Attention Deficit Hyperactivity Disorder (ADHD) is a controversial condition that is closely tied to culture, environment and lifestyle and yet is heavily medicated with side effect ridden pharmaceuticals. Below we take a look at anthropological underpinnings and solutions to ADHD that take a more conservative approach.

ADHD in England

Recently, Ken Jacobson at the University of Massachusetts conducted a groundbreaking study showing that Attention Deficit Hyperactivity Disorder (ADHD) may be a culturally defined disorder rather than a medical one. Jacobson studied a group of 53 English 10 and 11-year-olds to determine why the English diagnose ADHD much less frequently than their counterparts in America. He found that English children defined as normal in England exhibit the symptoms of ADHD as it is defined in America. However, English students are rarely diagnosed with the disorder or treated with the drug Ritalin. He suggests that there is no biological basis for dividing children into groups like "learning disabled," "gifted," and "abnormal" because these are socially constructed terms that vary across cultures. According to Jacobson, less than 1 percent of English children are diagnosed as having anything similar to ADHD while approximately 5 percent of American children are labeled as having ADHD. He finds this is because the English accept hyperactive behavior at certain times in certain places as normal in children more readily than Americans. Currently Jacobson is conducting a similar study with 10-and 11-year-olds in a town near Amherst, Massachusetts.

Multiple Intelligences

Another researcher examining the cultural construction of ADHD is Thomas Armstrong http://www.thomasarmstrong.com/ who notes that the tests that have been used to determine if someone has ADHD are either artificially objective and remote from the lives of real children (in one test, a child is asked to press a button every time he sees a 1 followed by a 9 on a computer screen), or hopelessly subjective (many rating scales ask parents and teachers to score a child's behavior on a scale from 1 to 5: these scores depend upon the subjective attitudes more than the actual behaviors of the children involved). Armstrong notes that ADHD is a popular diagnosis because it serves as a neat way to explain away the complexities of modern life in America. Over the past few decades, our sense of community has declined and mass media has created a "short-attention-span culture," and stress levels have skyrocketed.

Armstrong notes that ADHD even shows racist origins as another way to label ethnic minorities as somehow defective. Studies show that today special-education classes are often disproportionately filled with minority students. And Armstrong notes that historically the disorder of ADHD was first created in 1851 when a Louisiana physician Samuel A. Cartwright published a paper in the New Orleans Medical and Surgical Journal wherein he described a new medical disorder he had recently identified. He called it drapetomania (from drapeto, meaning "to flee," and mania, an obsession), and used it to describe a condition he felt was prevalent in runaway slaves. Attention-deficit disorder has recently been re-named attention deficit hyperactivity disorder and in fact, the syndrome has changed names at least 25 times in the past 120 years. At one point it was even called minimal brain syndrome. Social critic Ivan Illich once wrote that each civilization defines its own diseases be they genetic, criminal, sinful, or even virtuous and treatments be they torture, hospitalization, execution, exile, or even financial aid. Armstrong also attributes the formation of ADHD to the importance of the Protestant work ethic and the need to somehow classify unruly children. Early founding philosophers such as Hobbes emphasized the importance of attaining positions of wealth and power through the rational and efficient use of time and energy, willingness to control distracting impulses, and to delay gratification in the service of productivity, and thriftiness and ambition. Deviance from this worldview is defined as distractibility, impulsiveness, and lack of motivation, the same traits frequently used to describe children suffering from ADHD according to Armstrong.

In contrast to the limited view of childhood and adult development defined by ADHD, Armstrong advocates for the theory of multiple intelligences (Gardner 2000), a concept that takes a more multi-cultural approach to human learning and cognition. This theory defines human intelligence in a much broader fashion than the standard currently defined by the IQ test. The various types of intelligence includes linguistic intelligence, logical-mathematical intelligence, spatial intelligence, bodily-kinesthetic intelligence, musical intelligence, interpersonal intelligence, intra-personal intelligence, and naturalist intelligence. The founder of this concept, Dr. Gardner, says that our schools and culture focus most of their attention on linguistic and logical-mathematical intelligence. We esteem the highly articulate or logical people of our culture. Unfortunately, children without skills in these areas end up being labeled learning disabled, ADHD or simply underachievers.

The theory of multiple intelligences also has implications for adult learning and development. Many adults find themselves in jobs that do not make optimal use of their most highly developed intelligences. One excellent resource is the Johnson O'Connor Human Engineering Laboratory in Boston, which is an excellent resource for adults seeking to better understand their unique aptitudes and match them to a career. When adults are stuck in a career that does not make use of their aptitudes they experience stress that can lead to disease.

Rewards Deficiency Syndrome

Other researchers on ADHD take an evolutionary approach to the disorder. Originally proposed by Thorn Hartmann (http:/ /www.thomhartmann.eom) the evolutionary model of ADHD is now being supported by researchers at the University of California, Irvine, who have concluded that a gene variation associated with Attention-Deficit Hyperactivity Disorder (ADHD) first appeared 10,000 to 40,000 years ago and may have been an advantage to the early humans who had it. In an article published in the January 8, 2002 edition of the Proceedings of the National Academy of Sciences Dr. Robert K. Moyzis and other researchers speculate that early humans with ADHD traits such as novelty-seeking, increased aggression and perseverance were more likely to survive. These traits have been associated with the DRD4 7R gene. Up to half of ADHD individuals have this same variant gene, according to Moyzis, one of the authors of the study. Today, many of these same traits are deemed inappropriate in the typical classroom setting and hence diagnosed as ADHD. Like their early ancestors, today's ADHD children are more active and often more aggressive than their peers. These children are always looking for something new to capture their attention. Once they find something interesting, such as a video game, they "lock on" and focus intently on the task. They are often unable to shift their focus to something new. Researchers speculate that a "survival of the fittest" scenario may have contributed to an ever-increasing number of people with ADHD. For example, being more aggressive, inquisitive, and willing to take risks meant a higher probability for mate selection and perhaps multiple sex partners, spreading the gene and its associated ADHD behaviors through the population. Primitive hunters with this gene would have been more successful and would have been better providers for their families and tribes. These and other factors may explain why the gene is so prevalent now. Like Armstrong, Hartmann notes that in light of these findings, we must also revisit the way we approach ADHD treatment in adults, moving from a broken/pathology/therapy model to a skill-set/opportunity/coaching model, noting that Thomas Edison, Ben Franklin and other innovators, inventors, and rebels of history would probably be diagnosed as having ADHD if they were alive today. This also demonstrates the need for us to revisit the way our schools and classrooms are organized, so ADHD children are no longer wounded by the experience of growing up in public school.