Abstract
ADHD has become a rapidly growing issue with the percentage of American children diagnosed and treated for ADHD increasing each year. This article discusses what is known about ADHD, current treatments prescribed in the United States and discusses the general lack of a medical or a scientific approach to resolving the epidemic. After evaluating what is known, more precisely what is unknown this article discusses the root cause which has led to the uncontrolled rise in ADHD in the United States.
Keywords: ADHD, parents, consequences, behaviorism, medication, Ritalin
Introduction
Attention Deficit/Hyperactivity Disorder known as ADHD is a serious issue. According to the Centers for Disease Control and Prevention approximately 11 million American Children are affected by ADHD. ADHD in its basic understanding means a child is unable to provide any sort of sustained attention to any one task or any one person. This makes it difficult for educators to address and educate the child. The epidemic of ADHD has created issues related to the treatments doctors have been prescribing. Most treatments for ADHD are questionable at best as the majority of medications prescribed could be described as medical speed. It is believed administering medical speed has the opposite effect calming the child down allowing him or her to pay attention.
What is the cause of ADHD has been guessed at but with little relevant research or consideration of why this has become an issue of today and was not an issue of the past. From a behaviorist’s point of view ADHD is an issue or a failing of the parents, not the child. It could easily be argued it is also the failing of society leading to the increase in children effected by ADHD. For a behaviorist the prevention of ADHD is simple.
The Problem
ADHD is increasing, effecting 6.2 million children in the United States, nearly doubling the number of effected children in 2007 (Center for Disease Control and Prevention, 2018). The rapid growth of this disorder is presumably unknown with little focus on further research into the cause of the disorder. Often times conversations related to the issue quickly become emotional as parents demand treatment for their child avoiding a deeper discussion of the child’s symptoms. It is important to note not all children have been affected by ADHD at the rate American children have been with ADHD being almost nonexistent in locations such as France (Wedge, 2016).
ADHD is often treated with medication which is arguably not suitable for children and questionable for adults. ADHD has been treated with Ritalin and similar medications for decades with no justification from the medical community. Ritalin has been described by many as medical speed (Keane, 2008; Rawson, 2007). The idea behind this treatment is providing a stimulant to someone who is hyperactive has a counter effect causing the child to calm themselves or become hyper focused. It seems the medical community and society has gone without the conversation of what is ethical to prescribe to a child. Certainly, specific situations require any and all possible treatments to be used but a child being distracted, hyper or disobedient is not one of them. When the conversation is related to ADHD there seems to be no limits to the child needs help argument, preventing those who should be protecting children from standing up and questioning the treatment practices of ADHD diagnosed children.
The issues related to an ADHD child is the inability to function; in school, with obedience, in interactions with parents and siblings, and in interactions with others such as teachers. At its core ADHD seems to cause a child to be rebellious, self-centered and solely focused on what interests the child for that moment in time. These issues make it impossible for parents to raise their child, for teachers to instruct the child and for society to interact with the child. The parents feel helpless believing medication is required in order to be able to function with the child. The parent’s belief has become a reality for the family with an ADHD child and for society (Graham, 2012). These issues are how society has come to the belief, treatments such as Ritalin are acceptable.
Behavioral Analysis of ADHD
A behaviorist would view ADHD as a lack of proper conditioning or possibly in the reverse, improper conditioning. Either the child was not properly conditioned to act appropriately by the parents or the parent’s actions conditioned the child to act inappropriately. Translated, as the child grew, learned and discovered the world around them there was a lack of consequences. In life there are consequences for every action. However, if a child does not learn this as soon as the child becomes aware and relearn this fact at every stage of cognitive development the child undoubtedly will struggle to function within society.
For example, if every time a child is told no, once the child cries enough the child is given what it desires, the child is being conditioned to believe the act of refusing to cooperate will lead to what is desired. If a parent were to instead say no and as the child continues to rebel the parent were to add more consequences due to the child’s disobedience the child would learn to act out will not lead to what is desired. Freud’s pleasure principle states living creatures seek pleasure and ovoid pain (Freud, 1922; Hothersall, 2004).
This principle leads the understanding of a child’s behaviors to be directly related to what the child finds pleasurable or seeks to please itself. If a child’s sole desire is to seek pleasure and avoid pain than it is logically assumed every action the child makes is in pursuit of pleasure or to avoid pain. If a child is acting out or unable to function within society the question must be asked, is the child functioning in a manner which it believes brings it pleasure? The pleasure principle is at the heart of understanding the issue of ADHD.
John Watson, might have argued he could treat ADHD by disciplining the child for poor behavior. In Watson’s Little Albert experiment Watson created a loud noise when a white lab mouse was placed on the bed with a child (Hothersall, 2004; Clark, 2004). As a result of the loud noise over time the child came to fear the lab mouse. The child was conditioned to associate the mouse with the loud noise which the child disliked. Watson believed he could take any healthy baby chosen at random and raise the child perfectly by applying classic conditioning (Hothersall, 2004). In the same manor Watson may have argued he could treat ADHD by conditioning the child to associate poor behavior with a consequence or item the child dislikes.
Ivan Pavlov, a Russian behaviorist who is known for conditioning dogs to salivate when a bell is rung. Through his experiments Pavlov was able to prove deeper functions of the body could be conditioned (Hothersall, 2004; Clark, 2004). Pavlov, as a slightly rougher man than most associated with the history of behaviorism might have suggested utilizing a dog shock collar to treat ADHD. When the child misbehaves, the collar would send a small shock to the child. This method would cause the child to quickly associate poor behavior with the shock causing a quick correction in the child’s behavior. This method would not be acceptable by today’s standards but that does not change the fact in Pavlov’s classic conditioning this method would likely be successful. Although Pavlov’s testing with dogs would be ridiculed today for cruelty Pavlov did important and critical work which shaped the understanding of behaviorism and the psyche far beyond the field of psychology.
B.F. Skinner, one of the most well-known behaviorists might have argued he could treat ADHD by providing proper rewards. In contrast to Watson, Skinner believed incentives were the means to condition behavior. Using the incentive of food Skinner conditioned laboratory mice to run through a maze and press a lever (Hothersall, 2004; Clark, 2004). Once mice realized there was food when the lever was pressed the mice became quicker at completing the maze and pressing the lever. Although one of the great behaviorist his work was criticized due to his methods and reluctance to consider findings in other’s previous work (Hothersall, 2004).
Deci and Ryan would likely view the issue of ADHD in a completely different light than Watson, Pavlo or Skinner. Deci and Ryan believed autonomous motivation is the key to long-term behavior (Deci & Ryan, 2008; Niemiec, Ryan, & Deci, 2009). Deci and Ryan would likely have argued the cause of ADHD is a lack of intrinsic motivation which aligns with society. In an ADHD child the extrinsic motivations to conform to societal norms do not exceed or align with the child’s intrinsic motivations. Deci and Ryan might have theorized, the root to addressing ADHD is to discover the child’s intrinsic motivations and use those motivations to provide incentives for proper behavior.
Behavioral Solutions
Behaviorism’s solutions include; discipline negative behaviors, reward positive behaviors, discover what motivates the child and play to the child’s motivations. If clear expectations are understood between the child and parents, negative behaviors being disciplined would teach or condition the child to desire not to repeat the action as the action becomes associated with the discipline. Rewarding the child when behaving in a positive manor causes the child to associate the reward with the behavior motivating the child to act in a positive manor as the child desires pleasure. Observe the child to discover the child’s motivations or desires, play to those desires to incentivize the child to act in a manor appropriate for growing up and interacting with society.
Limitations of the Behavioral Solution
Limitations of behaviorism’s treatment of ADHD include; the ability of the parents to provide consequences for the child, any underlying medical factors and how they influence the child’s cognitive abilities. Behaviorism is unable to treat the issue if it is caused by a factor such as a chemical imbalance. Appropriate medical testing can be conducted to determine if there is an underlining cause outside of what is currently known as ADHD. The limitation of parents can be mitigated by providing training for the parents or if means exist providing a nanny who has been proven capable. The most significant limitation or issue with behaviorism’s treatment of ADHD is the amount of funds and influence the drug industry has related to this disorder.
Conclusion
The CDC provides a list of signs demonstrating if a child has ADHD. This list includes; constant daydreaming, forgetting, reluctant to sit still, talking a lot, making mistakes, giving into temptation, not playing well with others (Center for Disease Control and Prevention, 2018). Everything included in the CDC’s list is associated with being a child and have been signs of being an ordinary child since modern society. With a list of signs for diagnoses such as this it is surprising more American children are not affected by ADHD.
Sigmund Freud provided the pleasure principle which explains the core of motivation in a living creature such as a child. Watson might have argued using his classic conditioning to condition an ADHD child to associate something the child dislikes with poor behavior is the solution to ADHD. Skinner might have a similar argument using conditioning to condition the child to act appropriately. However, Skinner would likely have argued to condition the child by associating items with good behavior causing the child to desire to act appropriately. Deci and Ryan would likely urge parents of children with ADHD to discover the child’s intrinsic motivations then use those motivations to incentivize the child to act appropriately. All of these behaviorists would agree, a child effected by ADHD is not receiving the appropriate consequences for their actions.
ADHD is a serious issue as it effects not only the child but those around the child. A child with untreated ADHD will likely be unable to focus leading to an inferior education, the inability to interact with others and the inability to be able to complete simple tasks. There are several current treatments to ADHD which involve medicating the child. The issue of ADHD is behavior, requiring a behaviorist’s approach to solve. By changing parenting tactics when ADHD is recognized a child can be treated without medication. Raising a child with consequences based on the child’s good and bad behaviors will condition the child to avoid bad behaviors while seeking good behaviors. Why continue to treat a condition with medication when a non-medication, a non-harmful treatment is available.
References
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