Since 1990 the number of school-age children diagnosed with ADHD has more than doubled from less than 5% to 11%. The reasons behind the large uptick continue to perplex experts, some suggesting greater awareness has helped to drive up the number, while others point to better diagnostic tools as the reason for the surge.
In an article appearing in The New York Times Magazine, Maggie Koerth-Baker, a science editor at BoingBoing.net, suggests a far more compelling and fascinating explanation that draws on sociological research—or she says in the Eureka column, “The rapid increase in people with ADHD probably has more to do with sociological factors—changes in the way we school our children, in the way we interact with doctors and in what we expect from our kids.”
Koerth-Baker makes a strong case for her premise:
The beginning of ADHD as an “epidemic” corresponds with a couple of important policy changes that incentivized diagnosis. The incorporation of ADHD under the Individuals With Disabilities Education Act in 1991 — and a subsequent overhaul of the Food and Drug Administration in 1997 that allowed drug companies to more easily market directly to the public — were hugely influential, according to Adam Rafalovich, a sociologist at Pacific University in Oregon. For the first time, the diagnosis came with an upside — access to tutors, for instance, and time allowances on standardized tests. By the late 1990s, as more parents and teachers became aware that A.D.H.D. existed, and that there were drugs to treat it, the diagnosis became increasingly normalized, until it was viewed by many as just another part of the experience of childhood.
Stephen Hinshaw, a professor of psychology at University of California, Berkeley, has found another telling correlation…. The No Child Left Behind Act, signed into law by President George W. Bush, was the first federal effort to link school financing to standardized-test performance. … When Hinshaw compared the rollout of these school policies with incidences of ADHD, he found that when a state passed laws punishing or rewarding schools for their standardized-test scores, ADHD diagnoses in that state would increase not long afterward. Nationwide, the rates of ADHD diagnosis increased by 22 percent in the first four years after No Child Left Behind was implemented.
Koerth-Baker adds several other pieces to the puzzle, and in all cases is careful to note that correlation does not equal causation. But by parsing a lot of data not usually brought to bear in the discussion of why ADHD diagnoses have mushroomed, she poses interesting questions, suggesting the reasons have more to do with social factors than environmental or biological changes.
To read the entire article, see The Not-So-Hidden Cause Behind the ADHD Epidemic