Has the No Child Left Behind Act Increased Diagnoses of ADHD?

This article was titled, “The Not-So-Hidden Cause Behind the A.D.H.D Epidemic” written by MAGGIE KOERTH-BAKER  for the New York Times on October 15, 2013.  Maggie outlines how children are diagnosed at a much higher rate than they used to, likely due to “changes in the way we school our children, in the way we interact with doctors and in what we expect from our kids” (Koreth-Baker, 2013, New York Times). However, this is the most broad claim she made. She went deeper into a study that she did not source about how the No Child Left Behind act is what caused these changes in how we school our kids, interact with doctors, and expectations of the kids.

The author makes some drastic claims, but throughout her article does not cite any sources. Some of the statistics she puts out there include “Of the 6.4 million kids who have been given diagnoses of A.D.H.D., a large percentage are unlikely to have any kind of physiological difference that would make them more distractible than the average non-A.D.H.D. kid.” With specific numbers as these, you should probably state somewhere they came from, but she didn’t state who even figured that out. As she wrote this as someone with ADHD, who was diagnosed as an adult, she tried to illustrate that it’s hard to get diagnosed as an adult, but children can be diagnosed in one visit to their pediatrician. She talked about how some scientist named Hinshaw found that geographically, the distribution of kids who have ADHD is not distributed equally, and believed that the No Child Left Behind Act, which links school funding to standardized testing scores, to be the cause of such (Koreth-Baker, 2013, New York Times). By blaming the No Child Left Behind act for kids having ADHD, without any foundation for this claim or even citing this man’s study, it may leave people to believe that the No Child Left Behind Act pressures teachers and parents to make sure kids are well behaved in class and can focus on everything. This makes the implication that the NCLB act forces kids who don’t have ADHD to be on medicine so they do better in school. She later goes on to say “Nationwide, the rates of A.D.H.D. diagnosis increased by 22 percent in the first four years after No Child Left Behind was implemented. To be clear: Those are correlations, not causal links.”  (Koreth-Baker, 2013, New York Times). The author seems to confuse the words “correlation” with “causation”, seeming to imply that this is causation. However, correlation and a causal link are basically the same thing. They happen to be happening at the same time, but the NCLB act is not necessarily the cause of that.

This article was incredibly biased and didn’t seem to have any sort of foundation to me. She was making intense claims apparently some guy had figured out, but when I did research I could not find his specific study to cross check what she was saying. However, I found a similar study, that stated

“NCLB-initiated consequential accountability reforms were associated with more ADHD diagnoses among low-income children, consistent with increased academic pressures from NCLB for this subgroup. In contrast, psychotropic medication laws were associated with fewer ADHD diagnoses, because they may indirectly reduce diagnoses via restrictions on recommending or requiring medication use. Future research should investigate whether children most affected by these policies are receiving appropriate diagnoses.”

Again, they act like the ADHD diagnosis are directly caused by the laws. However, they simply studied the laws in each state and when they came into effect, and how many kids per state had been diagnosed with ADHD and how those numbers were changing. They stated that the reason for the increase in diagnoses and the relationship as follows:

“Children with ADHD show substandard academic achievement (13,14). Consequential accountability may indirectly result in more ADHD diagnoses, because diagnosed children are often treated with prescription medications, which are associated with small increases in standardized achievement scores (15), albeit with mixed evidence for improvements in school grades and grade retention (16). School districts are motivated to promote diagnoses, such as ADHD, to gain testing accommodations or even to exclude such children from formal academic testing, even though the latter became more difficult with implementation of NCLB (1719).”

They make some very intense claims, but there was no grounds for such claims. They say the school districts want kids to get diagnosed because it benefits them, however, they have no evidence for how school districts are convincing parents to get their kids diagnosed.

If this study and article was true, it would mean that kids are on medicine due to policies. While the rates of ADHD is rising, it seems like a stretch to blame it on the school districts encouraging diagnoses to get kids to do better in school or exclude them from testing.

Fulton, B. D., Scheffler, R. M., & Hinshaw, S. P. (2015). State Variation in Increased ADHD Prevalence: Links to NCLB School Accountability and State Medication Laws. Psychiatric Services, 66(10), 1074-1082. doi:10.1176/appi.ps.201400145

Koerth-Baker, M. (2013, October 15). The Not-So-Hidden Cause Behind the A.D.H.D. Epidemic. Retrieved November 12, 2017, from http://www.nytimes.com/2013/10/20/magazine/the-not-so-hidden-cause-behind-the-adhd-epidemic.html


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