ADHD: Difference or Disability?
In the landscape of spring there is neither better nor worse.
The flowering branches grow; some short, some long.
– Zen saying
No Known Biological Marker For ADHD
Dr. Russell Barkley essentially has created an industry surrounding his name and ADHD. While saying little that’s new to the field, he regurgitates the repetitive paradigm that essentially places AD/HD children and adults into the minimal brain dysfunction category, i.e., ADHD people are brain damaged. He pathologizes ADHD even though no known biological marker exists; no certain neuropathology or brain abnormality exists that definitively establishes the presence or absence of the disorder. The NIH Consensus Statement – Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder, states: “Although research has suggested a central nervous system basis for ADHD, further research is necessary to firmly establish ADHD as a brain disorder.” In short, does anyone know the cause? No. Has it been identified with a biological marker? No. Has it been positively attributed to heredity? No. The NIH publication, A Look At Attention Deficit Hyperactivity Disorder states, “The exact cause of ADHD has not yet been found.”
ADHD Is A Subjective Diagnosis
In other words, if one had a tumor, it could be located via scanning or possibly via X –ray and acted upon accordingly. Since AD/HD has no biological marker like a tumor, it is not identifiable as to physical location or magnitude. Simply stated, ADHD is a subjective diagnosis, an educated guess whose cause is unknown but is replete with theory.
A Neuropsychological Paradigm
While Barkley and others advocate the brain damage paradigm, this contradicts many psychologists’ current views that ADHD may naturally fall on the spectrum of genetic human traits like intelligence and hair color. Barkley’s neuropsychological paradigm predicts that ADHD will be found to have pathology, perhaps a single pathology. Proponents of this theory are looking for the Holy Grail of AD/HD – a single brain difference or dysfunction that will indicate the presence of ADHD. For many years researchers utilizing nascent technologies like SPECT, MRI, and QEEG etc., have produced reported structural and functional brain differences between subjects considered to be normal and those considered to have ADHD. Some research has demonstrated that ADHD people have brain sizes 2% – 5% smaller than their peers. Ridiculous as it may seem, this research, amounting to little more than a new phrenology, has contributed to a belief that these measurable differences establish a neurological basis for ADHD. This research has fundamental flaws and has greatly contributed to confusion regarding the cause of ADHD. Since no test exists to determine the presence of ADHD, and the diagnostic criteria are all subjective (and modified over the years), how does one select a group of normal subjects?
A Problem Of Antecedence
Assuming one could precisely find a normal group for comparative study, we still have the mystery analogous to the chicken and the egg – a problem of antecedence. Available research supports that any measurable differences in brain wave electroencephalography (EEG) or structural MRI (brain scanning) simply are the consequence of (and not the cause of) behaviors that define AD/HD or simply reflect personality differences.
