Bronwen Hruska gained national prominence last August as a mother and activist when she published an opinion piece in The New York Times called “Raising the Ritalin Generation.”
The piece was a clarion call to parents to closely assess the accuracy of a child’s Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) diagnosis. Hruska outlined her own son’s tumultuous journey when he was misdiagnosed with ADD at the age of 8. Two years later, Hruska and her son decided that the treatment was not only unnecessary, but had also been unwarranted. Hruska, the publisher of SoHo Press, recently published her first novel, “Accelerated,” through Pegasus Publishers. Part thriller and part social commentary, “Accelerated” is a brilliant, complex story about the consequences of over-diagnosing children with ADD and ADHD.
Q: There have been a number of articles, including your own, written about ADD and ADHD. Why do you think there’s an increase in interest?
A: With diagnoses of ADHD increasing 5.5 percent every year in this country, I believe we’re finally at a tipping point. As of 2010, 5.2 million children had been diagnosed with the neurological disorder. If that’s not an epidemic, I’m not sure what is. And I don’t believe that the increase in diagnoses has anything to do with a decreased attentiveness of children overall. There was an article in The Atlantic earlier this year that cited a study by a team of Penn State psychologists in The Journal of Attention Disorders that stated, “Children are no more or less inattentive and impulsive today than in 1983.” But schools and doctors routinely recommend medication for “Inattentive-type ADHD,” which means simply that in distracting situations, such as school, these children find it more difficult to focus. And with more and more children being medicated to help them succeed academically (as opposed to help manage the symptoms of the disorder), more children are at risk of suffering from the real and often scary side effects of the psychotropic medication that has been downplayed by the medical community as “safe.”
“Accelerated” examines the consequences of over-diagnosing children with ADD and ADHD. As medicating kids becomes more and more common, so does the general sentiment that if your child isn’t on medication, he or she is at a disadvantage. It’s the same mentality that created the phenomenon of “juicing” in athletics. We’re ratcheting up the level of competition in school with performanceenhancing drugs.
Q: “Accelerated” is told from a dad’s point of view. Would it have been a different book if the protagonist had been a single mother?
A: I wanted Sean Benning to feel very outside of the Manhattan private school community where his son Toby goes to school. Not only did Sean grow up in Troy, N.Y., but he’s also one of the only fathers in the estrogen-heavy circle of mothers that make up the vast majority of parents responsible for drop-off and pickup at The Bradley School. Without a community of parents to share information with, Sean feels even more at sea when the school strongly suggests that “a little bit of medication could turn everything around for Toby.”
Q: Third grade seems to be the time kids (especially boys like fictional Toby and your own son) are diagnosed with ADD. Why the zealousness? Is it warranted?
A: Schools tend to crank up the scrutiny in 3rd grade. As a parent, I was grateful that teachers were paying attention, making sure nothing fell through the cracks. But in their zealousness I worry that teachers are so determined to find something, anything, that they often err on the side of overkill. Don’t forget, 3rd grade is also the time when children are expected to sit still for longer periods of time, transition quietly between classes and cut the silliness. And the truth of the matter is that some children (especially boys) at 8, 9 and 10, who are perfectly within the developmental norm, still find this challenging.
It’s important to understand that Attention Deficit has become the go-to diagnosis. Sanford Newmark wrote in The Wall Street Journal this fall that many doctors making the diagnoses aren’t distinguishing between normal developmental immaturity and ADHD. These misdiagnoses could account for as many as 20 percent of the current ADHD diagnoses in the U.S., or about 900,000 children.
That said, for kids who do suffer from Attention Deficit, medication could truly turn things around for them. One adult, who was diagnosed late in life, told me that as soon as he took that first pill, the white noise in his head (a noise he’d never even noticed) turned off and he was finally able to complete projects he started, including reading books. It changed his whole life, and he wished he’d been diagnosed as a child. My worry is that kids who are simply not ready for the expectations of accelerated curricula are being diagnosed with a disorder. The flipside, of course, is that in poorly funded regions, children are being medicated so they can succeed within a broken school system with too few teachers.
Q: I read that boys are being treated like “defective girls” with regard to diagnosing ADD and ADHD. Do you think this has some validity or is it just an inflammatory statement?
A: Just look at the statistics. Boys are 2.8 times more likely to be diagnosed with ADHD than girls. If 13.2 percent of all boys have been diagnosed with the disorder (as opposed to 5.6 percent of girls), I’d say that we need to determine what the barometer for “normal” is. In “The War Against Boys,” Christina Hoff Sommers looks at how the education system was overhauled in the wake of Carol Gilligan to accommodate the specific learning styles of girls and as a result has left boys in the dirt. I think that schools now do value traits that are more traditionally female, and leave little room for the very normal (and different) developmental style of boys.
Q: Medication doesn’t carry as much of a stigma as it used to. Are we changing the way children develop with so many ADD and ADHD diagnoses?
A: I want to be careful because, again, I believe that for kids who do suffer from ADD and ADHD, medication can actually help them to develop on a level playing field with kids who don’t suffer from it. But when so many kids are taking medication to enhance their academic performance, it really does send a powerful message to an entire generation. We’re teaching our kids that challenges should be met and problems solved by swallowing a pill.
Too often, due to extreme pressure from an accelerated society that demands everything be better, faster and more impressive, kids aren’t being allowed to do the hard work of growing up, getting organized and learning what’s expected of them. Also, if a young child is put on medication and it’s deemed to be “working,” parents are loathe to take them off of it, and as a result will never know whether their child has “outgrown” the attention issues. Instead, dosages continue to be raised as the child grows, and soon kids are selling their prescription medication as study drugs in college where Ritalin and Adderall and other focus drugs are as commonly used the way No Doze was used when I was in college.
Q: How does your novel help parents grappling with the decision to give their kids Ritalin or even to seek out help?
A: The reason I started the novel was to explore the impossible position in which so many parents find themselves – deciding whether or not to medicate. When my son’s 3rd-grade teacher suggested we get him evaluated, it was a no-brainer. Of course, I wanted to catch anything that might be an issue. Of course, I’d trust the school if they thought there was a problem, and I’d trust the doctor who did the evaluation. But there’s a moment when, as a parent, you’re torn between your gut and the experts. There is both too little information out there and too much (if you’re looking on the Internet). You don’t know who or what to trust, and parents aren’t talking about it. There’s this feeling of being alone at sea – you feel like your child is the only one going through this.
As I started researching the topic for my novel, I realized that there were approximately 10.5 million parents having to make this very same decision. I thought it was crazy that no one was talking about it, sharing information, anecdotes, research. Simply knowing how many kids were getting this diagnosis made me think about my son’s diagnoses differently.
I’m hoping that parents read “Accelerated” and continue the dialogue. Whether they like what it has to say or hate it, I want people to tell each other their stories. Just talk. It’s a powerful thing.