From NPRed, I recommend http://www.npr.org/sections/ed/2016/01/04/459990844/were-thinking-about-adhd-all-wrong-says-a-top-pediatrician. The article is titled, “We’re Thinking About ADHD All Wrong, Says A Top Pediatrician.” The following block quote contains a concept I support:

From Diagnoses of attention deficit hyperactivity disorder are up around 30 percent compared with 20 years ago. These days, if a 2-year-old won’t sit still for circle time in preschool, she’s liable to be referred for evaluation, which can put her on track for early intervention and potentially a lifetime of medication.

In an editorial just published in the Journal of the American Medical Association Pediatrics, Dimitri Christakis argues that we’ve got this all wrong. He’s a professor of pediatrics at the University of Washington and the director of the Center for Child Health, Behavior and Development at Children’s Hospital in Seattle.

Parents, schools and doctors, he says, should completely rethink this highly medicalized framework for attention difficulties.

“ADHD does a disservice to children as a diagnosis.” — Dimitri Christakis

Here’s why. Researchers are currently debating the nature of ADHD. They have found some genetic markers for it, but the recent rise in diagnoses is too swift to be explained by changes in our genes. Neuroscientists, too, are finding brain wiring patterns characteristic of the disorder.

But the current process of diagnosis amounts to giving a questionnaire to parents and doctors. If they identify six out of nine specific behaviors, then the child officially has ADHD.

“If you fall on this side of the line, we label and medicate you,” says Christakis. “But on the other side of the line, we do nothing.”

This process is, necessarily, subjective. But there’s an awful lot of infrastructure and, frankly, money behind it, especially in our education system. A clinical diagnosis of “chronic or acute” attentional difficulties gives public school students a legal right to special accommodations under the Individuals with Disabilities Education Act. But a child who falls just short of that diagnosis is left without any right to extra support.

Christakis says that, instead, we should be thinking more about a spectrum of “attentional capacity” that varies from individual to individual and situation to situation.

Eduhonesty: I like the idea of placing ADHD on a spectrum. We have too many yes-no diagnoses as it stands. Many people are neither depressed nor not depressed. Many people are neither autistic nor not autistic. We acknowledge the autism spectrum, the kids with autistic characteristics who function adequately or even excellently in school. The same can be said of ADHD kids. One of my daughters once teetered on the edge of an ADHD diagnosis. I could have tipped that girl into medication and accommodations. But she was doing too well in school, despite erratic performance in a gifted program. She would eventually graduate magna cum laude from college and enter an Ivy League graduate program.

How much attention deficit qualifies as too much attention deficit? We all have drifty moments. Some kids may drift frequently and yet remain educationally functional. If the boy who blurts out random thoughts on firetrucks understands the week’s math, gentle reminders to get back on task may be all the help that’s needed. I was a strong but somewhat ADHD student in high school, and I still remember chasing a dandelion seed across my Spanish classroom, catching it, and exclaiming, “Lookie, Señor!” I did not come back to the moment until the class and teacher broke down in laughter. The either-or nature of ADHD diagnoses has always bothered me.

Attentional capacity seems a sensible approach to attention issues. I’d like to go one step further, too. Different does not mean deficient. In the end, an ADHD student who is frequently performing at or above grade level should probably be left alone. That student may be a handful in the classroom and at home, but sometimes the genetic dice roll combinations that are not easy to force down into a chair for hours. The inability to sit for prolonged period should not be viewed as a defect. I struggled to sit quietly through the years, but I now have two graduate degrees.

I will end by noting that many kids can easily sideswipe learning while watching fire trucks. These students are able to keep up with their classes even if they need extra management and occasional modifications. We are likely better off leaving those students alone who are not quite keeping up with the crowd in terms of overall grades, but who are testing at or near grade level on annual tests. Regularly forgetting to do or bring homework should not, in and of itself, result in a possibly prejudicial school placement. Viewing ADHD as a spectrum behavior rather than an on/off disorder would help kids who could benefit from a little extra help without falling into the full machinery of the state.