An Australian psychologist named Luise Kazda is studying this very question. In a 2021 review paper, she and her colleagues discovered 14 studies that have created a sense of “empowerment” by “supporting an understanding and a sense of legitimacy that involves reducing sympathy, guilt, accusations and anger.” However, in 22 other studies, Kazuda wrote: “The biomedical view of difficulty has been shown to be related to dismantling. By providing excuses for the problem, it can lead to a reduction in liability by all involved, often followed by omission and stagnation.” Additional 14 studies found that diagnosis increases feelings of stigmatization. “Diagnosis may create an identity that reinforces bias and judgment,” Kazuda reported.
It is not yet entirely clear why the simple act of providing a diagnosis of ADHD appears to have such a profound effect on some children and their families. However, under the medical model, diagnosis certainly sends a message that is very different from that made under a model like Sonuga-Barke's.
For some parents, being able to say, “My child is in a medical condition, so I need to take this medication every day” may actually be less stigmatized and more comfortable. However, for many children, the diagnosis of ADHD, communicated through the dominant medical model, can feel more than stigma. It can feel like a life sentence. The message to children is that ADHD is often a binary, biological category, and when symptoms place you in that category, the brain is damaged.
In contrast, alternative models tell very different stories to children. His ADHD symptoms exist in the continuum, where we all find ourselves. He may be experiencing those symptoms the same way, because of who he is and where he is. And if things change around him next year, those symptoms may change too. Armed with that understanding, he and his family can decide whether the drug makes sense – for him, benefits are likely to outweigh the shortcomings. At the same time, they can consider whether there will be changes in his situation, at school, at home. It helps to alleviate his symptoms. If he also experiences other psychological states (anxiety, depression, post-traumatic stress), they can take steps to address those deeper issues, regardless of whether they can't concentrate on the mathematics class.
Certainly, the ADHD version has certain drawbacks. It denies parents any clear and conclusive explanations for the child's problems that could become such relief, especially after months or years of frustration and uncertainty. Many times, there is a need for a lot of flexibility and experimentation on the part of patients, families and doctors. However, there are two important benefits as well. First, new models will more accurately reflect the latest scientific understanding of ADHD, and second, children will give visions of a future where things can actually improve.
Source Photo, from the top: Rob Lewine/Tetra Images via Getty Images; Brusinski/Getty Images; Pixelfit/Getty Images; Richard Hatchings/Corvis, via Getty Images.
