Maybe the rise in ADHD diagnoses is in part because kids aren't getting enough sleep


#1

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#2

I’m a substitute teacher, and I frequently work supporting ADHD kids. In my experience, this is plausible. My students are often awake most of the night, using electronic devices - playing games, chatting with friends on Facebook, etc. (I really wish their parents would take their devices away for the night!)

I do see one flaw with the hypothesis. Do the kids have insomnia because they really have ADHD, or do the devices deprive them of sleep so they look like they have ADHD?


#3

Living in the city, I have been shocked to see parents and children out and about at midnight… even 1 or 2 am. I was quite strict about bedtime with my son, and it sure as hell wasn’t midnight. I wonder what’s going on in these families?


#4

You’d think the biggest symptom of lack of sleep would be being tired.

I strongly suspect that a causal factor in ADHD is seeing fast-moving images on TV. It’s completely unnatural, and it’s getting worse. Take an average TV show and watch how long the camera stays at the same angle. On some shows, the camera angle changes every second or two for the entire show. Advertising is particularly bad.

I suffer from ADD, and I avoid this stuff like the plague. Perhaps coincidentally, I watched a lot of TV as a kid.


#5

Maybe there’s more diagnosis of ADHD because of better diagnostics. Maybe it’s better neural imaging. Maybe it’s recognition and wider acceptance of a malady that used to be considered bad behavior or a moral failing (‘you’re so smart, If only you’d apply yourself’). Or perhaps kids are up with their handhelds because their circadian rhythm causes them to be up at night rather than in the daytime.

And then, where do you put the kids whose ADHD causes them to sleep immense amounts?

Why is it so attractive to write off ADHD as bad parenting, or the evils of our modern world, rather than understanding it for what it is: a misfiring of neurons to the frontal lobe? Of course, it’s easy to blame parents, because all they want to do is keep their kids up all night looking at their hand held devices–and then maybe top off those hand held device ragers with a couple of lines of Ritalin.


#6

I haven’t read the New Yorker piece yet, but as perhaps a companion piece I’ve just stared listening to this week’s Freakonomics podcast which is a two-parter about sleep and the socioeconomic causes/effects - it might be interesting to tie these in together.


#7

Well, when my 3 and 5 year olds get tired they get hyperactive and punchy. I suppose that older kids and adults aren’t as much different as they would like to believe.


#8

On the other side of the age spectrum, I’ve always wondered just how many horrible decisions in world history were taken by cranky Chancellors and sleep-deprived Senators, and how many conflicts could have been avoided if everyone had just had a good night’s rest…


#9

Rest and sleep are no doubt important components of healthy neurological development. Proper nutrition with diets very low in sugar would be another. Having a food and water supply free of toxic industrial contamination like sodium silicafluoride and glyphosate would be yet another. My inclination is to suspect the food supply most, however, since changes in US industrial agricultural practice seem to coincide so neatly with huge health outcome demographic changes over these past twenty to twenty-five or so years.

Beyond that, I wouldn’t be surprised if there’s a causal link between poor nutrition or low-level poisoning from industrial contaminates and … yes, poor sleep/rest patterns.


#10

The number one complaint of parents at my kids’ high school is that there are too many hours of homework each night. Any teen who also is involved with sports, other extracurricular activities, or a job in any way is not getting to sleep before midnight EVER in four years, at a time when the brain is engaged in nearly as much development as it did when they were babies. Let’s not take the easy route and blame everything on electronics.


#11

Personally, I blame novels. All full of nonsense ideas filling children’s minds with lies. And the casual language certainly doesn’t stimulate the brain. It’s just lurid penny dreadfuls. And have you SEEN how many pages there are? All full of letters. It’s unnatural, I tell you.


#12

zenith and chgoliz ,

Clarification: I am not blaming all ADHD cases on electronics and/or bad parenting. The ‘maybe’ in Xeni’s headline is the operative word in this discussion.

It is POSSIBLE that a small minority of ADHD-diagnosed students are acting out in school because they have a bad home life, and they crave attention and structure from adults. It is POSSIBLE that a small minority of ADHD-diagnosed students are sleep deprived because of the white-blue light from their devices stimulating their brains and keeping them awake. A misdiagnosis is a grave disservice to these children and their families, especially if medication is part of their treatment.

Conversely, I’ve seen medication make a huge difference in an accurately diagnosed child’s ability to focus and succeed in school.

Hopefully, diagnosing neurological disorders accurately continues to improve.


#13

Totally agree with you. There isn’t one cause, and there isn’t one answer. And figuring out what it takes to help each person is the right thing to do.


#14

I used to teach kids with ADHD so severe they couldn’t function, they couldn’t even enjoy recreational activities without medication. There are a lot of kids who are diagnosed with ADHD and given drugs simply because their personalities don’t fit neatly into the paradigm of conventional schooling.

Don’t like sitting in a classroom while adults talk about things you’re not really interested in? ADHD. Do you protest non-verbally against doing worksheets and taking tests which punish you for not achieving the same things at the same times as other kids who were born the same year you were? ADHD. Do you feel like reading when the adults want you to do math? Would you rather do math when the adults want you to read? ADHD. Are you not reading with the kind of enthusiasm which educated adults expect from you? ADHD.

I think it’s a huge mistake to pretend that ADHD is something which is as grounded in scientific understanding as evolution or global warming.


#15

I think that parents and children alike are under increasing time pressures, so they share the temptation to cut out a little more time from sleep in order to spend time together.


#16

Sleep scientist here. There are actually numerous studies that suggest the link between ADHD diagnosis and sleep deprivation in children. In the clearest examples, when some children diagnosed with ADHD were treated for sleep disorders, their ADHD went away. Here is a layman’s summary from a few years ago (I tried linking to original articles, but pubmed has crashed at the moment!):

To be clear, this doesn’t account for everyone, but sleep deprivation is a strong candidate to explain the rise in ADHD.


#17

I think aikimo is spot on with this post. When a kid is a square peg in the round hole of our educational system, it’s ADHD. I see this is happening all the time with my kids’ classmates. They’re frustrated and bored to tears with the worksheets and testing, they’re not getting adequate recess or lunch. Lunch comes too early or too late in the day. Next thing you know, the teachers and administration are suggesting you get the child evaluated and dosed.

I don’t think we have more ADHD now than before. We just have an avalanche of diagnoses. Whether those are valid diagnoses is a big question mark.


#18

My background is child development and education. Because I have a degree in developmental psychology, when I worked in early childhood education (childcare settings) I was often consulted by other teachers and parents asking if I thought Johnny had ADHD because he was so active and wouldn’t sit still. It drove me crazy! Johnny is behaving like a typically-developing 2 year old! The teachers and parents expectations were often not in line with what was appropriate for the age of the child.

I also noticed a lot of anxiety about preparing kids for such and such. Parents and teachers would freak out about preparing the preschoolers for kindergarten. The 2-3 year old teachers and parents would freak out about them being ready for pre-school and so on down the line. This often resulted in expectations being raised because Johnny and Susie had to be able to do that next year so we better start expecting it now so they’ll be ready. I often had to explain that they will develop those skills next year when they are developmentally appropriate.

Anyway, I think a lot of the reason we are over-diagnosing is because everyone thinks they are qualified to identify it and people are planting the seed of suspicion at very young ages. Then you just get a self-fulfilling prophecy.

I had one mom really upset and worry because teachers would complain that her not yet 2 year old son was hard to handle. His behavior was completely normal for his development. I basically told her not to worry and not to listen to anyone who would suggest ADHD at such a young age because it isn’t really able to be diagnosed until much older since much of the symptoms are age-appropriate behavior for young children.


#19

I can definitely see sleep being a huge cause of many behavior issues in kids. I have worked with kids from infants to high school and it’s amazing how many kids do not get enough sleep. Part of the problem is that parents really don’t know how much sleep children at different ages need. We really need to do a better job about educating parents on sleep needs. The other problem is devices in bedrooms and parents who have given up or never even tried that battle. I think parents also struggle with older children wanting to stay up later as a privilege of being older.

My tip to parents: with your child look up what amount of sleep they need at their age (showing kids the actual source of information is key here), explain that this is what their body needs and why, then subtract that time from the wake up time they need and that is bed time. Kids are less likely to argue when bed time is framed this way as it isn’t some arbitrary number their parents picked. I also suggest an hour of quiet time in the room before bed. Helps them to wind down and gives parents the break they need and deserve!

edited to add:
If you use my tip with your kids, you should be willing to do the same for yourself. You have to model the behavior you seek from your kids. When I set my nephew’s bedtime (he was in my care), I did this and I also calculated my bedtime with him using the same method. Although he fought me on many issues, he never questioned the bed time.


#20

I’m a teacher who rarely assigns homework for gen ed classes because most students just blow it off. The homework most students get from me is either make up (absence) or work that they chose not to complete during class. I remind students that they really need to review their notes in preparation for an upcoming assessment, but they will not even do this. My guess is that the high school students who have hours of homework are AP students or students at highly competitive or high-scoring schools. Even papers are no longer independently assigned.

So I’m naturally curious as to the actual accounting of homework minutes by families. The best way to do this is to sit with your child with a stopwatch and stop the timer whenever he/she texts a friend, goes to the restroom, etc. You’ll be amazed how much distraction there is in a young person’s life. (If I even pause during instructional input, they think it means to start talking with their peers.)

All I do know is that I was inadequately prepared for the rigors of college due to little or no homework, and I often hear from ex-students who complain that we didn’t fully prepare them for college because of the lack of homework. Damn if I do; damn if I don’t.

As for the extra curricular activities: yes, they are important but parents and their children need to decide what is most important. I once had a parent write me a note asking me to allow her child extra time on an assignment because she had swim practice from 5:30 - 7:30 pm. I declined the request because it was an honors class and the student admitted that she chose to mess around from 2:00 to 5:30 pm. If the student was willing to admit this to me, why didn’t the parent know this? (And man, I really wanted to cave in due to her honesty!) If you want your child to take rigorous courses such as honors and AP, just remember that the lesson plans do not take into consideration extra curricular activities; especially AP courses, which are supposed to be taught at college level.