1. Ethical Human Psychology and Psychiatry, Volume 11, Number 1, 2009
Attention Deficit Hyperactivity Disorder:
Valid Medical Condition or Culturally
Constructed Myth?
J. M. Stolzer, PhD
University of Nebraska–Kearney
Over the last decade, Attention Deficit Hyperactivity Disorder (ADHD) diagnoses have
increased dramatically in the United States. This unprecedented increase in ADHD
across America has prompted scholars from various fields to question the scientific validity
of this relatively recent childhood disorder. This article openly challenges the definition
of ADHD as a legitimate medical condition and presents scientific evidence that corrobo-
rates the risks associated with prescribing dangerous and addictive drugs in order to con-
trol historically documented childhood behavior. According to published data, ADHD
diagnoses have reached epidemic proportions in the United States—particularly among
young males. Employing a multifaceted theoretical approach, ADHD typed behaviors will
be defined not as a “neurobehavioral disorder,” but as highly adaptive strategies that have
ensured the survival of hominid species across evolutionary time. Dissenting from the
DSM’s medical definition of ADHD, this article provides scientific evidence that substan-
tiates the economic and cultural factors that are associated with the ever increasing rates
of ADHD diagnoses in America.
Keywords: [Keywords here] [AuQ1]
A
ccording to the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV–
TR), ADHD is defined as a “persistent pattern of inattention or hyperactivity—
impulsivity that is more frequently displayed and more severe than is typically
observed in individuals at a comparable level of development” (American Psychiatric
Association [APA], 2000, p. 85). Symptoms of ADHD must be present in two or more
settings (e.g., at home and at school), and there must be verifiable evidence that the symp-
toms associated with ADHD interfere with social or academic functioning (APA, 2000).
Symptoms of ADHD include: careless mistakes in schoolwork, messy or incomplete assign-
ments, failure to pay attention, failure to follow instructions, lack of organizational skills,
lost or disorganized materials, and being easily distracted by extraneous stimuli (APA,
2000). According to the DSM–IV–TR, hyperactivity is confirmed by fidgetiness, squirming
in one’s seat, or not remaining sedentary when instructed to do so. Symptoms of hyperac-
tivity also include running, climbing, or refusing to play quietly. Children who are said to
have ADHD often appear to be “on the go” or act as if they are “driven by a motor” (APA,
2000, p. 86). Fidgeting with objects, tapping hands or feet, talking excessively, and acting
restless are also valid indicators of ADHD according to the DSM–IV–TR (APA, 2000).
It is interesting to note that the DSM–IV–TR states unequivocally that it is highly —S
unlikely children with ADHD will display the same level of dysfunction across contexts. —E
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DOI: 10.1891/1559-4343.11.1.5
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2. 6 Stolzer
According to the DSM–IV–TR, ADHD typed behaviors worsen in environments that
require sustained attention, sedentary activity, boring or mundane instruction, and monot-
onous or repetitive assignments (APA, 2000). Most importantly, symptoms of this disorder
typically cease to exist when: (a) the child is receiving frequent rewards for appropriate
behavior, (b) is under close supervision, (c) is in a novel setting, (d) is engaged in interest-
ing activities, or (e) is in a one-on-one situation with an adult (APA, 2000, pp. 86–87).
Although ADHD is the most commonly diagnosed neurobehavioral disorder in Ameri-
can children, many countries report little, if any ADHD among pediatric populations
(Breggin, 2002). Historically speaking, ADHD in America is a relatively recent phenom-
enon. In the 1950s, ADHD did not exist. During the 1970s, 2,000 American children
(the vast majority were boys) were diagnosed as hyperactive and behavior modification
techniques were the accepted method of treatment (Levine, 2004). Fast forward to
21st-century America, and ADHD diagnoses have skyrocketed as it is now estimated that
8–10 million American children have been formally diagnosed with ADHD and the vast
majority of these children are prescribed daily doses of methylphenidate in order to con-
trol undesirable behaviors (Baughman, 2006).
While it is certain that ADHD is generally accepted by the majority of Americans
as a valid neurological disorder, there exists no scientific evidence to substantiate this
newly constructed hypothesis (Baughman, 2006; Furman, 2005). There are no neurologi-
cal, metabolic, or attentional tests to confirm the existence of ADHD. Rather, formal
diagnoses are based on the results of a standardized assessment questionnaire, and it has
been suggested that the questionnaire is highly subjective and lacks scientific validity and
reliability (Baughman, 2006; Carey, 2002). Scholars have postulated that one of the major
flaws associated with current ADHD assessment procedures is that the status of the rater
(e.g., the person who is responsible for filling out the questionnaire) is not controlled in
any way. Tolerance level, understanding of normative developmental processes, gender,
age, personality type, education, individual perception, and cultural background are all
factors that influence rater perception, yet these critical variables are not taken into con-
sideration during the diagnostic phase (Carey, 2002; Stolzer, 2007).
According to the World Health Organization (WHO), diagnosing mental illness in
child and adolescent populations is precarious at best as drawing boundaries between
normal and abnormal child behavior is extremely difficult (Effrem, Hegg, Jackson, &
Jacobs, 2005). Furthermore, the Surgeon General of the United States has stated cat-
egorically that diagnosing mental disorders is problematic as there exists no definitive
medical tests or abnormality within the brain that could indicate the existence of such
disorders (Baughman, 2006; Effrem et al., 2005). Scientifically speaking, it is perplexing
that Americans in general (including the American medical community) have accepted
without question that ADHD is a verifiable neurological disorder when no neurological,
metabolic, or any other biologic pathology can be confirmed (Baughman, 2006; Furman,
[AuQ2] 2005). According to Jensen and Cooper (2002), “the assumption that ADHD symptoms
arise from cerebral malfunction has not been supported even after extensive investiga-
tions. The current diagnostic system ignores the contributory role of environment; the
problem is supposedly all the child” (p. 3).
How did Americans come to collectively accept the premise that ADHD is a verifiable
medical condition when there is no scientific evidence to support this claim? In the fol-
S— lowing sections, multifarious corollaries will be explored in depth in order to gain insight
E— into the ADHD phenomenon as it exists in America today.
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3. Attention Deficit Hyperactivity Disorder 7
ECONOMIC COROLLARIES
In 1975, legislation was enacted in America that allowed children with physical disabilities
full access to the public education system. In 1991, this legislation was amended to include
children with mental or learning disorders. Since the inception of the 1991 amendment,
ADHD diagnoses have continued to increase at an alarming rate. Under the amended
Americans with Disabilities Act, individual schools receive federal monies for each child
that has been diagnosed with a behavioral or mental disorder (e.g., the more children who
are diagnosed, the more money the school receives; Breeding, 2002; Stolzer, 2007). If one
examines the Americans with Disabilities data, it becomes apparent that male children
are disproportionately represented as U.S. Department of Education statistics reveal that
80% of public school students who have been diagnosed as behaviorally or emotionally
disordered are male (Annual Report to Congress, 2003).
The pharmaceutical industry also has a vested economic interest in promoting ADHD
as a valid medical disorder as 99% of children who are diagnosed with ADHD are pre-
scribed daily doses of pharmaceutical medication (Breggin, 2002). Relatively recently, the
pharmaceutical industry has inundated the American consumer with a flood of advertising
for ADHD medications. Parenting magazines, physician offices, television commercials,
and radio advertisements all routinely carry messages about the necessity and effective-
ness of psychotropic medications for children suffering with ADHD. This unprecedented
deluge of advertising of ADHD medications has conned the American consumer into
accepting not only the legitimacy of ADHD, but also of the medical necessity of prescrib-
ing dangerous and addictive drugs to children and adolescents (Stolzer, 2005).
Researchers from various fields have documented that an economic alliance exists
between the medical community and pharmaceutical industry. Cosgrove and colleagues
(2006) found that the majority of contributors to the Diagnostic and Statistical Manual have
direct financial ties to the pharmaceutical industry. In addition, the pharmaceutical indus-
try fallaciously refers to ADHD as a brain disorder although scientific evidence clearly
refutes this claim (Baughman, 2006; Breggin, 2002). The pharmaceutical industry also rou-
tinely funds major ADHD medical conferences; provides the majority of ADHD research
funding; provides financial incentives for physicians who prescribe specific ADHD drugs;
and funds groups such as CHADD (Children and Adults with Attention Deficit Disorder)
who openly promote the use of psychotropic drugs in pediatric populations (Jureidini &
Mansfield, 2001; Stolzer, 2005).
While it is certain that an economic alliance exists between the medical community and
the pharmaceutical industry, the public school system in America has also been implicated
in this unethical financial alliance. In the following section, the public school system’s role
in the ADHD epidemic in America will be explored in depth.
EDUCATIONAL COROLLARIES
Incredulous as it may seem, the vast majority of recommendations for ADHD diagnoses in
pediatric populations comes directly from the United States’ public school system (Baugh-
man, 2006; Breggin, 1999). Teachers and administrators routinely refer problem children
for psychiatric evaluation as children who do not conform well to a sedentary learn- —S
ing environment are suspected of being “neurobehaviorally impaired” (Phillips, 2006). —E
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4. 8 Stolzer
Increasingly, disruptive behaviors are defined as pathological and are assumed to be the
direct result of a chemical imbalance within the brain of the child. There is a scientific way
to confirm the existence of a chemical imbalance, yet the public school system continues
to perpetuate this scientific fallacy (Baughman, 2006).
It is imperative that administrators, teachers, and school counselors are informed of
the myriad of gender differences that exist in child and adolescent populations. At the
present time, behaviorism, feminist theory, and standardized assessment classes monopo-
lize teacher colleges across the United States, so it should come as no surprise that we
find ourselves immersed in the “medicalization of boyhood” in the American education
system. Behaviorism stresses that children are merely lumps of clay that can be molded at
will. No consideration is given to gender differences, divergent neurological development,
teacher–student fit, or esoteric mammalian behavior patterns. Feminist theory postulates
that gender is, at its core, merely a social construct that can be recalibrated at will with
the correct environmental influence. Assessment classes take the focus off of normative
developmental stages, and instead focus on determining pathology through the use of
standardized questionnaires. It should be noted that teachers and school administrators are
not now, nor have they ever been, trained psychologists, psychiatrists, or neurologists, yet
the vast majority of recommendations for psychiatric evaluation of our nation’s children
continue to come from the public school system (Baughman, 2006; Stolzer, 2005).
In the following sections, theories that are typically omitted from teacher college cur-
riculum will be discussed at length. These include: bioevolutionary theory, innate gender
differences, and divergent neurological and hormonal development.
BIOEVOLUTIONARY THEORY
Throughout human history, children and adolescents acquired cognitive acuity through
active, hands-on experimentation. However, in the current day public school system, sed-
entary learning has become the nucleus of academic instruction. This newly implemented
“focused seat work” is clearly at odds with children’s bioevolutionary heritage and their
natural tendencies to be active and explorative learners (Bjorklund & Pellegrini, 2002).
Various scholars have suggested that the high incidence of ADHD in American culture
may stem from the constraints and expectations of the public school system, and may be
due in part to a lack of understanding of bioevolutionary development among teachers and
administrators (Jensen et al., 1997; Stolzer, 2005).
Across cultures, across mammals, and throughout evolutionary time, males have been
documented to be more active, territorial, and aggressive than their female cohorts
(Bjorklund & Pellegrini, 2002; Buss, 2004). This “art of maleness” was considered essen-
tial to the survival of the hominid species, and was therefore, a highly prized trait through-
out human history. After millions of years of honoring particular masculine traits, we are
now immersed in a culture that eschews esoteric masculinity and has collectively pathol-
ogized primordial male attributes—particularly in the American education system. As
physicians, researchers, educators, parents, and concerned citizens, we must ask ourselves
what the future will hold for millions of American boys who now conceptualize the self as
“disordered.” Why do we continue to pathologize traits such as assertiveness, high activity
S— level, and competitiveness, as most certainly, these are traits that will be useful in later
E— developmental stages (McIntyre & Tong, 1998).
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5. Attention Deficit Hyperactivity Disorder 9
Clearly, the primal, bioevolutionary heritage of the human male is at odds with the cur-
rent educational environment. Schools require stillness, docility, and protracted periods of
silence. If a particular student can not, or will not adhere to these requirements, neurologi-
cal atrophy is assumed to be the underlying cause. After referral from the school system for
a supposed neurological abnormality, the majority of these children are officially labeled
(and labels do not go away), and are prescribed daily doses of psychotropic drugs so that
they can conform to the rules set forth by the American education system. While it is cer-
tain that drugs such as methylphenidate (i.e., Ritalin) will reduce bioevolutionary derived
behavior patterns, these types of drugs also reduce the desire to play and interact with oth-
ers and have been documented to decrease neural and behavioral plasticity (Bjorklund &
Pellegrini, 2002; Panksepp, 1998).
Natural selection assumes that behaviors and cognitions are the result of selection pres-
sures that occurred over the course of human evolution (Bjorklund & Pellegrini, 2002).
According to this basic theoretical premise, males that exhibited the highest activity level
would be more likely to survive in primordial environments, and thus, would be the genetic
line that survived throughout evolutionary time (Jensen et al., 1997). According to evo-
lutionary psychologists, ADHD is not to be conceptualized as “neurobehavioral dysfunc-
tion,” but is more likely the result of millions of years of male adaptation (Bjorklund &
Pellegrini, 2002; Jensen et al., 1997).
Is it possible that the millions of American boys who have been labeled as ADHD
are not chemically imbalanced but are in fact, displaying primal, evolutionarily induced
hominid characteristics? The answer of course is a resounding yes, and it is time to demand
that teacher colleges across the United States address this seminal theoretical postulate as
it relates to male developmental trajectories.
GENDER COROLLARIES
For decades, it was assumed that the vast differences in male and female children and ado-
lescents were the direct result of divergent socialization processes. However, ongoing data
confirms that there exists significant and quantifiable differences with regard to male and
female development. Throughout the various developmental stages, males and females
across cultures follow divergent pathways. From gestation onward, males and females are
distinct as illustrated in Table 1.
In the current public school system, female development is held up as the gold standard,
and boys who do not conform to this standard are systematically labeled and drugged
(Stolzer, 2007). It is time to demand that gender diversity be honored throughout the
American education system, and that historically documented male behavior patterns are
once again accepted as a normative component of human development.
The advent of high-tech brain imaging studies have confirmed that male and female
brains are quantitatively different. While it is certain that outliers exist, data confirms that
statistically significant gender differences can be detected with regard to neurological and
hormonal development (Bear, Connors, & Paradiso, 1996; Kandel, Schwartz, & Jessel,
1995). Table 2 provides a summation of the scientific findings regarding brain gender dif-
ferences.
Why such differences exist in the human brain is open to discussion. What is clear at —S
this time is that differences do exist, and these differences affect development trajectories —E
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6. 10 Stolzer
[AuQ3] TABLE 1.
Boys Girls
Prebirth
Develops testosterone Develops estrogen
Immune to female hormones Immune to male hormones
Fetus more active and restless Less active in womb
Cortex develops slower at 6 weeks, colossal Cortex develops faster
dose of male hormone that changes the brain
permanently
Greater idling in brainstem (reptilian brain) Greater idling in limbic system
Infancy
Prefers mechanical or structural toys Prefers soft, cuddly toys
More pronounced large motor activity Play is more sanguine
More easily angered More easily saddened
Less bothered by loud noises Less tolerant of loud noises
Toddlers
Speaks later than girls Develops better vocabulary earlier than boys
Less able to multitask Better able to multitask
More physically impulsive Less physically impulsive
Preschool and Kindergarten
Occupies larger space on playground Congregates in smaller groups
Play rough, vigorous, competitive, and aggressive Play quieter, less active, and more cooperative
Games involve bodily contact, continuous action Games involve turn taking and indirect
competition
Use dolls for attack weapons and warfare Use dolls for playing out domestic scenes
Express emotions through actions Express emotions with words
Less attention span and empathy Great attention span and empathy
Grades 1–3
Reading mastery later Reads better and sooner
95% of ADHD children 5% of ADHD children
Grades 4–6
Primarily focused on action, exploration, Primarily focused on relationships and
and things communication
More likely to use aggression to resolve Unlikely to settle differences with aggression
differences
Primarily focused on action, exploration, Primarily focused on relationships and
and things communication
S—
E— More likely to use aggression to resolve Unlikely to settle differences with aggression
differences
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7. Attention Deficit Hyperactivity Disorder 11
TABLE 1. (Continued)
Boys Girls
Middle School
Testosterone indisputably an aggression-inducing Estrogen generates greater activity in the
chemical brain
Amount of testosterone directly related to success Amount of estrogen directly related to success
at traditional male tasks of traditional female tasks
High School
More likely to be involved in criminal behavior Less likely to be involved in criminal
behavior
Majority of males surveyed suggested “fighting” Majority of females surveyed suggested “talk-
best way to resolve conflict ing things out” best way to resolve conflict
Pursuit of power universal male trait Pursuit of comfortable environment universal
female trait
Note. From Boys and Girls Learn Differently: A Guide for Teachers and Parents (pp. 34–38), by M. Gurian,
2001, San Francisco: Jossey-Bass. Copyright 2001 by [Name of Copyright Holder]. Reprinted [or Adapted] with
permission. [AuQ4]
TABLE 2. Neurological / Hormonal Corollaries
Part of Brain Function Gender Differences
Basal Ganglia Controls movement Likely to engage more quickly in male
Prefrontal lobe Associated with impulsivity Not fully developed in male until
control 20–23 years of age
Pituitary gland Secretes hormones Males fight or flight response more
rapidly engaged
Testosterone secretion Male sex hormone Increases aggression, competition, self-
assertion, and self-reliance
Thalamus Regulates emotional life and Data processed more quickly in
physical safety females
Amygdala Part of limbic system involved Larger in males; associated with
in emotional processing aggression
Estrogen secretion Female sex hormone Lowers aggression, competition, self-
assertion, and self-reliance
Note. From Boys and Girls Learn Differently: A Guide for Teachers and Parents (pp. 20–26), by M. Gurian,
2001, San Francisco: Jossey-Bass. Copyright 2001 by [Name of Copyright Holder]. Reprinted [or Adapted] with
permission. [AuQ5]
(Bear et al., 1996; Kandel et al., 1995). Evolutionary psychologists have hypothesized that
brains differ by gender because of millions of years of adaptation. Throughout evolutionary
history, males were required to be the hunter, the aggressor, and the protector if his genetic —S
line was to survive (Bjorklund & Pellegrini, 2002; Gurian, 2001). Evolutionary biologists —E
insist that gender is a biological construct and that theories supporting the notion that —L
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8. 12 Stolzer
gender is simply the result of distinct socialization processes are perpetuating an outright
scientific fallacy (Bjorklund & Pellegrini, 2002; Gurian, 2001; Moir & Jessel, 1990).
We can no longer afford to assume that evolutionary based gender differences do not
exist. Enough of feministic and behavioristic theories suggesting we can force males to
follow female developmental patterns. We can not. Enough of drugging young males into
a state of conformity, docility, and inactivity. Let us instead demand that scientific data
be presented. Then, and only then, will we understand and appreciate divergent develop-
mental processes.
Decades of scientific data clearly demonstrates that males are more rebellious, are more
likely to engage in conflict with authority, are more physically active than their female
[AuQ6] cohorts, and are more likely to get into trouble at school (Bush Keller, 1994; McIntyre &
Tong, 1998). It is common knowledge that the majority of public school teachers are
female, and this fact has led researchers to hypothesize that teacher intolerance of evolu-
tionary based male behavior may be contributing to the ever increasing referrals for ADHD
diagnoses within the public school system (Bjorklund & Pellegrini, 2002; McIntyre &
Tong, 1998).
In the 1960s, Sexton asserted that American schools were beginning to feminize boys
and this feminization was hypothesized to be in direct conflict with the development
of positive manhood (1969). Combine the institutionalized feminization of maleness,
the ever-increasing drugging of masculine attributes, the rise of the pharmaceutical
industry, and the unwavering acceptance of mainstream psychiatry, and it is no surprise
that the myth of ADHD has been unconditionally accepted by the American public
(Stolzer, 2005).
According to published research, 99% of children who are diagnosed with ADHD are
prescribed psychostimulant drugs—the most common being methylphenidate (Baughman,
2006; Breggin, 1999). In the following section, the risks associated with methylphenidate
use in pediatric populations will be discussed.
RISKS ASSOCIATED WITH METHYLPHENIDATE
Frequently, those who are invested in promoting the myth of ADHD will extol the effec-
tiveness of methylphenidate use in pediatric populations. It is absolutely certain that
methylphenidate decreases disruptive behaviors and increases compliance and sustained
attention. What is rarely discussed is the multitude of risks that are associated with meth-
ylphenidate use. It should be noted that the Food and Drug Administration (FDA) has
classified methylphenidate as a Schedule II drug along with morphine, opium, and barbitu-
rates as these classifications of drugs have been proven to be highly addictive and to cause
a wide range of physiological atrophy (Baughman, 2006; Breggin, 2002; Furman, 2005).
Methylphenidate has been documented to produce severe withdrawal symptoms, irri-
tability, suicidal feelings, headaches, and Tourette’s Syndrome (Breggin, 1999; Novartis
Pharmaceutical Corporation, 2006). This drug has also been associated with weight loss,
disorientation, personality changes, apathy, social isolation, depression, insomnia, increased
blood pressure, cardiac arrhythmia, tremors, weakened immune system, growth suppres-
sion, agitation, fatigue, accelerated resting pulse rate, visual disturbances, drug dependency,
S— anorexia, nervous disorders, aggression, liver dysfunction, heptic coma, angina, and toxic
E— psychosis (Breggin, 1999; Novartis, 2006).
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9. Attention Deficit Hyperactivity Disorder 13
According to Novartis (2006), methylphenidate is a central nervous system (CNS)
stimulant; however, the mode of therapeutic action is not known. Novartis (2006) states
unequivocally that the specific etiology of ADHD is unknown, and that there is no diag-
nostic test that can definitively confirm the existence of ADHD. Novartis concedes that
the effectiveness of methylphenidate for long-term use (i.e., more than 2 weeks) has not
been established in controlled trials, and has stated clearly that the safety of long-term use
of methylphenidate in pediatric populations has not yet been determined (2006).
The DSM–IV–TR (APA, 2000) states that the psychoactive effects of drugs such as
methylphenidate “last longer than those of cocaine, and the peripheral sympathomimetic
effects may be more potent” (p. 223). Psychostimulant drug use has also been associated
with “panic disorders, generalized anxiety disorder, paranoid ideation, and psychotic epi-
sodes that resemble schizophrenia” (APA, 2000, p. 225). In addition, withdrawal from
psychostimulants can cause depressive symptoms that can resemble a major depressive
episode (APA, 2000).
It is indisputable that drugs such as methylphenidate are an effective tool in helping
adults to control children’s evolutionary based response patterns as spontaneity, playful-
ness, talking, socializing, and all types of physical activity are suppressed while children
are under the influence of psychostimulant drugs (Breggin, 1999). However, it must also
be acknowledged that these classifications of drugs are highly addictive and have been
associated with “persistent brain dysfunction and potentially irreversible central nervous
system damage” (Breggin, 1999, p. 29).
CONCLUSION
Careless mistakes in schoolwork, messy assignments, failure to pay attention, fidgetiness,
squirming, and not sitting still are now accepted as valid indicators of a neurobehavioral
brain disorder. Across cultures, across time, and across mammalian species, young, inexpe-
rienced offspring were expected to be highly active, spontaneous, inattentive, nonconfor-
mative, jubilant, restless, impetuous, and to run, jump, and irritate their elders. Truly, this
was the hallmark of youth. Today, it is a multibillion dollar a year industry. Pharmaceutical
companies, physicians, psychologists, and schools are profiting economically from norma-
tive, historically documented behavior that has, over the last few decades, been redefined
as pathological.
Millions of American children are diagnosed with ADHD and are prescribed danger-
ous and addictive drugs, all in spite of the fact that the DSM–IV–TR has stated empa-
thetically that “there are no laboratory tests, neurological assessments, or attentional
assessments that have been established as diagnostic in the clinical assessment of Atten-
tion Deficit Hyperactivity Disorder” (2000, pp. 88–89). Millions of children diagnosed
with a disease for which there exists no confirmatory evidence? This is the height of
absurdity. After acknowledging that there is no valid way to confirm the existence of
ADHD, the DSM then goes on to state how to eradicate ADHD. In order to cure the
number one neurobehavioral disorder afflicting millions of American children, the fol-
lowing steps must be implemented: (a) administer frequent rewards for the appropriate
behavior; (b) keep the child under close supervision; (c) make sure the child is in a
novel setting; (d) provide especially interesting activities; and (e) provide one-to-one —S
situations (e.g., one-on-one interaction with an adult) (APA, 2000, pp. 86–87). Imagine —E
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10. 14 Stolzer
medical textbooks stating that in order to completely eliminate childhood lymphoma,
one must administer frequent rewards, keep the child under close supervision, provide
novel and interesting activities, and provide an abundance of adult-child interaction.
Of course, this is preposterous since no valid medical condition can be cured by altering
relational processes.
The DSM–IV–TR also appears to suggest that removing children from the current edu-
cation system would alleviate the ADHD epidemic in America. With ever increasing
student–teacher ratios, it would be impossible to implement the above mentioned strate-
gies in the public school system, but most certainly, a competent, caring adult could pro-
vide frequent rewards, close supervision, novel and stimulating activities, and one-on-one
social interactions. Perhaps the answer to this unprecedented American epidemic is not
pharmaceutical intervention, but a recalibration of our collective educational ideology.
For those individuals who wish to concentrate on overhauling the current education sys-
tem, perhaps they would be wise to follow the DSM–IV–TR’s recommendations and work
unceasingly to prohibit sedentary activity, boring and mundane instruction, and monoto-
nous and repetitive assignments (APA, 2000).
Americans are famous for paying lip service to the adage “children are our future,” yet
rarely are policies implemented that honor this ancient dictum. The time has come to
demand that we will no longer tolerate the mass labeling and drugging of our nation’s
children. No longer will we accept a premise that is based on pseudoscience. No longer
will we tolerate the economic alliance that exists between the medical community, the
pharmaceutical industry, and the American education system. Enough is enough. The
time for action is now.
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Correspondence regarding this article should be directed to J. M. Stolzer, PhD, University of
Nebraska, Kearny. E-mail: stolzerjm@unk.edu [AuQ8]
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12. [AuQ1] Please provide four to six keywords.
[AuQ2] Please provide a full reference entry for this in-text citation Jensen and Cooper
(2002).
[AuQ3] Please provide title for Table 1.
[AuQ4] Please check copyright information for Table 1. Is the table reprinted or adapted
from Gurian? Who hold the copyright?
[AuQ5] Please check copyright information for Table 2. Is the table reprinted or adapted
from Gurian? Who hold the copyright?
[AuQ6] Please supply a full reference for this in-text citation of Bush Keller, 1994 or
delete here.
[AuQ7] Please insert an in-text citation for Fogel (2001) or delete here.
[AuQ8] Please provide full mailing address for Stolzer.
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