Out From Under the Rug

As college students, we are exposed to and expected to live up to the conventions of adulthood on a daily basis, and each day we succeed or fail on and at many different levels. In many ways we are living out an increasingly nuanced version of the life we've led since kindergarten, when we first entered into a world of social convention and conformity. Since then, we've always been looking to buy into the positives of conforming without selling out to the negatives.

With our school days and our assimilation nearing completion, we've changed our minds about Thoreau more than once, and it's even questionable as to whether a nonconformist is wearing sheep's clothing. Rather than dwelling on that grown-up paradox, think of childhood, when the behavioral variations weren't quite so polar. That such a diversity of functioning in childhood exists may help to explain childhood cruelty--a cruelty that attempts to set standardized conventions, leaving no room for dissent.

Underneath it all, children are no more varied in their cognitive styles and personality types than adults are, it's just that there's less to get underneath in a child. As less self-conscious beings, their social variations are more readily manifested and less easily suppressed. Most haven't been forced to give in to the cruelty of their peers, a resoluteness that will soften into adulthood as we harden into adults.

The holdouts--unconventional adults--are almost always born of unconventional children. Although unconventional traits like idiosyncrasy and genius are finally valued in adults, their roots in children are less often identified, much less appreciated, and more often severed completely.

What is being done for (or perhaps to) today's unconventional children? Those who don't fit into standard or acceptable modes of teacher-student or parent-child interaction are still obliged to function within those structures, somehow, someway. We all know kids who fit the mold of not fitting the mold. We volunteer with them, we babysit them, and perhaps at one point we were even one of them.

The clinical phrase Attention Deficit Disorder, or ADD, was coined to fit such children in 1980, when the current undergraduate community was anywhere from its first solid food to its first day of school. Although this phrase has outfitted many children of our generation with a lifetime of social baggage, these children don't really fit the phrase. It's not necessarily true that children diagnosed with ADD are suffering from an attention deficit; rather, it seems they're paying too much attention.

Such children suffer from disorder only so far as they have trouble keeping all of their observations in order, and from disease only so far as their extraordinary acuity makes it difficult for them to integrate into "ordinary" society. Many of the so-called ADD children I've encountered, though on the fringes of social acceptance, have been among the most energetic, imaginative and interactive kids I've ever met. But unfortunately, creativity is no substitute for conventional competency.

ADD has become a catch-all for misbehavior of all kinds, and rightly, no stereotypical ADD child emerges from the many who have been labeled as such. The only pattern is a rising level of children subdued by medication, attended to by science rather than cared for by the human resources to whom they cry out the most.

We are children of the clinical age, and the ADD phenomenon is a very concrete and democratic example of this fact. While the shrink and the quack are psychiatric types confined to a certain cross-section of society--types that have been vigorously caricatured in Hollywood movies--no one is making light of ADD, a phenomenon which directly affects far more people from all walks of life.

No one is making much sense of ADD either. Shortly after the disorder was first identified, a spin-off, Attention Deficit Disorder with Hyperactivity, or ADHD, was born. As an elementary school student in the mid-'80s, you may have encountered one or two children who had to take regular medication for hyperactivity. They were most likely taking Ritalin, the ADD and ADHD treatment of choice since the early days of the disorders.

This past summer, I worked as an instructor and residential adviser at a sleepaway camp for children aged nine through 12. I encountered many children who had been diagnosed with ADD and ADHD, most of whom were taking Ritalin. "Brad," as I will refer to him in this column, had been diagnosed with a particularly severe case of ADHD, and was correspondingly receiving heavy doses of medication, including Ritalin after breakfast and a sleep-inducing pill before bed.

Brad was an extremely dynamic and original child, and he was also frequently punished. Outbursts of imagination were as common as outbursts of antisocial behavior, and Brad quickly became a marked man in the eyes of the counselors. Repeated infractions eventually led to Brad's removal from camp, a decision to which I was virtually alone in protesting.

Punishment is the understood consequence of deviation in our society, and when punishment fails, termination follows closely on its heels. Witness capital punishment. Witness the broken home. When children "misbehave," they are punished. Failing that, they are "grounded," or they may face more severe consequences, but as such problems escalate, enforcing morality upon children becomes a more difficult and ambiguous task.

As an ADD child, Brad was suffering from manifold problems at camp, many of which were as much due to nurture as to nature. He has been on Ritalin since age four, and has no recollection of a time when he was an individual apart from his disorder and his medication. When Brad's parents were notified of his misbehavior, they decided to increase the amount of medication he received.

Since loss of sleep and stomach pains are two of the major known side effects of Ritalin, it makes sense to me in retrospect that Brad was frequently up until one and two in the morning with his Walkman and his drawings. He developed heavy black circles under his eyes within days. Because the two main meals of the camp, lunch and dinner, were served when Brad's Ritalin was working at peak potential, he had no appetite whatsoever for these meals, and he subsisted mainly on the many snack foods which he hoarded in his bedroom.

Brad was frequently disciplined at breakfast, when, free from the effects of Ritalin, his appetite would spike and he would try to compensate for three meals in one fell swoop. Of course he was denied a larger portion, because each camper had a limited amount of food available to them in any one sitting.

The largest amount of food I ever saw Brad eat in one sitting was at a night game at Fenway Park, where he ordered a hot dog, popcorn, cracker jacks, pretzels and cotton candy. He ate them all. At the time I viewed the indulgence as 12-year-old consumer culture run amok; today, I wonder if the binge might not also have been triggered by the fact that for once that summer, Brad had access to large quantities of food at 9 p.m., after the effects of the Ritalin were beginning to wear off, but before he had received his sleep-inducing pill.

Speculation? Perhaps, but in a harmless fashion, unlike the dangerous speculation that the psychiatric professional makes everytime he diagnoses a child with ADD and prescribes Ritalin or other similar medicines whose effects have not been conclusively determined.

The U.S. Department of Agriculture lists Ritalin as a Schedule II Controlled Substance, placing it on a list next to Cocaine and Methamphetamine. It is a potentially dangerous drug whose long term effects are unclear, and its emergence as a street drug may be quashed only by the disproportionate amount of negative to positive effects on consciousness.

Despite the uncertainties and unsavories of Ritalin, over one million children currently take Ritalin to counteract the manifestations of ADD. In a recent Newsweek article, Dr. Laurence Greenhill of Columbia Medical School called Ritalin "one of the raving successes in psychiatry." Parents everywhere are seeking a mandate from medicine, taking unmanageable children to doctors who tend with very little resistance to diagnose them as ADD and put them on a regular diet of Ritalin, sometimes supplementing the prescription with Prozac.

Such "early detection" is more common at higher income levels, where parents can afford to and often depend on clinical salvation. ADD has become so stylish in recent years that school psychiatrists have picked up on the trend, and the numbers of ADD-diagnosed children has skyrocketed. Consumption has quadrupled in the past decade, and Ritalin use is five times higher in the United States than in any other country. Some medical experts are willing to go so far as to assert that one in every 20 children is ADD, with a significant number of those being ADHD.

While few will argue the reality of our nation's rapidly declining attention span, I find it harder to believe in modern science than in the children who have become its guinea pigs. Without making any clear diagnosis, it is clear that many of today's children have trouble interacting with peers and staying on task. These are not deliberately mischievous, and they are not in need of a chemical or genetic makeover. They are vibrant contributors to the playground and the snack table, and they are not the enemy.

I wish that Brad had been given a more fair chance by my fellow counselors. He had two strikes against him going in as an ADHD kid, and he certainly didn't make a very strong case for himself. But was kicking him out of camp the most productive solution? I struggle to see a scenario in which it was.

Rather than sweeping the differences of ADD-diagnosed children under the rug, we must break out the vacuum of personal engagement and clean off the residue left by years of clinical and medicinal approaches. Only when the dust clears can those exceptional children in our ranks begin to show us what they have to offer in a constructive, healthy and productive way.

Jim Cocola is a junior living in Winthrop House.