NeuroSCIET

“You understand this…you should write an article.”

My wife told me again. She says this every time a program on TV talks about ADHD.

But I only know about myself. The people on the tube seem to exhibit more severe symptoms than I remember having, but then, I don’t remember it from an observer’s point of view.

It is a problem, but is it a disease or a disorder? 

Conventional thinking is that it is a disease because you must have a disease to get the drugs to treat it.  The market for these drugs is in the billions of dollars and growing. Over-diagnosis and over-prescribing have spawned a cottage industry in high-profile dissenters who exclaim loudly that it is all a drug industry scam.

Typically, controversy swirls around those who claim its not a disease, but is instead a behavior problem or an allergic response or some nutritional deficiency.  A program on television last week featured a doctor who claims that it is all diet and behavior. She believes using drugs is the wrong way to go, an excuse for lazy parents and teachers. 

I’m afraid I have to disagree with either side, but I see very little discussion related to my own experience. 

I grew up in the fifties and sixties. I was simply lazy and unmotivated, and I did not have an excuse.  It did not occur to me that I needed one. I was smart enough to get by with a mix of grades depending on the teacher.

If the teacher spoke passionately in class about the subject and described it with scenarios to illustrate how it happened or worked, I was fine. Still, if I was expected to remember only words or names with some abstract relationship, I was screwed. 

I do not remember the sound. I can listen to a song on the radio ten thousand times without being able to recall more than the first three seconds, maybe six words. Growing up, I converted what I heard into visual associations or scenarios and could get by in most situations. It was how my mind worked, and I had no idea there was another way. My mother would say that words went in one ear and out the other. She was right. I used the incoming sound stream to create an image, which was lost. I could not recall it a minute later. 

I have come to understand the difference between linear and spatial thinking. I am a spatial thinker. I did poorly with linear thinking in school. Subjects that were rule-based were not the problem so much as the fact that many teachers would teach those subjects by asking you to remember the rules and apply them appropriately.  The same subjects taught by a teacher using situational examples were understandable, and I got good grades. Because I am a spatial thinker, I convert sound into spatial imagery and remember the images. I don’t remember sounds, but I recognize them. I know them, but I can’t recall them.

A good way to understand the difference between linear and spatial is to imagine hiking overland, getting from point A to point B. The linear thinker follows the trail, remembering each part of it and the sequence in which the part occurs. The spatial thinker wants to know the context of the entire hike, the large landmarks, and how to get from the beginning to the end. The actual trail is secondary. The spatial thinker expects to make his way through the terrain by deciding the easiest way as he comes to it, not by remembering a line on the ground.

In the April 2002 Popular Science magazine, an article titled “Your Caveman Gramps had Ants in his Pants”, suggests that a genetic mutation that causes hyperactivity was spread through natural selection over the past 50,000 years. It speculates that the variation of gene DRD4, which causes hyperactivity benefited people migrating from Africa. They do this by analyzing the distribution of the gene and calculating its spread from generation to generation. They concluded that it must have given those who possessed it an advantage, making them more likely to procreate. 

It would also make them more likely to migrate, giving rise to problems with fitting in with established societies with strong oral traditions and expectations to conform with the words of the leadership. America probably has the largest percentage of ADHD genetics for this reason.

In hunter-gatherer societies, there would be an obvious advantage to those with enhanced spatial thinking abilities. It is unlikely that the successful procreators were dysfunctional misfits. It is much more likely that those who rose to leadership, had children, and protected them until they could survive on their own, were gifted with enhanced abilities to hunt, forage and travel through new territory.

We can assume that most ADHD people today would have been very successful in hunter-gatherer societies, but we do not need to go that far into the past to discover a time when ADHD was not a problem. Before the wide availability of books in the late nineteenth century, most people learned a trade through apprenticeship; they learned by doing. ADHD is not a disadvantage when learning on the job because it works well with their visual/spatial abilities. 

The trait of spatial thinkers to look for landmarks and find their own shortest route between two points makes them more creative than the general population. America is the land of the invention for many reasons, but the high percentage of ADHD people must be contributors.

Unfortunately for ADHD people, we now require a substantial amount of linear thinking to succeed. The ability to sit in a chair and attend to what is being said is now the foundation of education. The “hyperactive” are branded as troublemakers. Their difficulty with learning in this fashion is generalized as an overall stupidity or that they are lazy and unwilling to try. They are thought of as behavior problems.

ADHD is not a behavior problem, but it can lead to one. Continually tell someone that they are not trying when they are and see if they do not become angry and confused and act out. If they are behavior problems, it is because of the unrealistic expectations that are put on them. Simply having ADHD is not a cause for willful disruptive behavior. Outbursts of anger and scolding from parents and teachers lead to imitative behavior by the ADHDer toward peers and those younger.

ADHD people need to move to think. Movement through space drives the exchange between the brain halves that we now know to be the requirement for “thought.” ADHDers lack an adequate supply of the neurotransmitter dopamine, which is used for processing language. 

Talking to yourself 

It may seem strange to those without ADHD, but the ability to dialog quietly in your head is associated with adequate supplies of the neurotransmitter dopamine. Without it the dialog is exhausted after a few sentences or less. So when an ADHDer sits in class and listens to a lecturer go on about something they can not visualize, the surrounding visual and auditory stimulation begins to drive visual/spatial associations unrelated to what he or she started to do only moments before.

And they cannot help it. It is not a behavior problem; it is a natural behavior.

Teaching those with ADHD must begin by recognizing what they can and can not do. It is not about intelligence. It is about ability. The ability to think is driven by the movement and visual/spatial cues. Classes that enable the ADHDer to learn while moving will allow him or her to build the internal associations required to store information for later recall. All subjects can be taught to the ADHD student when visual/spatial associations are combined with contextual meaning. Topics normally considered “linear,” such as language or math, can be taught through scenarios or situational examples using the ADHDer’s path-finding and problem-solving skills by emphasizing the journey’s goals in the context of its environment.

Classes should begin by making a presentation that explains with real-life scenarios why the subject and class are important and present to the students a puzzle of getting from where they are at that moment and how they will get where they need to be at the end of the class. It must be a puzzle to be solved through daily accomplishments, understandable in context, and visualizable from the beginning.

This is what I believe would have enabled me to learn easily in school and reflects all the insight I have accumulated as an individual with ADHD. It is not a prescription for a new kind of educational institution. It is intended to provide some insight to those currently dealing with an ADHD child and has only been exposed to the behaviorist approach to ADHD.  

Could you do your research and think about it? Not all of those diagnosed with ADHD have it as an inherited condition.  However, many parents grew up with it and seek treatment with an acute understanding of its difficulties and want a better life for their child than they experienced. I would like them to realize that this is only a problem because of the expectations of the institutional school system and not a disease or disorder.  

An informed and aware choice of drug therapy can be a real benefit to a child, but the opportunity for harm is too great to treat it casually. Fitting in and progressing with peers is critical, so when the situation insists that your ADHD child attend an institutionally run school, it can be a wise and beneficial choice. It should be regarded as an opportunity to experience life in an average way but in the context of the child’s other unique abilities.

About drug therapy

Drug therapy is not needed for an ADHD student to succeed at learning or in life, but it may enable him or her to express what they have learned in writing.

Writing requires the ability to hold a thought as language and edit it for content in the context of what has already been saying and what will be said in the entire piece. This is very hard to do when you have ADHD. 

I have ADHD and learned to write after using appropriate medication to supplement my naturally low dopamine levels. I started taking meds after I was forty-three years old, and it took me years to express a complex thought in writing. It was very different than speaking because the sound of my voice would supply the auditory stimulation to drive my thought processes. In school, I could explain the answer to a question in class but could not write the same information as the answer to an essay question. As soon as I began to write, my mind would go blank. It was as if the pen in hand was a switch that turned my mind to mush.

I never felt it would be impossible to get my ideas into print, though, because I loved to share them in conversation, and there were always others who could be recruited to do the writing. I later discovered that complex ideas are too difficult to convey secondhand and that I had to do it myself or it would not happen. I’m still working on them, but this small commentary is a good exercise.

Dane M. Arr

Tempe AZ

9/9/02