Tessa had the worst case of ADHD I’ve had to deal with in a long time. She was a high school junior who’d been in special ed classes her entire school career, and I was recommended to tutor her for her SATs.
Upon first impression, Tessa seemed, frankly, dull-witted. Her speech was slow and her eyes were listless. Her lengthy psych ed. report indicated a number of vague and (to me) not especially helpful prognoses: a processing problem, a memory problem, an executive functioning problem. And, yes, ADHD.
Intriguingly, Tessa’s IQ score was well above average.
It’s rarely a problem for me to engage with a student. I’m adept at getting them talking and thinking and involved with the material. Some of this comes from experience. But a lot of it, I believe, lies in the naturalness of the one-on-one human interaction. Tutoring is like a dance, where each partner follows the cues of the other. It doesn’t take long to develop a rhythm and a rapport. I expect every student to have a unique learning dance, and I let them lead, until they can’t or won’t, and then I gently guide them until they regain their confidence.
But Tessa wasn’t like this. She would not engage. She was marginally polite, but also clearly, openly disinterested. Her answers to my friendly questions came out as grunts. She fidgeted, she squirmed, she doodled, she took lots of bathroom breaks and every other minute she asked ‘Are we almost done?’
Tessa’s SAT scores were at the very bottom of the scale, little better than random guessing, which is exactly what Tessa had done. On every practice question I gave her, Tessa passed her eyes rapidly over the material, and then selected an answer without actually reading, calculating, or using her mind in any meaningful way. When asked how she got her answer, her reply was ‘I dunno.’ And when asked to re-do a question, Tessa would simply make a different blind stab.
It was easy to suspect that Tessa just wasn’t trying, that she was being stubborn and uncooperative. Yet, she was trying. I could feel it! Tessa simply could not marshall her attention long enough to do any better than what she was showing me, and it was painful for her. She was using the bathroom trips and the doodling to escape from the mental discomfort.
Two striking qualities of ADHD are the record number of diagnoses and the controversy behind them. Scientific debate about ADHD swings wildly; at the same time some are claiming to have found hard genetic and psychological causes, others argue that the condition doesn’t even exist. This debate has raged since the 1970s (which is when I began tutoring) and there’s no resolution in sight. Meanwhile, ADHD is the most commonly diagnosed psychiatric disorder in children, with some numbers estimating 16 percent of the school-age population being afflicted. What can this extreme polarity of opinion tell us about ADHD?
The combination of ADHD’s apparent pervasiveness and its mysterious definition makes me suspect that some wider dynamics might be in play. One of my deep convictions is that frustrating school experiences often contribute to creating “learning disabilities.” And Tessa was making me think something similar about ADHD.
Like certain other disorders, ADHD’s symptoms are an amplification or deficiency in otherwise normal human behavior. For instance, “hyperactivity” in an adult or older child might be considered normal if observed in a younger child. This is where many ADHD “deniers” begin: by claiming that “hyperactivity” and “attention deficiency” are normal in human children. There is an element of truth to this. At a certain age, human children, like all young, intelligent animals, go through an exploratory and playful period of high energy. This is hardwired and beneficial; high-energy children crave stimulation and excitement, which leads to greater knowledge of their environments and higher intelligence.
Children (and all people) are naturally different. Some learn more quickly than others, or more easily in certain subject areas, or with varying strategies. Some people are more active than others, physically as well as mentally. Human beings are social animals, designed to differ from one another so as to be able to occupy a variety of social niches and roles.
Yet schools expect sameness. They require conformity. They need all of their students to listen and learn and behave within the same narrow ranges, and they exert a lot of pressure on kids to meet the prescribed expectations. Many kids don’t happen to fit conveniently into school norms, and far too often they become labeled as deficient in some way or another.
I wonder if Tessa “really has ADHD,” meaning, was she born with it? Is it possible that her other learning “differences” might have caused this bright girl to be stuck in one boring, frustrating special ed class after another, until Tessa learned to squirm and tune out, as strategies to avoid mental suffering? Might school have “taught” Tessa to have ADHD?
Tessa has been improving, slowly. I give her small assignments she can force herself to focus through. I give her choices so she can develop a sense of ownership and commitment to tasks. I ask her what she needs (she generally doesn’t know, but trying to answer this question helps her reflect on her own thinking and become more active in helping herself). We’re trying to retrain her brain to tune IN and not OUT.
Meanwhile, I now wonder if some forms of ADHD might be genetic and others might be learned.
Cousins, L. (2010). Might Schools Be Teaching ADHD?. Psych Central. Retrieved on May 25, 2013, from http://psychcentral.com/lib/2010/might-schools-be-teaching-adhd/
Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
Published on PsychCentral.com. All rights reserved.