Beyond The Medical Model: A Biopsychosocial View of Attention Deficit Disorder and other Childhood Developmental Disorders

The diagnosis of attention deficit disorder, or AD(H)D (with or without hyperactivity), is burgeoning. Nearly three million children in the U.S. take stimulant medications for this condition, while in Canada the number of Ritalin prescriptions has more than quintupled in the last decade.

The prevailing medical model of ADHD views it as an inheritable illness. In his bestselling Scattered Minds Gabor Maté rejects a narrow genetic perspective – and this despite the fact that he has been diagnosed with ADD himself, as have two of his children. He shows that while genetic predisposition may play a role, it is by no means decisive.

Neurobiological research has clearly demonstrated that the development of the human brain is not genetically determined but rather is significantly influenced and shaped by the environment. An increase in societal and parental stress, affecting the developing highly susceptible brains of infants — as opposed to some sudden, highly implausible proliferation of an “ADD gene” on a large scale — is responsible for the increasing number of cases now being diagnosed among children and adults.

Such a biopsychosocial view has profound implications for the treatment of AD(H)D and related developmental disorders in both children and adults. The circuitry and physiology of the brain are affected by the environment not only during critical periods of early childhood development, but throughout the human lifetime. Medications may be part of the overall treatment plan, but they should not necessarily be the primary, and never the only, line of treatment. Too often, symptom-control approaches actually undermine what should be the long-term goal: neurobiological and psychological development.