We ask elementary school children to sit quietly and focus on school for ten hours per day only to label them disruptive or disabled for failing to do so. Expecting children to behave in ways that are challenging for many adults and subsequently diagnosing them with a disorder when they cannot amounts to the medicalization of childhood.
For children who are further along the normal spectrum of childhood traits including restlessness and distractibility, the gulf between how their brain is expected to work and how it actually functions is even wider. This incompatibility does not mean the brains of children with ADHD are broken or inferior, it simply means they are even less suited to perform in a system unsuited to children’s brains to begin with.
It is also patently unethical to medicate children for the convenience of parents and teachers, or at the behest of parents determined to give their child a competitive advantage academically that the child themself likely has no interest in. A critical prerequisite for writing a stimulant prescription for a child must be that it is for their own benefit, not the benefit of their school or family.
The challenge for providers, parents, and teachers is thus to accurately assess to what extent a child is struggling due to ADHD, what adverse outcomes the child is at risk for, and what interventions may mitigate those risks. Given that we often cannot modify their environment, our aim should be to help each individual function their best within the constraints of an environment to which they may be poorly suited, while acknowledging that they are different not defective.