On Normal, ADHD, and Dyslexia: Neither Pathologizing, Nor Rendering Invisible

No child struggling to read should have that struggle rendered invisible, but pathologizing behavior that does not conform to a narrow definition of normal also carries significant and negative consequences.

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Photo by John Jennings on Unsplash

In 1973, Elliott Kozuch explains, “the American Psychiatric Association (APA) — the largest psychiatric organization in the world — made history by issuing a resolution stating that homosexuality was not a mental illness or sickness. This declaration helped shift public opinion, marking a major milestone for LGBTQ equality.”

Homosexuality in many eras and across many cultures has been rendered either invisible (thus, the “closet” metaphor) or pathologized as an illness (thus, the horror that is conversion therapy).

This troubling history of responses to homosexuality confronts the inexcusable negative consequences of shame and misdiagnosis/mistreatment against the more humane and dignified recognition that “normal” in human behaviors is a much broader spectrum than either invisibility or pathologizing allows.

How we determine “normal” in formal education is profoundly important, and the current rise of dyslexia advocacy as that impacts and drives reading legislation and practice for all students parallels the dangers identified above with rendering invisible or pathologizing children who struggle with reading.

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Photo by David Lezcano on Unsplash

Further, this more recent focus on dyslexia looks incredibly similar to the increased diagnosis of ADHD, which was initially left invisible and then pathologized (probably over-diagnosed and heavily medicated).

Let’s focus first, then, on ADHD, and how the dynamic of “normal,” “invisible,” and “pathologized” impacts children.

In 2013 Maggie Koerth-Baker reported:

But here is the problem:

For context, when I was exploring the ADHD phenomenon in 2013, I ran across a provocative piece from 2012 about ADHD in France, Why French Kids Don’t Have ADHD, published in . Immediately, this spoke to my concern about both pathologizing human behavior that may be within a broader understanding of normal and my skepticism about immediately medicating, instead of addressing diet, environment, etc.

However, the situation in France is far more complicated as noted in a piece also published by in 2015 , French Kids DO Have ADHD, this time acknowledging:

The circumstances around ADHD in France reveal the , any people’s perception of “normal.” A study by Sébastien Ponnou and François Gonon from 2017, in fact, details the pervasiveness of different narratives about ADHD in French media:

Back in the US, in Room for Debate from 2016, several experts challenged over-pathologizing children with ADHD labels, the racial disparity in that pathologizing, and the dangers of medicating for ADHD as an avenue to controlling children.

Thus, the interaction among the fields of medicine and psychology, media representations of clinical conditions, and the spectrum along “normal,” “invisible,” and “pathologized” has profound consequences for children/teens and formal education.

Currently, we are witnessing mainstream media build a compelling narrative about the “science of reading” and the needs of children with dyslexia; this is a narrative about children with dyslexia being rendered invisible and there existing a “science of reading” that is the medicine necessary to cure that pathology.

However, as the examinations of homosexuality and ADHD above demonstrate, when it comes to the humanity and dignity of children being served by the institution of public education, .

This leads to the current rush to assess and identify dyslexia as a foundational part of teaching all children to read, policies about which the International Literacy Association (2016) offer several concern:

Yet, the rise in advocacy for identifying dyslexia has gained significant momentum in state policy even as ILA warns:

No child struggling to read should have that struggle rendered invisible, but pathologizing behavior that does not conform to a narrow definition of normal also carries significant and negative consequences. As ILA notes above, a more reasonable approach is simply to while building a supportive environment tempered with patience.

I teach a graduate student whose child is now in a school for dyslexic children. That child was floundering personally and academically in traditional school, and now flourishes, something everyone would applaud.

The parent, however, made a really powerful observation, noting that the child’s recent success comes in a school that champions Orton-Gillingham-based reading programs [1] (often OG for short).

Advocates for universal screening for dyslexia also advocate for systematic intensive phonics for all students, specifically OG. Yet, this child is now in a school with a 1–8 teacher-student ratio and a guaranteed 1.5 hours a day with 1–2 teacher-student ratio instruction.

The parent stated flatly that almost any child would flourish in those conditions and the different way the child is being taught to read is not necessarily the real cause of the new success. I must add, we absolutely have no research exploring these dynamics and controlling for variables that would help us understand the importance of reading programs versus learning/teaching conditions (see, for example, unfounded and overstated responses to 2019 NAEP reading scores).

Struggling to read is, in fact, quite normal, and a long, chaotic process. Teaching reading is very complex, unique to each child, and as ILA clarifies, “there is no certifiably best method for teaching children who experience reading difficulty.”

Demands that all children attain some prescribed proficiency in reading by third grade are artificial and themselves unnatural, abnormal.

No child should be invisible in schools, but pathologizing childhood behavior that is quite normal because some adults have irresponsible deadlines and expectations for those children is inexcusable.

, one that acknowledges the power of learning and living conditions while avoiding the dangers of finding fault in any child that we can simply cure with some magical quick fix.

[1] From ILA:

Written by

P. L. Thomas, Professor of Education Furman University, taught high school English before moving to teacher education. https://radicalscholarship.wordpress.com/

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