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Dialogues@RU is published
annually
by the
Writing Program at
Rutgers, The State
University of New Jersey
Volume 4
Fall 2005
The Clockwork of Attention Deficit Disorder: Mechanisms in Illusion - Page 3
By Xiaolei Shi
He suggests, then, that a shared practice such as labeling is all that is needed to establish and perpetuat e cultural prejudices as truisms. Conversely, if a culture defines hyperactivity through certain societal standards then a shift in culture would mean a whole new set of standards. The definition of " normal " would then have different connotations when the behavior is placed in another social environment. This would imply that the definition of ADD would be different in another culture, if it existed at all. For Armstrong, this phenomenon can be observed clearly in dining habits of villagers in Papua, New Guinea, where "the villagers don't expect children to sit quietly for an hour while orders are taken and adults chat" (27). Contrary to the dining etiquette in North America, the children in Papua , New Guinea, are free to roam and explore (27). Naturally, hyperactivity in Papua, New Guinea, is not seen as a disorder, while "for societies with stricter behavioral norms than those of United States - including China and Indonesia- research suggests that mental health clinicians are more likely to identify "normal" children (by US standards) as hyperactive" (27). Thus both ends of the cultural spectrum attest to the idea that culture, specifically the concept of " normal, " plays an important role in the definition of Attention Deficit Disorder.
Whose interests are served by categories of "normal" and "disabled"? Economically, various entities gain from the existence of ADD. "Schools gain extra funds each child classified with ADD. Likewise, parents on government assistance receive extra money if their child has ADD" contends Debra Jones, "president and founder of the 2600-member Parents Against Ritalin (PAR)" (Koch 908). Moreover, "[p]harmaceutical companies collect hundreds of millions of dollars annually from the drugs that are sold to treat the estimated one million children who are currently being medicated for ADD" (Armstrong 9), contributing to the prevalence of ADD as a favorable source of economic gain. In addition to government funding and corporate profit, many jobs are created to deal with ADD. According to the National Institute of Mental Health, "Child psychiatrists and psychologists, developmental/ behavioral pediatricians, or behavioral neurologists are those most often trained in differential diagnosis. Clinical social workers may also have such training" (Strock). The more inclusive the definition of ADD becomes, the more these various entities gain, resulting in a net widening-effect in the definition of ADD . Similarly, the various economic factors that operate in the misdiagnosis of ADD are difficult to ignore: "it takes time to track down these disorders and sometimes it takes money - and HMO doctors can't spend either," writes Sydney Walker, Director of the Southern California Neuropsychiatric Institute. "So instead, a physician takes 15 minutes to label a child as hyperactive or attention disordered, and write out a prescription that will mask the child's symptoms but won't do a thing to treat the causes of these symptoms" (Koch 921). Economic reinforcement, as much as medical conviction, increases the diagnosis and prevalence of ADD, and this reinforcement ultimately supports Swain's assertion that "culture is an activity that harnesses, in its interests, the social institutions that hold a society together" (117).
Perhaps the most glaring element in the controversy of Attention Deficit Disorder is that even with the advent of advanced medical technology, "there exists no physical test to detect ADD" (Palladino 173). The current definition is fundamentally an extension of Bradley's initial notion that hyperactivity is an undesirable trait in society. With an estimated "17 million diagnosed with ADD" (Lawis 5) from a set of guidelines with a "strong subjective component" (Palladino 173), the existence of ADD becomes a moot point of fierce contention amongst professionals and parents alike. The symptoms of ADD such as "failure to pay close attention, being forgetful of daily activities, and the inability to listen when being spoken to," can, according to Dr. Lawis, be attributed to "dementia, delirium, disorders due to medical condition, substance abuse, and anxiety disorders." Furthermore, and more troubling, Lawis contends that "all children [exhibit] these symptoms at times especially during high-stress periods" (10). Therefore, critics argue that there does not seem to be a defining attribute to Attention Deficit Disorder, and that the growing number of ADD cases is due to an expansion of this subjective definition. This criticism in turn, attests to the growing skepticism toward ADD and its treatment practices.