Read the transcript at the link below the audio file.
Transcript by Julie Ann Lee: Transcript_Matthew_Smith_Noncompliant
Matthew Smith is Professor of Health History within the Centre for the Social History of Healthcare. He is Vice Dean Research for the Faculty of Humanities and Social Sciences at the University of Strathclyde. He has written many books about the history of medicine, including two about ADHD and Another Person’s Poison: A History of Food Allergy –as well as co-editing the 2016 collection: Deinstitutionalisation and After: Post-War Psychiatry in the Western World (2016).
Matthew Smith is an expert on the history of the ADHD diagnosis, which emerged out of the late 1950s, when researchers broadened this area of diagnosis and Americans were living in the era of the Sputnik satellites and the attendant anxiety around the “space race.” This, along with demographic and economic changes, all had a significant impact on education policy priorities in the US. Shifts in the field of child psychiatry and in psychopharmacology also played a big role.
Classroom environments changed dramatically in the 1950s. Kids had to adapt to these changes; some could and some could not. All of these factors came together to create the perfect storm for an “ADHD epidemic,” a further diagnostic expansion and an uptick in prescription for Ritalin and like drugs.
Matthew talks about the trajectory of the ADHD diagnosis in the last half of the 20th century and shifts in child psychology as well as Ritalin marketing and sales. We also discuss the impact of society’s responses to ADHD in kids, as well as the problem of teaching to the test and the current use of ADHD drugs for performance-enhancement or as an “easy fix” replacement for meaningful inclusion. As Matt says: “The knee jerk reaction is to consider that it’s the child that’s wrong and is at fault for whatever reason — ‘something in their brain is not firing correctly’– and we turn to drugs. And I think one very simple change that I would like to see is if we saw Ritalin as the last resort, rather than the first resort.”
I also ask Matt about a program he is involved in: a pilot project in Musselburgh, Scotland where many children had been receiving the ADHD diagnosis. The school principal there chose to “change the ethos in the school” and commit to an inclusion-based model. They modified the school to be inclusive, with a series of 10 projects that the students take on, none of which cost much to do and all of which were sustainable.
As Matt notes: “It [isn’t] a whole bunch of intensive interventions. These were actually quite simple things that the school took on board to make considerable difference”. At the school, children are being taught with more hands-on learning (including producing a podcast series!) As well, the school undertook a popular new program in Scottish schools called the Daily Mile, where kids get more physical play time and breaks. The EAs also took on a radical new role (Listen to learn more about the pilot project!).
As a result of all of these changes, “the school saw a real reduction in referrals to psychiatric services as well as academic improvement.”
Professor Smith’s blog on Psychology Today
Professor Smith’s book, Hyperactive, The Controversial History of ADHD
New York Times series about ADHD drugs in America