The Not-So-Hidden Cause Behind the A.D.H.D. Epidemic is test-based accountability argues Maggie Koerth-Baker in the New York Times Magazine. Diagnoses are skyrocketing, she writes. “Before the early 1990s, fewer than 5 percent of school-age kids were thought to have A.D.H.D.” This year, the Centers for Disease Control and Prevention estimated that 11 percent of children ages 4 to 17 had received the diagnosis. When test scores count, schools have an incentive to diagnose more children as disabled, she believes.
The No Child Left Behind Act, signed into law by President George W. Bush, was the first federal effort to link school financing to standardized-test performance. But various states had been slowly rolling out similar policies for the last three decades. North Carolina was one of the first to adopt such a program; California was one of the last. The correlations between the implementation of these laws and the rates of A.D.H.D. diagnosis matched on a regional scale as well. When (Berkeley Psychology Professor Stephen) Hinshaw compared the rollout of these school policies with incidences of A.D.H.D., he found that when a state passed laws punishing or rewarding schools for their standardized-test scores, A.D.H.D. diagnoses in that state would increase not long afterward. 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. But A.D.H.D., education policies, disability protections and advertising freedoms all appear to wink suggestively at one another. From parents’ and teachers’ perspectives, the diagnosis is considered a success if the medication improves kids’ ability to perform on tests and calms them down enough so that they’re not a distraction to others. (In some school districts, an A.D.H.D. diagnosis also results in that child’s test score being removed from the school’s official average.)
Rates of A.D.H.D. diagnosis vary widely from country to country, Koerth-Baker observes. In 2003, nearly 8 percent of U.S. children — but only 2 percent of British kids — had been given a diagnosis of A.D.H.D.