Recent coverage drawing attention to the likely over-treatment of Attention Deficit Hyperactivity Disorder (ADHD) in the United States is very concerning. Data from the Centers for Disease Control and Prevention (CDC) show the diagnosis being made in 11 percent of youth by the time they finish high school, which amounts to a near six-fold increase since 1990. There is much to question about the stark rise in this largely-subjective diagnosis, particularly given the medications used to treat ADHD carry significant side-effects for patients (e.g., insomnia, appetite loss, hallucinations) and come at a hefty financial cost to society.
Experts suggest far more children are taking meds for ADHD than really need to. While severe cases of ADHD require medication, the estimated prevalence of these cases is considerably less than the number being treated today. The majority of reporting on the over-treatment of ADHD focuses on the pharmaceutical industry's comprehensive sales and marketing toolkit, which has no doubt played a large role in the rise of the diagnosis. Makers of drugs for ADHD have strategically targeted parents and teachers for the past two decades, selling their drugs as quick fixes for hyperactive kids that are "safer than aspirin," a questionable assertion at best.
Yet there may be an additional force underlying the surge in ADHD and one that is rarely mentioned if at all. America has seen an extensive reduction in physical activity, a trend that has run in lock-step with the rise of ADHD.
Kids have lots of energy and are losing opportunities to expel it naturally. According to the CDC, less than 30 percent of adolescents meet the guidelines for daily physical activity. The reasons for this are many, ranging from neighborhood safety (i.e., crime and vehicular traffic), to urban density (and subsequent reductions in green space), to the cannibalization of what was once active time with screen-based entertainment. When taken together, the vast majority of America's youth are not moving much at all. Perhaps all of this bottled up energy is being manifested as unnatural hyperactivity, when the most unnatural part of the situation is the sedentary behavior of kids.
One of the few places youth can get protected and regular physical activity is in school, yet school districts across the country are cutting back on recess, gym classes, and after school sports programs. The most common rationale for this is that dwindling resources need to be spent on core topics (e.g., math and science) to prepare America's youth for a competitive global economy. Using precious time and money to invest in meaningful physical activity programs is thus inefficient. This is particularly ironic given studies demonstrate that when youth are engaged in regular physical activity they show less anxiety, increased focus, and better performance in academic settings, many of the primary symptoms of ADHD (not to mention the clear benefits of physical activity in reducing obesity, which some consider the country's most significant economic threat -- far greater than a lack of mathematicians and scientists). It seems we may be missing the forest for the trees.
Physical activity may work just as well if not better than strong drugs in countering the symptoms of ADHD. Yet we live in a culture where people are conditioned to want a quick fix for everything, and with a medical system that has learned to provide it. Unfortunately, this is not always the best approach, and the case of ADHD may be the latest example. Before turning to expensive drugs rife with side-effects to treat ADHD, parents, physicians, teachers, and education policy makers should consider the role of physical activity, and promote making it a regular part of children's diets.
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