New study on ADHD diagnosis raises questions

A new study shows that the likelihood of being diagnosed with ADHD (attention-deficit hyperactivity disorder) very much depends on an individual's economic and social status, including educational attainment. The study's results challenge basic assumptions about pedagogical ideals.
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Högskolan Dalarna

Restless, unfocused pupils require considerable resources. Teachers, teacher educators and researchers are all involved in trying to find ways to deal with overactivity, lack of impulse control and concentration difficulties. A new study from Dalarna University, Uppsala University and Karolinska Institutet raises questions about pupils with ADHD, teaching and which qualities are acknowledged in education.

– We have identified what the objective requirements are for being diagnosed with ADHD. The central message of the study is that low socioeconomic status is a strong contributing factor to an individual being diagnosed with ADHD but that ADHD itself is not a cause of low socioeconomic status or poor academic performance. Two factors related to socio-economic background are income and level of education, explains Madeleine Michaëlsson, Senior Lecturer in Educational Work at Dalarna University.

Attention difficulties, hyperactivity and lack of impulse control are central elements of ADHD. Previous research has shown associations between ADHD and low socioeconomic background and ADHD and level of intelligence. The purpose of this study was to investigate the direction and strength of such associations.

– This research is important because it shows that there’s nothing wrong with pupils who have concentration difficulties and that there are ways to provide them with the tools, they need to benefit from what school has to offer, says Madeleine Michaëlsson.

The study shows that an ADHD diagnosis has strong ties with socioeconomic factors, regardless of an individual’s level of intelligence. What is more, ADHD appears less likely to result in more than a moderate decline in socioeconomic status while low intelligence does not appear to be either a cause or a consequence of ADHD.

– Since as far back as antiquity, self-control and concentration have been considered desirable attributes, not least within the context of education. We need to reflect on how pupils’ current circumstances and expressions are interpreted in the context of teaching, and how norms and values relate to the teaching and educational ideals of today, says Madeleine Michaëlsson.

Both diagnosis and treatment of ADHD have grown in scope over the past two decades but with significant variations by region, and both within and between countries. There are also significant differences between the proportion of diagnosed children and adults.

– We need to investigate why socioeconomic background links strongly with an ADHD diagnosis and the medication that often accompanies the diagnosis. The results of the study lead to further reflections – whether it is the pupil who needs to adapt or whether it is the teaching that needs to be adapted, says Madeleine Michaëlsson.

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