crimes instead, and the seed of nonconformity is chemically suppressed in the brain.

> - "Persisting for at least 6 months to a degree that is maladaptive and immature..."

> - "The disorder impairs school, social or occupational functioning."

Which is pretty much the definition of typical little boys until recently. Read "The Ransom of Red Chief" http://www.eastoftheweb.com/short-stories/UBooks/RanRed.shtm... for what was once considered typical. Today, that kid would be drugged into submission.

Which is pretty much the definition of typical little boys until recently.

No, it's not. Typical members of an age group are by definition not immature relative to the average member of their age group. Thus they can't be maladaptively impaired in their functioning due to immaturity.

> Typical members of an age group are by definition not immature relative to the average member of their age group.

I think the argument is: "what happens to the average of a distribution when you throw out one tail?"

Yes, so - how does this make a difference? These qualifiers are subjective and add nothing on top of the diagnosis criteria above.

"persists for 6 months" - so you don't get Ritalin for the first tree you climb. Good.

"maladaptive and immature" = the "out-of-lockstep" factor I mentioned in my comment

"The disorder impairs school, social or occupational functioning" = you keep doing these things even though teachers and parents get annoyed at you.

It's hard to be "guilty" of doing the things in the list repeatedly, without also fulfilling the qualifiers.

I was diagnosed with ADHD, and while these criteria might have led to the testing, the actual testing was relatively scientific. There was a several hour battery of tests where my scores were compared against average. Most of the tests were relatively boring, like a computer screen would show letters, and you were supposed to hit the space bar for every character except Xs. People with ADHD performance at that task degrades much more quickly over time vs people without. There were also tests where people would employ different memory strategies to do them, and people with ADHD tend to use particularly poor ones. The doctor would read a list of 12 words, and you were supposed to recite it back. Then he'd tell you what words you missed, and you'd try to say the whole list again. Most people can get the whole list in 3-4 tries.

They also did an IQ test and the scores on all the ADHD tests were compared to what would be expected for my IQ. I performed at sub tenth percentile on many memory tasks, but my IQ was substantially hire than tenth percentile.

Just including multiple-choice questions doesn't make a test scientific. It's easy to fail all of those tasks if you simply see no point in them and keep wishing you were outside, climbing a tree instead.

This just sounds like a normal 6 year old to me.

Yes. Specifically, a normal 6 year old boy.

I'm a woman and I'm pretty sure I was like this when I was in kindergarten, as were most of my friends. I would be kind of concerned to meet a 6 year old girl who never acted this way.

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