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Irish Times
05-05-2025
- Health
- Irish Times
‘My son's teacher thinks he might have ADHD but my husband does not want to have him assessed'
Question My nine-year-old son has been struggling in school for a few years. The teachers say he can be disruptive, talking out of turn and interrupting everyone. He also is tuned out with the school work and does not apply himself at all in class, though on formal tests he is quite bright. His teacher, who is very nice and patient with him, says she thinks he might have ADHD (attention-deficit/hyperactivity disorder) and needs to be assessed. This all makes sense to me, but my husband is against it. He doesn't want to label him and thinks he is a normal active boy who is getting a hard time in school because they don't know how to 'teach him right'. My husband had a terrible experience in school and left early, though he has done well as an adult setting up his own business. As he was talking, it struck me that he might have ADHD too, and when I said that to him he laughed. I am not sure what to do, as it is now a source of argument between us, and I need my husband on board to start my son's assessment. I do most of the liaising with his teacher and the school, so it is me who sees the problems and not him. Answer Couples often have different feelings when the issue of a potential ADHD assessment comes up for their children. One parent might be keen to get the label to access supports for their child's education and another might be concerned about the process of the assessment or how the label might affect their child's identity. Certainly, most parents are reminded about their own childhood experiences when their child has challenges in school. Many ADHD children have a parent who is also neurodivergent, and indeed a significant number of adults who seek their own ADHD assessment start this because their own child has being assessed. In helping their children, it can be helpful for parents to reflect on their own experiences and to compassionately explore their similarities and differences. READ MORE [ I cannot accept that mental health issues and neurodivergence are 'overdiagnosed' Opens in new window ] The important thing to remember is that you don't have to start a formal assessment to support your son. More important is to collaborate with your husband so you are both on board and co-operating as you support your son. You can still reach out for information and support with or without diagnosis from family support charities such as ADHD Ireland. More than half the parents who attend the Parents Plus ADHD children's programme do not yet have a formal diagnosis for their child. Talking to your husband When talking to your husband, focus on your common concerns rather than your areas of disagreement. For example, you both want what is best for your son and to make sure he is getting the right supports in school. Listen to your husband's concerns and indeed see them as strengths – he wants to make sure his son is 'taught right' and that he does not have the same school experiences he had. Encourage your husband to talk about his own childhood and school experiences and to explore what he would like different for his son. Your husband could also seek his own personal support or to attend counselling about his own past, if he feels this might help him. [ 'My 15-year-old son hates going to school and is not doing any homework' Opens in new window ] Encourage your husband to get more involved Encourage your husband to get more involved in the process of supporting your son in school. This might mean making sure he attends all school meetings with you and also that you both get involved in learning more together about your son's needs. For example, you could attend webinars or join social media groups for parents wondering if their children have ADHD or who have children struggling in school and so on. Your husband might benefit from listening to the experience of other parents and fathers in similar situations as himself as well as the lived experience of parents raising ADHD children. One of the great benefits of the modern internet is the access it gives us to information and support from real people facing similar challenges to our own. Seeking formal supports Reassure your husband that you will take time to discuss things and to make assessment decisions together. As waiting times are long, you might agree to put your son on different waiting lists for assessment but agree you will decide together how to proceed before an assessment starts. Also, your husband might be more open in exploring certain assessments first. For example, you could do seek cognitive psychological assessment to see where your son's strengths and challenges lie. For example, he might be gifted or have a high IQ while also having specific learning challenges such as dyslexia (both of which can co-occur with ADHD). This information could provide useful information for his teacher in providing the best teaching for him. It also may provide a route for the school to provide extra resources. Either way, do work with his teacher to support his school experience and to design the best educational programme that builds on his strengths. John Sharry is clinical director of the Parents Plus Charity and an adjunct professor at the UCD School of Psychology. He is delivering a parenting workshop on Helping Your Children and Teenagers Manage Anxiety and Stress on May 13th, 2025.
Irish Examiner
29-04-2025
- Health
- Irish Examiner
Colman Noctor: Not everyone who struggles to focus has ADHD
Once a niche childhood condition, attention deficit hyperactivity disorder (ADHD), has become one of the most common mental health problems. The increase in diagnosis is not just in children, but also in adults. The numbers are staggering. In the US, ADHD diagnoses in children increased by 42% between 2003 and 2011, and, according to the US Centres for Disease Control and Prevention (CDC), adult diagnoses have risen even faster in the past decade. According to ADHD Ireland, as of October 2024, ADHD affects approximately 5% of children and 3% of adults, amounting to 230,000 people. The spike in ADHD diagnoses has prompted a vigorous debate about the legitimacy of these presentations. Are we finally recognising a condition that has long gone undiagnosed, or are we pathologising normal variations in behaviour and attention? Is this surge a reflection of increased awareness, or is it a symptom of something deeper? Much of the polarisation stems from an inability to consider both perspectives. My 25 years of working in the mental health field have taught me that there is rarely one explanation for any condition or presentation, and being open to multiple causes can offer far more insight. Technology, education, and work have undergone seismic changes in the past two decades, which may be reshaping not just how we live but also how we function and, in turn, how we diagnose dysfunction. Mental illness is not a static, universal phenomenon. It is dynamic, context-bound, and shaped by society's values, expectations, and structures. So, while mental illnesses are ever-present, their presentation may change as society changes. One of the most significant societal shifts contributing to the rise in ADHD diagnoses is the advent of the 'attention economy'. In the past two decades, our lives have become saturated with digital technologies designed to capture and monetise our attention. Social media platforms, video streaming services, gaming apps, and news feed notifications ping throughout the day, demanding our attention. The result is that we are constantly switching tasks, scanning headlines, and skimming content. This always-on environment does not just cater to a short attention span, it cultivates it. It's not hard to see how typical traits associated with ADHD, such as difficulty sustaining attention, impulsivity, and restlessness, could be exacerbated or even produced by the demands and distractions of the modern world. Our brains are neuroplastic; they adapt to the environments they inhabit. And, increasingly, those environments are designed to create hyper-distraction. Children growing up in this environment face particular challenges. Screen usage has soared, and opportunities for unstructured play and outdoor activity, which were once crucial outlets for youthful energy, have declined or become non-existent. Classrooms, meanwhile, are increasingly focused on standardised testing and prepping young people for state examinations, leaving little room for creativity, varied learning styles, or divergent thinking. Explosion in adult diagnosis The story of ADHD in the 2020s isn't just about children. The explosion in adult diagnoses is one of the most remarkable aspects of the recent surge. For many adults, an ADHD diagnosis can feel like a revelation that explains years of difficulty with organisation, time management, emotional regulation, or meeting deadlines. Online forums and social media communities are awash with stories of people, particularly women, overlooked as children, but who now recognise symptoms in themselves, due to greater public awareness. I worked in CAMHS (Children and Adolescent Mental Health Services) for years, and ADHD was primarily associated with hyperactive boys. In hindsight, girls, who are more likely to present with inattentive symptoms (daydreaming, disorganisation) rather than hyperactive and disruptive ones, and especially those who were academically functioning, tended to slip through the cracks. An expanded understanding of ADHD was long overdue. Many parents who bring their child for an ADHD assessment see themselves in the questions being asked, prompting them to seek an evaluation. It's a legitimate reason, as ADHD can run in families. However, the speed and scale of the diagnostic surge also raise reasonable questions about whether we are medicalising behaviours, which, in a different era, might have been seen as personality quirks, lifestyle mismatches, or responses to stress. So, instead of asking if the diagnosis spike reflects an actual neurological difference, or whether people are seeking a diagnosis to explain their struggles with lifestyle management, why not ask if it is a reflection of an increasingly fragmented and demanding world? Modern work culture may also significantly shape perceptions of attention and productivity. The rise of remote work and the 24/7 hustle culture have created environments where individuals are expected to be constantly available, responsive, and self-motivated. This flexibility is liberating for some, but overwhelming for others, particularly those who struggle with executive function: The ability to plan, prioritise, and stay on task. What constitutes 'normal' productivity is being unrealistically redefined by cultural, social, economic, and technological standards. Any deviation can feel like failure when the baseline expectation is constant output. For individuals who struggle to focus or stay organised, this pressure can lead to burnout, anxiety, and a search for answers, which could culminate in them suspecting that they might have ADHD. I see this in the many young people who feel overwhelmed by the demands of life and ask me whether I think they have ADHD. Some young people ask this not because they genuinely believe they have ADHD, but because they desire to belong to an ADHD community as a means of providing identity. Digital platforms, such as TikTok and Instagram, contribute to this identity-seeking phenomenon as they are hubs for mental health content, including ADHD awareness. While these platforms have democratised information and helped to de-stigmatise mental health struggles, the algorithms tend to reward dramatic, relatable content, which can sometimes lead to oversimplification, self-diagnosis, and misinformation. Messaging like, 'Do you forget where you left your car keys? Then you probably have ADHD' is deeply problematic. Consider the recent surge in the diagnosis of gluten intolerance. The awareness of gluten intolerance has led to many people with coeliac disease being identified sooner and receiving treatment. At the same time, we have seen a raft of self-diagnoses of gluten intolerance. That doesn't mean that coeliac disease is not real; it means that some people have taken it upon themselves to align with this group without the testing or clinical assessment. Cultural causes Ultimately, we need to consider how the surge in ADHD diagnoses reflects more than just medical or psychological trends. It is a cultural mirror, revealing how our society defines 'normal' behaviour, and how that definition is being strained by modern life. We live in a time of relentless overstimulation and declining downtime. We expect children to sit still for hours, adults to juggle multiple roles, and to be constantly connected and perpetually productive. In such a world, is it any wonder that more and more people feel like their brains are not functioning 'correctly'? This is not to say that ADHD doesn't exist. Of course it does. For many, diagnosis and treatment can be transformative, and going through life without a diagnosis or understanding can be detrimental. But as with all aspects of over-correction, it is also true that we might be diagnosing more people more quickly and broadly than ever before. And instead of only asking what is wrong with individuals, perhaps we should also ask what is wrong with the world they live in. We need a more nuanced approach to ADHD that balances awareness and compassion with critical thinking and understanding. We need to better distinguish between genuine neurological conditions and socially induced struggles. We must also rethink how schools, workplaces, and digital environments are structured to allow for a broader range of human attention styles and learning modes. Not everyone who struggles to focus has a disorder. Sometimes, the problem is not the person, it's the system. As the conversation around ADHD evolves, let's make room for complexity. Let's respect the stories of those who have found clarity and healing through a diagnosis, while remaining vigilant about the forces, such as economics, technology, and culture, that may be shaping our understanding of what it means to be 'normal'. The surge in ADHD diagnoses may tell us as much about society as it does about individuals. I hope we find the insight needed to regain control over our attention and build a world that demonstrates an understanding of our brain's limitations, leading to fewer people struggling to keep up with an unattainable pace.
