Drugging children for gender differences could be harmful

by Steve Edelman

Far more males than females are diagnosed with ADHD. Is this a result of diagnostic bias?

There is no denying that boys are different than girls. Does this mean that boys should be routinely given drugs like Ritalin? The fact that they seem less interested in disruptive behavior when drugged does not necessarily mean that they are being more attentive. An understanding of the gender differences in male and female brains can help in the search for alternative approaches to dealing with innate gender differences in behavior.

Our brains have evolved little in terms of instincts and natural function. As Thomas Hartmann documents in Hunters in a Farmer’s World, there was an original division of labor between men and women that is maintained by biology in spite of modern attempts to make males and females equal. Men were the hunters. They explored, they moved, their creative efforts focused on obtaining animal protein for the entire tribe. Women rarely went hunting. They stayed at home (cave, tent, hut, etc.). Women might wander within earshot of their child’s cries in order to gather vegetable material for food, medicine and clothing (the ability to pay attention to two or more things – gathering while not concentrating so much on this activity that they forget to remain aware of the activities of their child). A quote from Project Lab expresses it well:

“Hunters have a unique way of concentrating that one author (Hartmann) calls ‘global concentration.’ While concentrating, every sense is turned on and is rapidly processing information (e.g., sight, sound, smell, feel, intuition, etc.). It is nearly impossible to sneak up on a hunter and they are usually extraordinarily observant of their environment. In the average classroom, however, this characteristic becomes a liability when minor distractions constantly tug at their consciousness and compete with the teacher and/or the textbook for attention.”

How many times have men gotten into trouble when their wives or significant others told them something while they were watching a football game? Most men who get involved with what they are watching on television have been on the receiving end of complaints from wives, who feel that their husbands are being inattentive to their needs.

The best help is to develop a method to redirect attention. Men and women need to work out an understanding of their attention differences. This is significantly related to a major problem for boys in school.

Boys in school can’t pay attention if there are distractions. They may be thinking about a girl, or planning what they want to do after school. The teacher (usually a female in elementary school classes) can become concerned when a boy’s attention seems to have drifted.

It may help when the teacher consistently uses phrases such as “This is important class,” or claps her hands for emphasis to get attention. One of the best teachers I know (a male, third grade teacher) uses several tricks to gain the attention of his class, including a rather loud air horn that he keeps on his desk.

Another important difference between boys and girls that makes it more likely for boys to be diagnosed with ADHD or ADD is developmental. Most educational psychologists and sophisticated teachers know that boys, as a group, learn to read at a slower pace than girls. Boys do not catch up to the reading level of girls until the sixth or seventh grade. Requests to read at a higher level can cause inattentive and disruptive behavior. (Girls, as a group, are much slower than boys at learning math and math concepts.)

Traumatic brain injuries on the left side where most people process language demonstrate that there are important differences between male and female brains. An injury to the language processing area of the brain is usually much more catastrophic for males than it is for females. Failing to take into account gender differences in the way the brain functions could lead to gender bias in the diagnosis of ADD/ADHD.

A fourth important difference also increases the tendency for more boys to be diagnosed with ADD/ADHD than girls: The social maturity factor. Many trained professionals say that boys are slower to develop social skills. Girls in school frequently make negative comments about the social maturity of the boys in their grade. This may explain why girls tend to form relationships with older boys. A lack of social maturity is part of the diagnostic framework of identifying children with ADD/ADHD, and once again, it is women (as teachers) who do most of the referring.

What, then, is the purpose of claiming gender bias against males in the identification of ADD/ADHD? First, we must get past the step of bashing women or men. Then educators in the US urgently need to reevaluate their basis for the all too frequent diagnosis of ADD/ADHD. Drugs should be the last choice for problem solving, rather than the first.

Steve Edelman served as president of the North Carolina School Psychology Association and works as a school psychologist for Cumberland County Schools, Fayetteville, North Carolina. In addition to his experience in American schools, Mr. Edelman studied the education system in Japan under a grant from the Fulbright Memorial Fund. He has been married for 26 years and has a daughter.