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Tuesday, March 7, 2006

Is attention deficit a disorder?

From today's Science Times, psychiatrist Paul Steinberg writes:
We live in an information age, in a knowledge-based economy.

For those of us who have "attention-surplus disorder" — a term coined by Dr. Ned Hallowell, a psychiatrist in Boston who has A.D.H.D. — this knowledge-based economy has been a godsend. We thrive.

But attention disorder cases, up to 5 to 15 percent of the population, are at a distinct disadvantage. What once conferred certain advantages in a hunter-gatherer era, in an agrarian age or even in an industrial age is now a potentially horrific character flaw, making people feel stupid or lazy and irresponsible, when in fact neither description is apt.

The term attention-deficit disorder turns out to be a misnomer. Most people who have it actually have remarkably good attention spans as long as they are doing activities that they enjoy or find stimulating. As Martha B. Denckla of the Kennedy Krieger Institute in Baltimore has noted, we should probably be calling the condition something like "intention-inhibition disorder," because it is a condition in which one's best intentions — say, reading 50 pages in a dense textbook or writing a 10-page paper in a timely fashion — go awry.

Essentially, A.D.H.D. is a problem dealing with the menial work of daily life, the tedium involved in many school situations and 9-to-5 jobs.

Another hallmark, impulsivity, or its more positive variant, spontaneity, appears to be a vestige from lower animals forced to survive in the wild. Wild animals cannot survive without an extraordinary ability to react. If predators lurk, they need to act quickly.

This vestige underscores the fact that human genetic variability, the fact that we are not all simply clones of one another, has allowed us to survive as a species for 150,000 years in a variety of contexts and environments.

In essence, attention-deficit disorder is context driven. In many situations of hands-on activities or activities that reward spontaneity, A.D.H.D. is not a disorder....

If it is indeed a context-driven disorder, let's change the contexts in schools to accommodate the needs of children who have it, not just support and accommodate the needs of children with attention-surplus disorder.

For those with attention disorder who wish to be full participants in a knowledge-based world, medications equalize their opportunities. The drugs should and can be used only as needed in the context of dealing with the tedium of school or the drab paperwork of some jobs.
It's frightening to think that the modern world has been organized around what are aberrant capacities (like "attention surplus"), putting those with normal capacities (that were useful when evolved) at such a disadvantage that drugs -- dangerous drugs -- must be used to compensate.

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