An anti-oppressive approach to AD/HD




  • AD/HD affects 5% to 10% of children and 3% to 6% of adults.
  • It is a highly heredity disorder: If one person in the family has AD/HD, there is a 25% to 35% chance that another close family member will have AD/HD.
  • Parenting children with AD/HD is stressful — 23% of parents of children with ADHD divorce, compared to 13% of other parents, according to a recent study.


AD/HD: Where are the social workers?

The problem of AD/HD has been primarily viewed from an individual perspective. It is the domain of the teachers who have to deal with it, the psychologists whose tests diagnose it, and the psychiatrists who do clinical trials on the meds that manage the symptoms.

Where are the social workers in this picture?


Societal impacts of AD/HD

AD/HD has serious societal impacts. It is dramatically over-represented among disadvantaged groups, such as the prison population and people living in poverty. Among its many consequences are higher rates of criminality, delinquency, risky sexual behaviour, high-risk pregnancies, unstable personal relationships, and lower levels of global functioning.  Adolescents 15 and older with AD/HD are far more likely to become addicted to drugs or alcohol than other youth, with half of all adults with AD/HD having a substance abuse problem. People with AD/HD also have high comorbidity with mental illnesses such as depression, obsessive-compulsive disorder, anxiety disorder, and others.


A critical perspective on AD/HD

AD/HD has been socially constructed in a negative way. It is often viewed as the result of bad parenting or poor diet. The typical image of someone with AD/HD is a male child with poor grades who is disruptive and bouncing off the classroom walls.The parents of these boys are told to get them diagnosed and treated, because they are a classroom management problem (which may result in overdiagnosis of AD/HD in some situations).

Some groups of children are over-diagnosed, but AD/HD is also often underdiagnosed (girls, non-white children). In particular, very few black children receive treatment in the US. According to Gail Mattox, a member of the Black Psychiatrists of America, key factors in the fact that black children receive treatment at half the rate of white children are: poverty, culturally inappropriate services, lack of information and misinformation in black communities, and the fact that many black children are in care.

Many other children fall through the cracks. My son with inattentive AD/HD (without hyperactivity) quietly failed his way through school for no apparent reason, despite my repeated attempts to find out why. Girls are also often missed, partly because they present differently and partly because AD/HD has been associated with boys. Gifted children with AD/HD do not get picked up. They do well in school, but they still suffer from other AD/HD symptoms, such as low self-esteem, and later-life problems with substance abuse and intimate relationships.


The role of privilege in diagnosis and treatment

I think that privilege plays a big role in how a parent responds to the suggestion that their child might have AD/HD. As an educated, middle-class white woman, I took steps to research AD/HD and to get my son diagnosed and treated. This is a typical response of middle class parents. But I also have friends living in poverty who do not see the point in getting their children or themselves tested and treated. The father is functionally illiterate, probably as the result of undiagnosed AD/HD and other learning disabilities. The mother believes that both parents and at least two out of three children have AD/HD, but is overwhelmed with parenting challenges and poverty. Nor does she see a benefit to a diagnosis. Other families in similar social locations are simply struggling so much that they can’t face adding anything else to their mix of problems. Or they get offended — “There’s nothing wrong with my kid.”

Often I have wondered, “How could one approach a disadvantaged family in a way that helps them understand how they might all benefit by diagnosis and treatment of one or more members?” For sure it would be quite different from how I would approach a middle class family.


The social work contribution

The great inequities in diagnosis and treatment across social location is one important issue that social workers should be addressing. Access to treatment is another, because while Ritalin may be covered by government medication plans, multi-modal treatment for AD/HD is only available for those who can pay for it.

However, I see a double bind in providing improved access to diagnosis and treatment. Black children are currently being treated for AD/HD at half the rate of white children. But if they are labelled as having AD/HD, will they not be further disadvantaged, more so than the white children? Will the diagnosis that is meant to help them actually create additional barriers to accessing societal resources — an intersection between AD/HD and race?


There is a crying need for anti-oppressive social workers to contribute to research, advocacy, and practice related to AD/HD. I believe that AD/HD increases the risk of poverty and the intergenerational perpetuaton of poverty, considering all the above factors.

There are many ways that social workers should be getting involved with the problem of AD/HD among children and adults — whether they are clinical or community workers, whether they are guided by a systems model or an anti-oppressive approach. I plan to work in this area — what about you?


11 responses »

  1. Pingback: Pages tagged "oppressive"

  2. Hello!
    Very Interesting post! Thank you for such interesting resource!
    PS: Sorry for my bad english, I’v just started to learn this language 😉
    See you!
    Your, Raiul Baztepo

  3. I don’t doubt the impact of ADHD on the lives of those afflicted and on their families…

    I often wonder though, how much of the ADHD diagnosis is trend-based, and how many of those cases may be FASD, which is way harder to diagnose (and treat).

  4. I was diagnosed with ADD over 20 years ago and thank goodness I have supportive parents who were open minded enough to listen and work with me all through school. Even with their help it’s been a bumpy road that I wouldn’t wish on anyone. The skeptisism and snide jokes surrounding ADD & ADHD as I was growing up were especially hurtful–particularly when the public school system resists giving the federally mandated assistance as much as they can….and when teachers are resentful of the accomodations that a parent/child requests that they make for 1 student. Sure, it’s more frustrating for the teacher, but nothing compared to the hell that I call grades 3-12. BTW: I am a college graduate. Best of luck to all. Don’t give up! Try Concerta!

  5. P.S.: when dealing with school systems, don’t give up. They HAVE TO help you. Parents, make as many phone calls, have as many meetings with teachers and school administrators as you have to have to get your ADD/ADHD diagnosed child assistance in school. Do research online. But if you have a kid whom you know is bright but they’re having a horribly difficult time in school and just CAN’T get it together…don’t give up. It’s absolutely crucial. Make sure your child understands that taking meds doesn’t make them pay attention–it gives them the capacity to focus…the focusing and applying of hard work is up to them. Don’t listen to the misguided critics who say that giving Ritalin or Adderal kills your child’s creative spirit or turns them into a zombie. The medications certainly are not for everyone, but it definitely doesn’t kill creativity. I was MUCH more productive in my private art classes when I took my meds! Make sure your kids aren’t ashamed of their condition. (fortunately, I don’t think the stigma associated with ADD/ADHD is as bad as it was when i was a kid). But most of all, make sure they know that you support them and that you are proud of their tenacity.

    And now, a joke:

    ritalinkid: How many ADD kids does it take to screw in a lightbulb?

    otherguy: I don’t know, how many?

    ritalinkid: Hey! Wanna go ride bikes?

    Take care, everybody!

  6. P.P.S.: To get you started in your research on how to deal with school systems to help your ADD/ADHD child, first look up info on the Americans With Disabilities Act of 1990. It’s because of this legislation that the public school system is required to provide at least a certain level of assistance and accomodation (extra time on tests, taking tests in a separate room at an alternate time, etc.)

    My mother said that one of my teachers actually confided in her that she would have to be very stubborn and request that the school test me to show that I needed further assistance. She said that persistence and stubbornness would be needed because of the fact that, due to limited funding and a resistance to change, the school system actually made it routine to reject requests for assistance because if they opened it up to EVERYone who needed it, they knew that they’d be overwhelmed.

    Again, don’t give up!!!

  7. Only a smiling visitor here to share the love (:, btw outstanding style . “The worst-tempered people I’ve ever met were the people who knew they were wrong.” by Wilson Mizner.

  8. Maybe it’s time we live to learn to live for ourselves, with what we’re given, and take care of our own. We live it everyday, and somewhere deep in there we understand so much more than those that while maybe have done some observation, learned some, they don’t know it all. Some of the professionals may be very helpful and effective, though the big picture is much less successful.

    I was diagnosed about 35 years ago. Back then they just threw Ritalin, then more Ritalin at it. About 28 years ago when they took me off the Ritalin, all of a sudden everything I knew was different. Because of the fact that I’d been altered so long from what was natural, I had no clue about what was exactly real, how I actually felt. It had been “medicated” to some other state. I still probably haven’t gotten back everything it prevented me from learning about myself during those critical learning years.

    And this was from below middle class. My drive was always to learn it all. Though for that time, I lost much of my desires. Even today, without filling my drive to know more about so many things such as technology, I can become nearly suicidal. I get extremely depressed, and so on. I’m sure I’m not alone at that. I’d hope to find others that have common ground living with this, that can strive to find what’s working best to do great things instead of getting lost in the sidelines. WE NEED THAT, WE DESERVE THAT, as long as it doesn’t hurt others, and avoiding that is quite possible… JUST SAYING..

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