Any parent who has taken their child to their physician or some type of private practitioner (psychologist, counselor) for a behavior problem or attention problems has probably filled-out a behavior checklist of some sort. This is standard practice in placing any kind of behavior related label on a child. Whatever your view is on these (even if you’ve never experienced one), consider this. Think of yourself at work. If your tired, hungry, or have a lot on your mind you will be distractible, and some days more than others. If I had your boss fill out a checklist regarding your behavior that day you would come out significant for distractibility. In other words, this checklist would tell your employer that distractibility is a serious problem for you. But in fairness to the people who make checklists and the schools who use them, checklists usually require that the rater know the person for at least two weeks.
So let’s say your going through a divorce and naturally you may be very preoccupied, or “distractible,” for a fairly lengthy period of time (two weeks or more). Then we have your employer fill out a distractibility checklist about you for the past two weeks. Well again, you come out significant for distractibility. Does that mean you have a true disorder? No! It means that you are distracted by the events going on in your life, and things will likely return to normal once you are through this rough time. You are supposed to have some problems when you go through a divorce. It’s normal. Well most of the time this is how we incorrectly use behavior checklists in the schools. Kids who come from chaotic, dysfunctional, neglectful homes naturally have behavior problems at school. And typically their home problems have been occurring for a long period of time.
So at school they are distractible, impulsive, and hyperactive, to name just a few. They should be. They don’t have a true disorder, or disability. But because the schools can’t get the parents to do anything, and can’t control the student’s behavior, they use checklists to “prove” that the student has a disorder, or a special education eligibility. And then when the school does get the parents to do something, like take the child to the physician, if he even asks for a checklists from the school, he relies on them heavily during his three minute office visit. In other words, the doctor usually does not do anything else other than agree with the results of the checklist from the school.
Inappropriate labeling and diagnosing doesn’t account for the majority of kids having learning or behavior problems, but it is a significant number and a poor reflection on our society nevertheless. I have seen far too many times, and heard the same account from many colleagues, of children who are taken to the doctor and diagnosed with ADHD without any information from the school. This is very disturbing and troubling when you consider that the behavior problems ADHD kids exhibit are mostly a problem at school. In other words, school is where their ADHD has the most devastating impact. If they are not paying attention and doing their work, they are not learning, or getting an education.
Although at home an ADHD kid may be difficult to manage and annoying, the long-term impact of their behavior is greater at school. But doctors will diagnose and prescribe medication based just on what the parent says and maybe a two minute “observation” in the office. You have to understand that by this point the child has been having problems in school for an extended period of time. He may be doing such things as not listening to the teacher, not doing his work, chatting too much with his neighbors, and getting out of his seat too much. The school has tried the standard battery of interventions, such as praising, redirecting, rewarding, choices, and preferential seating. Then the teacher, nurse, and eventually a team of specialized staff members, such as me, talk with the parents. In by far the majority of these situations, I have not met parents who were at all convincing in their commitment and discipline at home. Their child didn’t have any real respect or fear the consequences of what his parents might do to him.
Here their child is in school, misbehaving, not listening to the teacher, not doing his work, and basically doing what he wants, but his parents can’t get him to stop! And of course they tell you that they’ve tried everything – even taking everything away (yeah right). Meanwhile, their child watches TV, plays video games, plays with his friends, talks on the phone, etc (remember, because taking those things away didn‘t work, so why not let him have them back?).
So instead what happens, they go to their friendly neighborhood physician and get a diagnosis and medication. Another part of the problem, that is very troubling to me as a professional working in the schools (and should be for our society and educational institution), is that the schools, because they can’t handle kids whose parents won’t stop them from misbehaving, often times encourage and persuade parents to go get medication.