Neurodiversity: Is ADHD a True Mental Disorder?
Margaret V. Austin, Ph.D., edited by C. E. Zupanick, Psy.D.Controversies Surrounding ADHD
ADHD has become a controversial psychological disorder. Debates center on whether or not ADHD is a mental illness/disability: Perhaps ADHD is merely a variation of a normal condition. There are notable cultural variations and gender differences. Additionally, the accuracy of prevalence rates has been called into question. As we will soon see, these two camps (real disease vs. variation on the norm) have different explanations for the rapid increase in ADHD rates. This controversy is further fueled another debate about the wisdom and ethics of giving children powerful medications; and, the stigma of an ADHD label. This diverse group of concerned people include ADHD professionals, educators, caregivers, child advocates, religious and ethical groups, and others.
Neurodiversity: Is ADHD a true mental disorder?
The central controversy surrounding ADHD is whether or not it is actually a "disorder." Despite well-documented brain differences and significant impairment, some experts do not view these differences as symptoms of a disorder. Instead, they see these differences as normal, but somewhat extreme, variations of human behavior. These experts use the term "neurodiversity" to describe normal, genetic, brain-based variations in behavior.
Some disorders are evidenced by symptoms that represent a complete and total deviation from normal and healthy functioning (e.g., diabetes). Likewise, some conditions are perfectly healthy but uncommon (pregnancy). However, in both cases, these are all or none. You cannot be a little bit pregnant, nor have a touch of diabetes. You either do, or you do not, have these conditions. Think of this like a light switch. It is either on, or it is off.
However, unlike many biologically-based symptoms, behavioral symptoms can be a matter of degree. There are some behaviors that everyone demonstrates to some degree or another (e.g., inattention). Think of this like a dimmer switch with an infinite intensity range from on to off. ADHD is like a dimmer switch. It is characterized by behaviors (inattention, impulsivity, excessive energy, distraction) that everyone demonstrates in varying degrees. Therefore, the question then arises: At what point does something become a disorder?
The neurodiversity argument asserts that since a large portion of the population demonstrate ADHD-like behaviors, albeit to a lesser degree, ADHD is not actually a true disorder. It is simply an extreme example of a normal variant. To complicate matters, as we mentioned before, symptoms like impulsivity and excessive energy are not unique to ADHD. Several disorders have these symptoms. The fact that ADHD symptoms are not exclusive to that disorder seems to bolster the neurodiversity argument that ADHD is not an actual disorder.
Naturally, there are those that oppose the neurodiversity argument that ADHD is not a true disease. These experts readily acknowledge that people naturally vary in terms of energy, attention, and impulsivity. However, these experts emphasize that only some people experience impaired daily functioning as a result. This interference in daily functioning is central to distinguishing disorders from normal variations of behavior. In fact, this problematic interference in social, educational, and/or occupational functioning is a requirement for all psychiatric disorders. In the normal range, behaviors such as occasional inattention or daydreaming tend to be sporadic and are usually present in only one setting. This is in contrast to ADHD where the behaviors are readily observed in multiple settings.
For children with sub-clinical ADHD symptoms, their behaviors may cause them some problems. However, these problematic behaviors are not the dominant behavioral style across different settings. Most children are able to demonstrate some control over their problematic behaviors when sufficiently motivated. In contrast, children with ADHD seem to lack this ability to self-regulate, despite their motivation and desire to do so. Their problematic behaviors are frequent and severe enough to impair their functioning in multiple settings, across time.
Fortunately, this argument over the validity of the ADHD diagnosis has faded in recent years. This is attributable to the increasing number of studies that have found consistent biological differences between people with ADHD, as compared to those without. Repeated findings of biological markers support the idea that ADHD is a diagnosable condition. LINK
Beyond the United States, the international community reached an official agreement about the nature of ADHD. In 2001, over 80 ADHD experts around the globe signed and published the International Consensus Statement on ADHD. The purpose of this document was to challenge widely-held public skepticism and debate surrounding the validity of an ADHD disorder, requiring medication. By 2005, an additional 100 experts in Europe signed their names to the document. This additional support further strengthened and validated the statement that ADHD is indeed a valid mental disorder. At this time, the majority of professionals around the world view ADHD as a true, diagnosable condition.
Resources
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Articles
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Childhood ADHD Overview
- Introduction to Attention Deficit Hyperactivity Disorder (ADHD)
- Signs & Symptoms of ADHD
- ADHD Signs and Symptoms: Attention Difficulties
- ADHD Signs and Symptoms: Hyperactivity
- ADHD Signs and Symptoms: Impulsivity
- Are There Different Types of ADHD?
- The Social, Educational, Financial & Occupational Impact of ADHD
- What are the Legal Rights of Caregivers and Their Children with ADHD (USA)?
- A Positive Spin: Is There Anything Good about ADHD?
- Signs of ADHD in Children at Home
- Signs of ADHD in Children at School
- Signs of ADHD in Children in Peer Relationships
- How Do I know if My Child Needs an ADHD Evaluation?
- What Should I Do If I Think My Child Might Have ADHD?
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ADHD Discoveries and Controversies
- ADHD: New and Exciting Brain Research
- ADHD: New and Exciting Brain Research - Part II
- Neurotransmitter Changes with ADHD
- Executive Functions
- Neurodiversity: Is ADHD a True Mental Disorder?
- ADHD Statistics
- Cultural and Gender Differences in Prevalence Rates
- Should Children with ADHD Be Medicated?
- New and Promising Areas of Research
- Causes of ADHD in Children
- ADHD or Another Condition?
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Diagnosis of ADHD in Children
- Who Can Diagnose ADHD?
- How Does ADHD Multi-Source Assessment Work?
- Assessment Instruments: Behavioral Checklists
- Assessment Instruments: Intelligence Tests
- Assessment Instruments: Achievement Tests (or Academic Tests)
- Assessment Instruments: Tests of Attention
- Assessment Instruments: Memory and Other Common Tests
- Step 2: Clinical Interviews
- Step 3: Physical Exam and Medical History
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ADHD Treatment in Children
- Multimodal ADHD Treatment Approach
- ADHD Medications
- Treating ADHD with Stimulant Drugs
- Commonly Prescribed ADHD Stimulant Medications
- Treating ADHD with Non-Stimulant Drugs
- Risks of ADHD Medication
- Risks of ADHD Medications - Part II
- Benefits of ADHD Medication
- Side Effects of ADHD Medications
- Medication Decisions and Medication Management
- How Long Should ADHD Medication Treatment Last
- Psycho-Education about ADHD and Its Management
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- Individual and Cognitive Behavioral Psychotherapy for the Child with ADHD
- Skills Training
- Social Skills Training and Coaching
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- Alternative ADHD treatment: What Does NOT Work?
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Family and Personal Supports
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- Learn about Resources and Be Proactive
- Manage Stress, Self-Regulation & Provide Order
- Develop Routines, Organization and Expectations
- Communicate and Collaborate with Schools
- Express Confidence in Your Child's Abilities
- Help Children Improve Social Skills and Peer Relationships
- Avoid Homework Battles and Monitor Medication
- I Think I have ADHD. What should I do?
- I Think I Have ADHD - Part II
- Famous People with ADHD
- Adult ADHD Overview
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Diagnosis of Adult ADHD
- How is Adult ADHD Diagnosed?
- Diagnostic Challenge 1: Looking into the Past
- Diagnostic Challenge 2: ADHD versus Similar Disorders
- Diagnostic Challenge 2 - Part II
- Diagnostic Challenge 3: ADHD Symptoms
- Diagnostic Challenge 3 - Part II
- Diagnostic Challenge 4: A Concealed Disorder
- Specialized Tests and Tools
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Adult ADHD Treatment
- ADHD Medication Treatment
- Stimulant and Non-Stimulant Drugs for Adult ADHD
- Medication Timing, Dosage, Monitoring, and Duration of Treatment
- Weighing the Risks and Benefits of Adult ADHD Medications
- Psychotherapy for ADHD
- Coaching/Supported Employment for Adult ADHD
- Social Skills Training for Adult ADHD
- Psycho-Education and Cognitive Behavioral Therapy (CBT)
- ADHD Resources and References
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Childhood ADHD Overview
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Questions and Answers
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- Making ADD Work
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- New Look at ADHD: Inhibition, Time, and Self-Control
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- Overcoming ADHD
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- Reclaiming Our Children
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- Ritalin is Not the Answer Action Guide
- Ritalin Nation
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- Should I Medicate My Child?
- Taking Charge of ADHD, Revised Edition
- The Explosive Child
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- Conditions May Mimic ADHD
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- Department of Education Guidance Broadens Understanding of 504 Rights for Kids with ADHD Part I
- Treating ADHD in the African American Community
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- ADHD in Preschoolers: What to Look For and How to Help
- FYI on ADHD Evaluations
- Teaching Grit, Perseverance and Frustration Tolerance to Students with ADHD
- Does my Child Have ADHD?
- How to Start Eating Well When You Have ADHD
- 5 Solutions for Common ADHD Social Struggles
- Is My High School Student Ready for College? (And Is My College Student Ready to Go Back?)
- Understanding and Applying the Science of Time Management
- ADHD Medication and College Students: Prevent Misuse, Abuse, and Diversion
- Improve Homework Time with Strategies That Work For ADHD
- Student Voices: What Really Matters to Young Adults With Learning and Attention Issues
- 5 Ways Nutrition can Impact ADHD Symptoms
- 3 Tips for Adjusting to a New Diagnosis of ADHD
- Creating the Best Learning Environment for Students with ADHD
- ADHD & Executive Functioning
- Department of Education Guidance Broadens Understanding of 504 Rights for Kids with ADHD Part II
- Ask The Expert: Neurofeedback Treatment for ADHD
- ADHD and Suicide Risk Factors
- The Choice is in the Details: Medication Options for ADHD
- Understanding and Supporting Young Adults with ADHD
- Helping Your Young Adult Become Independent
- Creating Structure and Routines for Children with ADHD
- When You and Your Child Have ADHD - Communication Skills to Resolve Conflict
- Guidance for Uncertain Times: Navigating Relationship Challenges
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- Couples with ADHD: Creating Caring Connection amid the Chaos
- Disclosure and Workplace Accommodations for Individuals With ADHD
- A Summer At Camp
- Self-Advocacy Tips For Teens With ADHD
- ADHD and Curbing Impulsive Spending to Help Your Relationship
- ADHD: Signs, Symptoms, Research
- ADHD & Risk of Adult Drug Use
- Health and Life Expectancy in ADHD
- Focus on ADHD
- Pediatrics: ADHD and Food Allergies
- ADHD: It's a Family Affair
- Does Your Child Have ADHD?
- ADHD in Children
- Living with ADHD
- Rise in ADHD Cases in Children
- Why is Dating Difficult When You Have ADHD
- Video Games, Screens, and ADHD A Potent Mix
- Ask the Expert Helping Children with ADHD LD Conquer Chronic Stress
- Ask the Expert: Mindfulness, Stress, & Emotion
- Attention Deficit Hyperactivity Disorder
- Ask the Expert Educator Edition: ADHD & Executive Functioning
- Ask the Expert - Academic Evaluations - What Parents Need to Know
- ADHD and Sibling Relationships
- Medication Treatment for ADHD
- Using Time Out
- Treating Childhood ADHD
- ADHD-friendly Summer Family FUNdamentals
- Preparing Older Teens for the Road Ahead
- Tips for Teachers: Tailoring homework to make a difference
- Your Active Preschooler: Could it be ADHD?
- Tips for Teachers: Creating a positive dialogue with parents of students with ADHD
- Helping Parents & Kids Understand the Social & Emotional Aspects of ADHD
- Social and Emotional Concerns of Children with ADHD: Strategies to Help
- Holiday Gifts for Children with ADHD
- Behavior Management and Combined Treatment for Children with ADHD
- Setting Realistic School Expectations for Students with ADHD
- On Their Own: Helping College Students with ADHD
- Children's Communication Challenges: Is it Attention, Language or Both?
- Out-of-School: Parenting During the Summer
- ADHD in the Workplace: Finding Success
- Emotions and Motivation in ADHD
- The Role of Medication in Managing Children's ADHD Symptoms
- Top Tips for Combating Stigma and Addressing Myths about ADHD
- Facts and Myths about ADHD
- What To Do If Your Child Has ADHD?
- How Common is ADHD?
- Children, Meds, and Heart Safety: A Tale of ADHD and Public Health
- ADHD & Your Child’s Transition to College
- Your Teen with ADHD: Challenges and Strategies for Success
- Ask the Expert - No more homework battles
- A Frontline to ADHD
- Understanding Girls with ADHD
- What is ADHD?
- What To Do When Your Child With ADHD is Bullied
- Stop the Chaos! Tips for Creating a Peaceful Household When Mom has ADHD
- Is It ADHD?
- Ask the Expert - What else can I do? Complementary approaches to ADHD treatment
- All in a row: Getting your kids with ADHD organized
- Your Student With ADHD Was Admitted to College, Now what?
- Evidence-based treatment for ADHD in young children
- Home life when Mom or Dad has ADHD: Succeeding with your family
- How does technology affect ADHD?
- Diagnosing ADHD
- Helping Your Child Successfully Handle Change
- Recognizing challenging behaviors in young children: Could it be ADHD?
- Classroom Managment Supports for ADHD Behaviors in Preschool Settings
- Getting through to your teenager with ADHD
- What Everyone Should Know about ADHD
- Make Learning Exciting: Apps for Executive Functioning
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