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Senior Correspondent

Are Drugs the Answer?

Are Drugs the Answer?

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The new school year is still fresh and “it” has already begun, “it” being the ongoing effort on the part of schools to persuade parents that there is something wrong with their kids’ brains.

This year, this effort is about something called “executive function,” which the Harvard Center on the Developing Child defines as the “mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. Just as an air traffic control system at a busy airport safely manages the arrivals and departures of many aircraft on multiple runways, the brain needs this skill set to filter distractions, prioritize tasks, set and achieve goals, and control impulses.”
(Full disclosure! According to HCDC, I am not qualified to be an air traffic controller.)

A number of teachers have told me that over the past year or so they have been required to attend seminars on executive function led by psychologists, psychiatrists, or pediatric neurologists who claim that the frontal lobe moderates executive function; therefore, deficiencies in executive function are due to frontal lobe dysfunctions of one sort or another. The solution: expensive therapies and—yes, you guessed it—drugs.

Be assured, folks, that this is about as scientific as most of the “brain differences” babble that has proliferated over the past decade, which is to say it is not very scientific at all. The fact is that barring obvious, measurable, and reliably verifiable brain impairment (lesions, e.g.), this stuff is theoretical. At best it is educated speculation.

The further fact is that all skills are brain-based and all brain-based skills are distributed within a diverse population according to the bell-shaped curve, which educators are in danger of forgetting even exists (surely indicating a problem with executive function). In other words, it does not take brain problems for some kids to be below average with respect to a given skill. In many cases, the issue is simply maturity. Furthermore, the measures in question are unreliable. This adds up to the fact that a child who is below average with respect to a skill at age 7 may be above average at age 15.

I maintain that this executive-function-left-frontal-lobe-brain-difference brouhaha is the latest iteration of the four-decades-long effort by the unholy alliance of psychology, psychiatry, pediatric neurology and Big Pharma to proliferate the spurious diagnosis of ADHD (for more on that volatile topic, see "The Diseasing of America’s Children" by yours truly and pediatrician Bose Ravenel). When one label has exhausted its half-life, a new name will give it new life.

Before I go into the witness-protection program, one last fact: Good research (see "Failure to Connect" by professor Jane Healy, for example) has found that early and continuing exposure to electronic media (television, video games, smart phones, computers) can and does compromise the skills HCDC associates with executive function.

In other words, the solution to many if not most childhood executive function issues may be as simple as shutting down electronic media. But that takes properly functioning parental executive function, which is another matter entirely.

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