I just watched the Kara Swisher interview with Maria Shriver and her daughter Christina at SXSW about Alison Klayman’s upcoming film, “Take Your Pills” that they co-produced. The movie will be on Netflix on Friday, March 16th and I am cautiously optimistic. My sincere hope is that it will address the serious and dangerous issue of the misuse and abuse of Adderall while at the same time recognizing the valuable and safe use of medication for those who truly have properly diagnosed ADHD.
I do want to raise a concern about something I heard during the interview and share my perspective. In response to Christina, who mentioned that she was taking Adderall in high school, Kara asked, “You were prescribed it to, what?, get you to do your homework better?” Christina said, “No, just help me focus.” Kara continued, “You didn’t have executive function is that right?” and “which I don’t know why a 16-year-old needs executive function, but ok”.
I just want to clarify that everybody has executive function. It is part of the brain located in the prefrontal cortex. Executive function is the set of mental skills or processes that allow us to use our intelligence and problem-solving abilities to help us work toward achieving our goals. Basically, it helps us do what we intend to do.
Most parents of kids with ADHD are not just trying to “get their kids to do their homework better”. While I do support kid’s (and adult’s) choice to take meds for ADHD, it should be only after they have been properly diagnosed by a specialist who has done a full family history and comprehensive evaluation in multiple settings. As Maria said to Kara, “With all due respect, other parents saying to other parents, you drug your kid, is a shaming thing, and there are kids, literally, no matter how many hours they do their homework, they can’t remember a thing. They cannot – remember – a thing. And if you understand the brain. And you understand the entire thing of the brain and you understand it’s way beyond executive function for some families.” Parents are wanting to help their children access learning and manage other related challenges. Kids who genuinely have ADHD need tools, strategies, and support from parents and educators who truly understand the neuroscience of how ADHD and executive function impact learning, motivation, and behavior.
During the SXSW interview, they also discussed that if schools were more flexible and let kids be more creative, perhaps things would be different. From my perspective, while that may help some, that is not the answer for many of the kids. Not every family can afford to send their child to that “just right” school, as was mentioned in the interview. And in many parts of the country, these schools are not even available.
So much of what we are seeing in the breakdown of kids in school is because we have pushed down the learning so that kindergarten looks like 2nd grade. I do believe that we may be medicating some kids who might just need a more appropriate learning environment and more realistic expectations. Unfortunately, as I have done professional development about ADHD and executive function across the country, I have found that teachers and related school professionals are often unaware of the full impact and more importantly how to support these kids in the most helpful ways. It’s not entirely their fault. Most never received research-based comprehensive training in ADHD and executive function in their initial professional education. It’s time the schools start investing in updated training and materials to help these kids not feel like square pegs in round holes so that they can thrive, feel confident, and secure.
I know how to build a better school within what already exists. It’s no more expensive, and in fact, would greatly reduce the need for extra services and classes. It starts with reducing the stress and building kids’ executive function skills is by letting young kids play interactively, have supervised unstructured time, and focus more on their process of learning and less on the outcome of the tests. And all kids in every grade should have access to flexible seating, fidgets, and movement as long as they know how to not be distracting to others. This will help them learn to manage themselves in the real world. And we need to train and support educators in know how to help kids learn skills without just relying on sticker charts that for most kids with ADHD are counter-productive.
We need to let go of the judgment and shaming about who is using meds and create environments where all kids can succeed.
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