“Controversial” because he needed to publish a book?

This is a review of the 2012 Hyperactive: The Controversial History of ADHD by Matthew Smith, a chaired faculty member of the University of Strathclyde in Glasgow, Scotland.

My first reaction to this book is loathing. Dr. Smith’s two basic premises are: (1) because CIBA (now Novartis) encouraged the potential over-prescription of Ritalin as a medical treatment for ADHD when Ritalin was first commercially available; (2) because the medical community’s understanding of, and therefore terminologies for, ADD/ADHD have evolved over decades, there must not be such a neurological condition as ADHD. The astonishing callousness of these “conclusions” is monstrous: within his own Introduction: Why the Hype?, page 12,  paragraph 1, he writes:

“Hyperactivity is all around us. If current estimates are to be believed, anywhere between 2 and 18 percent of children in the United States, for example, have hyperactivity or Attention Deficit/Hyperactivity Disorder (ADHD). A recent survey of worldwide prevalence suggested that 5.29 percent of the world’s children had the disorder. Most of us know a  hyperactive child, or, increasingly, an adult diagnosed, and even if we do not, we could probably describe one quite accurately. Hyperactive children tend not only to be overactive, but also inattentive, impulsive and often defiant and aggressive as well. They have difficulty at school, have problems in their relationships and may eventually struggle in the world of work. The disorder is also associated with higher rates of imprisonment, drug and alcohol abuse and other mental illnesses, particularly depression.”

He blithely forgets that paragraph immediately. The tortured logic and scant research he uses to arrive at his opinions are blinding. There is not one mention in this book of world-renowned clinicians such as Dr. Edward Hallowell, complete disregard for dozens if not hundreds of documents providing detailed analyses of every aspect of ADD/ADHD, from compilations of case studies, to its potential origins to the biochemical and physical differences evident in the brains of ADD-abled and non-ADD-abled individuals.

Physicians’ understanding of cancer has undergone drastic changes over millennia. It was once thought to be contagious. Early humankind thought illness came from the gods: Antony Leeuwenhoek discovered bacteria in the 1670s and slowly knowledge of the inextricable connection between “germs” and disease developed. The naming of Bipolar Disorder has a long, and almost colorful, history. To condescend to disavow an illness because science, as a mandated part of its procedures, refines itself over time, is unforgivable. To invalidate an illness because American laws around marketing medicines are obscene is equally unforgivable.

I work with people with ADD/ADHD. People who’ve lost jobs because of their ADD. People who have confessed to using speed before their diagnosis, because it was the only effective tool they had for some kind of focus. People who have divorced, who are estranged from their children, because the chaos caused by their undiagnosed ADD/ADHD wrecked havoc in their lives. Deliberate disinformation leaves me livid.

Equally disheartening? There is, buried in the dreck, Dr. Smith’s compelling plea for a much more profoundly humane, child-centered approach to teaching American children, which Cold War politicians who had no business pretending they understood anything about teaching dispassionately forced American educators to abandon in response to Sputnik. And, equally worthwhile, he synthesizes decades of research that our larger environment(s) – home, school, community – have almost immeasurable influence over our lives, so that it can be argued that strong safety nets – addressing malnutrition, for example – may well have tremendous impact to eliminate learning and behavior challenges.

That was the book worth writing.