Dangerous Distraction.

• Author: Sholl, Jason
• Position: Review

The Hyperactivity Hoax: How to Stop Drugging Your Child and Find Real Medical Help, by Sydney Walker III, New York: St. Martin's Press, 260 pages, $23.95/$6.99 paper

Ritalin Nation: Rapid-Fire Culture and the Transformation of Human Consciousness, by Richard DeGrandpre, New York: W.W. Norton, 284 pages, $23.95

A 1998 conference on Attention Deficit/Hyperactivity Disorder (ADHD) sponsored by the National Institutes of Health concluded that after years of clinical research and experience with ADHD, our knowledge about the cause or causes of the disorder remains speculative." The uncertainty hasn't stopped any number of researchers, journalists, and pundits from commenting on everything from the tricky ethics of diagnosing the disorder to the dangers of treating it with Ritalin. The debate over ADHD--biological reality or social construction, legitimate learning disability or cultural artifact--is one of the most heated in science and education today. And while the appearance of two new books on the subject doesn't promise answers to any of these thorny controversies, it does mark an opportune moment to sift through a decade's worth of information on ADHD and ask what, if anything, we have learned from the national experiment that has made this term a household word.

In The Hyperactivity Hoax: How to Stop Drugging Your Child and Find Real Medical Help, neuropsychiatrist Sydney Walker calls attention disorders "symptoms of modern life, rather than symptoms of modern disease." In Ritalin Nation: Rapid-Fire Culture and the Transformation of Human Consciousness, psychologist Richard DeGrandpre argues that attention disorders are the inevitable byproducts of a culture-wide addiction to speed--to cellular phones, to faxes and e-mail, to hard-driving rock music and seven-second sound bites on TV. Both believe that the tendency to portray ADHD as a purely "biological" condition, with Ritalin as its "cure," has more to do with culture and politics than with science. In fact, if these two books can be considered representative, then current thought about ADHD is so firmly on the side of nurture that one is left wondering what evidence, if any, was ever advanced on behalf of nature.

People undoubtedly felt differently 10 years ago, when newspaper headlines blithely announced genes "responsible" for everything from homosexuality to migraine headaches. One seminal experiment on ADHD from around this time seemed to demonstrate differences in brain metabolism between normal and ADHD individuals. Its results were never reproduced. Another early study found that a peculiar gene was overwhelmingly present in families with a history of ADHD. But as Walker notes in The Hyperactivity Hoax, this "doesn't mean that hyperactivity is a genetic disease. It means that many genetic diseases can cause hyperactivity." In fact, about the only thing that a decade of research on the disorder has established beyond doubt is that Ritalin does help children concentrate. Given that Ritalin helps just about anybody concentrate (as do amphetamines, its pharmaceutical cousins), one can see how the biomedical model of ADHD has become the subject of such fierce attack.

It was never the strength of the science, however, that carried the day for the biomedical view. All of a sudden...