Notes on ADHD and Gender

A post on another blog that linked to my “Understanding ADHD” post caused me to think about my current understanding of the connection between gender and ADHD. This was a topic of passionate interest to me when I first began to work with college students with ADHD in the early 1990s. At the time, it seemed clear to me that there is significant under-identification of ADHD in girls and women, and that this was a real problem.

Some progress has been made since that time, thanks to the work of people like Nancy Ratey and Kathleen Nadeau, but I still find that many of the women I work with were identified only in adulthood, often only after they experienced failure in college. So it is still a very real problem. It is still the case that three males are diagnosed for every female, even though there is no strong indication in the genetics research to indicate that ADHD is gender-determined, at least not the extent that would result in this large disparity. Continue reading

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ADHD: Disorder or Difference?

An interesting discussion in my writing class today–should we use the term “disorder” or “difference” to describe the neurodevelopmental condition that my sixteen students share and that brought them into my class? This came in the context of my review of the mainstream literature on ADHD as a disorder of executive functions, using Russell Barkley’s very powerful theory of ADHD. (Here’s a link to a lay version of the theory, published a long time ago but still salient.)

Is “difference” a wishful euphemism or an accurate descriptor? Is “disorder” the accurate term or a label conferred by psychiatric fashion? Continue reading

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Creativity, Disorder, and the Madness of History

This piece was published in yesterday’s issue of “The Commons,” Brattleboro’s independent weekly. I’ve re-posted here as well since the link may be hard to read in some browsers. It’s a screed, but I like it:

Lately I’ve been preoccupied with two things: researching the literature regarding the relationship between creativity and psychological disorders like ADD and bipolar disorder; and wondering, as I watch the current political campaign, why so much of our national political discourse seems tinged with madness.   Continue reading

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ADD, College Writing, and Mystification

My first writing class with 16 new students, all bright, all with some form of ADD, all but one separated from their first college because of academic difficulties. What struck me most was how much they know about themselves–about the nature of their struggles–and how little they understand. Or at least, how little they understand in terms that might actually be useful, rather than terms of moral judgment and self-blame.

I always like to ask this question–I think it is the very best diagnostic question in the world, far superior to the Stroop or the Tower of Hanoi: “Do you often find that you have raised your hand in class because you have a good point to make, but forget what you were going to say by the time the teacher calls on you?” They all raised their hands, and we laughed; it is fun to be in a room where everyone shares the same rather comical experience.

What this is about, of course, is that they all share a more permeable filter, a less dogmatic and insistent ability to inhibit new information and stimuli–mostly internal information or novel things in the auditory and visual fields–from displacing whatever it was they were holding in working memory, “concentrating on,” in order to deliver a statement. I love it when students forget what they are about to say in my classes. It provides the best illustration I know of the challenges that working memory and weak inhibition of prepotent response, in Russell Barkley’s phrase, present to those of us who share these neurodevelopmental variations.

What I find most interesting, in a way, is that no one has ever taught a class like this before. I mean, I have been teaching this selected group of students in a specific Landmark College curriculum for a long time now, but this class is the most homogeneous, the most precisely selected, the brightest and most capable, I have ever encountered. I wrote elsewhere about teaching writing to gifted students with ADD, and I am realizing now that I am starting to blog this class. I don’t know if it makes sense to continue with this or not, but tonight I am.

My starting point for the group was this. Still’s first notice (1902, look it up) of what we call ADD resulted in the label of “A Failure of Moral Development.” Lazy, bad, procrastinating, failing to live up to their potential, acting out, rebellious, incorrigable–or dull, absent-minded, spacy, light’s on and no one’s home. So: no moral judgment in this baliwick, just the most accurate and supportive accounts I can give of what I see, and then the best questions I can ask about what to do next. Maybe some advice, certainly some teaching–some information. But no one ever died because someone failed to hand in an English paper. Let’s get that straight, at least. It’s a practical issue, not a moral one.

Second, I gave them Anne Lamont’s riff on “Shitty First Drafts,” from Bird by Bird (1994). Shitty first draft is a technical term in the class. I assign students to write shitty first drafts, and grade them down if their work is too polished. I always like the way students laugh when I introduce the concept–a kind of glee. “This week you are going to be required to write a shitty first draft on this topic.” They like it. I like it. A place to start.

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Teaching Writing to Gifted Students with ADD (Part 1)

In a few days I’ll start a new first-semester comp. course, and this one really fascinates me. The students are grouped because they share two common themes. All of them have difficulty with “self-management” and producing writing at what Russell Barkley calls “the point of performance.” And all of them have Verbal IQs in the superior or very superior range–120 and up.

Many of them also have come to Landmark College after failing out of the selective university or college where they first matriculated. I met one student this summer and he told me that he had “failed out of every selective Catholic college on the Eastern seaboard.” I’ve been working with this population for a while now, and I’ve had students from Brown, Dartmouth, Vasser, Tufts, Wesleyan, Hamilton, Middlebury, Georgetown, and so on.

I’ve written elsewhere about the general problem of bright students who fail to make the leap from high school to college, Continue reading

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Writing, ADD, and Culture

The mainstream press has devoted a great deal of space to Attention Deficit/Hyperactivity Disorder (ADHD) in the past few years. The coverage has focused on two related questions: is ADHD over-diagnosed, and are we medicating children too quickly and frequently? TheNew York Times has been at the forefront of this discussion, with a series of op-ed pieces that raise significant questions about psychiatric practices. The discussion in general has occurred against a backdrop of increasing questions about the rate of psychiatric diagnoses and the prevalence of medication in general.

Responses by the psychiatric profession have been relatively weak and tepid. At the same time, the psychiatric consensus that creates an ever-expanding population of children with ADHD and an ever-growing market for the pharmaceutical industry seems unshaken. For the lay person surveying this terrain, the picture must seem confusing at best—and certainly unsettling for anyone who is facing…

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Creativity, Disorder, and the Madness of History

Lately I’ve been preoccupied with two things: researching the literature regarding the relationship between creativity and psychological disorders like ADD and bipolar disorder; and wondering, as I watch the current political campaign, why so much of our national political discourse seems tinged with madness. Continue reading

Posted in Culture, Learning Differences, Politics | Tagged , , , , | 2 Comments