In The Times this morning, a sharp increase in the prescriptions of Ritalin to control ADHD has reportedly drawn the response from Amanda Spielman, Chief Inspector for Schools at Ofsted, that “parents are medicating away their children’s bad behaviour.” It’s written as indirect speech so perfectly possible that she has been misquoted, but if these words were spoken, it’s a worry. It shows a lack of understanding of ADHD, presupposing that it is synonymous with ‘bad’ behaviour and it shows a lack of understanding about the process of diagnosis and prescription – parents cannot and do not prescribe drugs for their children. More worryingly, it exposes a prejudice that is wholly unacceptable for someone in a position of public trust. Parents rely on Ofsted to hold schools to account for providing the services their children are entitled to. It is not, in any sense, ok for the chief inspector to be making blanket statements about their actions and intent in relation to children who are struggling to fit in with an increasingly formal and demanding school experience.
To be fair to Spielman, she does suggest that we look beneath the symptoms to the cause of this increase – a sensible suggestion. She may do well to look at the study undertaken by Stanford University that showed that delaying the start of formal education in children reduced significantly the number of diagnoses of ADHD. And this research would seem to be supported by findings that Summer born children entering reception class are more likely to be diagnosed with ADHD. It would seem that we are simply expecting too much too young from children and in order to push them into our ‘expected standards’ we are potentially damaging them. If this is the case then there seem to be two possibilities – the first that too much school pressure early on is developmentally causing ADHD by the age of 11, which is one possible interpretation of the Stanford study, or that the pressure to have children meet a spurious standard, regardless of their age/development, is leading to misdiagnosis – that left to their own devices and informally educated in language rich and socially playful setting, fewer children would be labelled.
In spite of this research, Ofsted and the DfE continue to push for more formalised learning in the Early Years. In her speech to the Pre-Learning Alliance, Spielman is clear that in her opinion “teaching 4 and 5 year olds is really important” going on to place great emphasis on the formal teaching of Phonics. In the new Early Years Goals, currently being piloted, the words “expected level” are mentioned 16 times. It is noted that assessment must take place in the final term of reception year and that children will either be exceeding, at or below this “expected level” regardless of their actual chronological age. How might that impact on parents? Hearing that their child is ‘below expected level’? Hearing that they can’t sit still, are struggling to manage themselves and their relationships with others? What parent wouldn’t worry themselves sick on hearing their child is falling below expectations? If the head of the schools accountability system can conflate an inability to concentrate and a struggle to fit in with increasingly demanding school expectations with ‘bad’ behaviour, what are parents expected to do?
Parents do not prescribe drugs for their children. They may beg for them. I’ve had a couple of unedifying appointments in a doctor’s surgery begging for antibiotics for my child that has been resolutely refused. Probably rightly so. Medical professionals prescribe drugs, not parents. It is perfectly possible that we, as a society, are medicating our children to cope with school, but parents are not writing those prescriptions. Is it not possible, chief inspector, that it is not the parents who are to blame for wanting their child to be able to cope in a system that you help to design?
ADHD is a complex diagnosis and to assume that it equates simply to bad behaviour is quite simply, shocking. It’s akin to telling a paralysed person that they are too lazy to walk. For a start, ADHD doesn’t always exhibit as ‘bad behaviour’. It can simply be that the child is quiet and ‘not present’ in terms of concentration, but perfectly still and ‘well behaved’. This is particularly true of girls and of course as a result, girls are less likely to be diagnosed and to be excluded from school. Where ADHD does present in more physical ways, the behaviours are more likely to be seen as problematic and more likely to lead to interventions. The impact of ADHD on girls is devastating, but it would seem that as long as they are quiet, no-one really pays too much attention.
Where attention is directed to symptoms that sit outside of what is deemed acceptable in the classroom, there tends to be a negative feedback loop for the child. Words like ‘naughty’ and ‘bad’ become the norm, particularly pre-diagnosis. Punishments are common. A child with hyperactivity being kept in at break or lunchtime instead of running off some energy outside, is not going to magically “get better”! Constant negative feedback can lead to a rapid deterioration, leading to mental health and oppositional disorder conditions. Yet in other speeches, Amanda Spielman encourages firmer discipline in schools. Put these three things together – more formalised learning, more discipline, more high stakes testing, is it any wonder that a parent with a child presenting with ADHD symptoms might be desperate for help? DfE and Ofsted documents are full of the frightening phrase “falling behind” – who wants their child to fall behind?
It worries me that people in such a position of authority can use prejudicial language with impunity. We have seen our chief inspector for schools accuse white working class parents as lacking aspiration for their children this week. Now we see her accuse parents of fecklessly drugging their children as a means to avoiding taking responsibility for their child’s behaviour. The lack of understanding of the social complexities of both issues is worrying. The selective use of information and evidence is worrying. The push towards more testing of the young in spite of all this is worrying. No, it’s more than worrying, it’s divisive, ill considered and judgmental. It indirectly endorses what is an increasingly negative view of children with SEND across the school system, in which children with additional needs are now far more likely to be excluded and home schooled by parents who simply cannot find adequate provision for their child. In fact, one might say to act and speak in this way as a chief inspector is very bad behaviour indeed.