About the Author

Richard Louv is Co-Founder and Chairman Emeritus of the Children & Nature Network, an organization supporting the international movement to connect children, their families and their communities to the natural world. He is the author of eight books, including "Last Child in the Woods: Saving Our Children from Nature-Deficit Disorder" and "The Nature Principle." In 2008, he was awarded the Audubon Medal.

NATURE WAS MY RITALIN: What The New York Times Isn’t Telling You About ADHD

ADDkids_001

Source: Human-Environment Research Laboratory,
University of Illinois at Urbana-Champaign

Is Attention Deficit Hyperactivity Disorder (ADHD) a painful neurological reality for many children? Undoubtedly. But could it be that at least some of the increase in diagnosis and treatment of ADHD may have to do with the fact that we took the calming effects of nature away from kids in the first place?

On December 15th, The New York Times ran a major front page report, “The Selling of Attention Deficit Disorder.” The good news, according to the piece, is “severely hyperactive and impulsive children, once shunned as bad seeds, are now recognized as having a real neurological problem.” Now here’s the bad news. The rate of diagnosis and drug prescriptions may have more to with the force of advertising, and other manipulations, than with the real extent of the disorder.

The story quoted Dr. Keith Conners, a leader in the decades-long fight to legitimize ADHD. Speaking to a group of fellow ADHD experts in Washington, D.C., he pointed to recent data from the Centers for Disease Control and Prevention, revealing that the diagnosis of ADHD or ADD has been made in a staggering 15 percent of high school-age children. And, the Times reported, the number of children on medication for the disorder has “soared to 3.5 million from 600,000 in 1990.”

In fact, ADHD is now the second-most-frequent long-term diagnosis made in children – a close second only to asthma.

Conners, a psychologist and professor emeritus at Duke University, called the rate of increase “a national disaster of dangerous proportions.” He added, “The numbers make it look like an epidemic. Well, it’s not. It’s preposterous. This is a concoction to justify the giving out of medication at unprecedented and unjustifiable levels.”

While several recent reports have questioned the rate of diagnosis and the increase in the prescriptions of stimulants, the Times moved into relatively new territory, reporting the sometimes hair-raising methods of pharmaceutical companies to market ADHD drugs to doctors, parents and educators. Many parents are grateful for the prescriptions, but others feel pressured to medicate their children. In some cases, treating the disorder has evolved into using these medications as smart pills, to improve competitive academic performance, despite dangerous side effects.

The reporting is solid, but here’s what the Times piece does not offer: a deeper look into prevention and treatment alternatives. That is the next logical question in what I hope will become a more public discussion. One potential alternative, or additional therapy combined with other treatments, is nature itself.

Some of the most important work in this arena has been done at the Human-Environment Research Laboratory at the University of Illinois by Andrea Faber Taylor, Ming (Frances) Kuo, and William C. Sullivan. In a series of studies, they found that green outdoor spaces foster creative play, improve children’s access to positive adult interaction — and relieve the symptoms of attention-deficit disorders. The greener the setting, the more the relief. By comparison, activities indoors, such as watching TV, or outdoors in paved, non-green areas, leave these children functioning worse. They found that greenery in a child’s everyday environment, even views of green through a window, specifically reduces attention-deficit symptoms.

As they reported in the journal Environment and Behavior, outdoor activities in general help, but “activities in natural, green settings were far more likely to leave ADD children better able to focus, concentrate.” Taylor’s and Kuo’s more recent research findings suggest that attention performance for unmedicated children clinically diagnosed with ADHD was better after a simple twenty-minute walk in a park, with a natural setting, than a walk through well-kept downtown and residential areas. Other studies in Sweden and the U.S. support these findings.

Even if the increase in ADHD does reflect a real epidemic, an over reliance on pills does nothing to attack the root causes. 

Possible environmental reasons for the rise of attention difficulties include toxins in food, air, and water; the proliferation of distracting digital communications; and a sedentary lifestyle enforced by fear, bad urban design and an educational ethic that appears to value sitting for tests more than running at recess.

The Times report is one more reminder that we need a deeper understanding of what is probably too loosely diagnosed as ADHD. In some cases, the symptoms may suggest an advantage. Daniel Goleman has written in his book “Focus” that so-called open awareness is what some people with characteristics of ADHD experience, and that kind of awareness may have been — the theory goes — essential for survival in humankind’s earlier days: the ability to take in all of the surroundings sans filters. That sensitivity to environment may also stimulate creativity. Channeling that ability may be the point, not the eradication of it.

Alternative or additional treatments should be included in the discussion. Also needed is skeptical vigilance. A recent advertisement for a pharmaceutical treatment listed the symptoms for ADHD. Among them, for children: “May climb or run excessively, have trouble staying seated.” Teens: “May lose things such as homework and schoolwork, make careless mistakes and fail to complete task.” And adults? “May feel restless and impatient, like they’re always ‘on the go,’ always need to be busy after work or on vacation.” Reviewing the symptoms listed in this ad, a friend remarked, “Wow, this reads like a horoscope.”

In other words, broad enough to ring true for just about everyone. Regarding the symptoms for adults, she asked, “Um, isn’t this a description of parenthood?” Do we all need Ritalin?

There’s a relative paucity of research into nature experience as an alternative to pharmaceuticals; most of the existing research, as positive and encouraging as it is, is correlative, not causal. That fact has less to do with the relative value of such approaches as it does with where research funding comes from. So, yes, we need more research on the preventive and therapeutic benefits from time spent in nature, nearby or far. But we already know enough to act.

two jackets2__________________

Richard Louv is the author of THE NATURE PRINCIPLE and LAST CHILD IN THE WOODS, from which some of this essay is adapted. He is co-founder and Chairman Emeritus of The Children & Nature Network.

Reading and Resources

“The Selling of Attention Deficit Disorder” by Alan Schwarz, The New York Times 

Human-Environment Research Laboratory at the University of Illinois.

The Hybrid Mind: The More High-Tech Schools Become, the More Nature They Need 

C&NN Report on Education: Children’s Contact with the Outdoors and Nature

C&NN Research & Resources: Studies, Reports & Publications

 

 

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  1. Days before Schwarz’s NYT article “The Selling of Attention Deficit Disorder” hit, I wrote a blog post entitled “Affordable Ashmordable … What About Desirable Care?” In my blog post I simply asked, “Is feeding our kids copious amounts of behavioral drugs more potent than cocaine desirable care?” I suggested that as we endeavor to make care affordable, we should also focus on making care desirable.

    Much of the information that Schwarz presents can also be found in books such as Gary Greenberg’s book “The Book of Woe: The DSM and the Unmaking of Psychiatry,” Ronald Dworkin’s book “Artificial Happiness: The Dark Side of the New Happy Class,” and Ernest Keen’s “Chemicals for the Mind.” In my blog post I suggest that we are feeding our kids a very dangerous double message with respect to performance enhancing drugs: study dirty in the classroom while playing clean on the athletic field.

    Within all of this is a deeper issue (not mentioned in the NYT article): how behavioral drugs are being used as parent substitutes. This brings up the broader topic of parent substitutes in general. Presented in her book “Home-alone America,” here are the parent substitutes that Mary Eberstadt points to: the aforementioned behavioral drugs, food, consumer goods, over use of day care, technology (like smartphones and Facebook), inappropriate sex, certain forms of music with violent themes, and the list goes on. So, I agree that nature may be an effective way of treating ADHD, but maybe reconnecting kids to parents may also be an effective treatment for ADHD. And it may well be that nature could act as the conduit allowing for parent – child reconnection.

    The sad thing about behavioral drugs is that they tend to imprison kids’ minds (again, not mentioned in the NYT article). As ADHD expert Russell Barkley tells us in his book “Executive Functions,” behavioral drugs do control behavior but they do little if anything as far as connecting kids to EF skills such as focusing attention, appropriately shifting attention, planning, delaying gratification, perspective-taking, etc. Ironically, these are the cognitive skills necessary to help kids heal from and move past ADHD. Barkley frames ADHD as an epidemic of kids suffering from a deficiency of EF skills and functioning. As Barkley points out (as do EF experts in general), parents must act as a surrogate prefrontal cortex (which is the area of the brain that plays a central role in EF skills). So, sure, nature is one path toward developing EF skills, but reconnecting kids and parents is certainly another. In both cases an over reliance on parent substitutes would have to be curtailed.

    By the way, once the Schwarz article hit, I immediately wrote an update to my early blog post. Schwarz’s article certainly adds fuel to the fire, “Not all care is desirable care.”

    Happy Holidays!

  2. It was good to see the NYT bring the over-medication of our active children to the forefront and to expose some of the destructive practices of the pharmaceutical marketing machines. But Richard is correct; this type of exposure is just the beginning of the discussion. Time in nature, particularly loosely structured time, is what are children and families need.

    I work to promote nature in our local, urban elementary school and encouraging people recoginze the value of nature time in the midst of the financial and academic pressures of testing achievement is a constant, uphill battle.

    Thanks to all of you that support and advocate for this cause.

  3. Linda Shaw says:

    As a mother of an ADHD diagnosed child, I have particular interest in this article. From my perspective, a mother of six children ages 32-16, I want to say thank you to Mr. Louv for having the courage to speak out about the educational and environmental changes through the past 20 years. Very few leaders want to admit that many of societies choices have diluted our basic recipe for parental and childhood success. Sometimes the changes are so subtle that we barely notice them, but our children who follow behind us notice and pay the price.

    Changes in the educational bureaucracy have eroded the autonomy of classroom teachers to the point where they are limited in the amount of free or creative time they are allowed to offer their students. Changes in societal awareness concerning the impact of a parents influence are disconcerting. When my husband and I started our family it was the norm for at least one parent to devote a portion of their time and ideals toward family values. Finding time was never difficult.

    When my youngest was diagnosed, I was incredulous of not only my Doctor’s willingness to subscribe a growing cocktail of drugs but also of the educational environment that refused to consider his emotional and social well being. Our family Doctor at the time had little difficulty in dosing out prescriptions to those who even remotely fit the bill of diagnosis. My son’s principal refused to consider his relative age or his many talents. I even had one Social Skills Doctor tell me that he only worked with children and that he wasn’t in the practice of helping families!

    That might have been good for young families that didn’t know better but having raised 5 older children (all who now have post graduate degrees) I knew that the solution to our problem child was much bigger than society wanted to admit.

    After doing my own research and obtaining a partial degree in Behavioral Management, and after listening and paying attention to not only my son’s needs but those of our family, we moved the family back to our southern roots. It was here during annual summer vacations my son had spent hours bathing in the waters of the ocean, letting the swells of the sea pour over him and it was here that he would once again find himself, in a social environment where he was not awkward or anxious but was received by friends who knew the value of outside play, a fishing trip, shooting hoops or a good tackle.

    I want to say that when we moved, we had him repeat a grade, I took him off all of the medications that he was on and helped him walk away from the computer hobby that his previous life had encouraged. He is still very much interested in computers and has recently built his own, but he learned the value of finding balance through nature.

    He fishes, he plays football, he runs. Would he have done these things if we had not taken him off of the medication? I don’t believe so. He was so robotic and content with his mental state while on the meds.
    Now he is learning the names of the birds and the difference between a bird and a squirrel nest. He is waking up to a new reality.

    What concerns me is the increasing sense of social norm to excuse someone’s behavior because “they forgot to take their meds,” or even worse those who can’t preform in the classroom without stimulant help. My son now very much aware of the academic competition he faces recently asked if he could take meds again… just to help him through tests and to help him focus while he studies. (mind you he has all A’s and B’s) He is learning how our new view of life through the lens of “Lily-land” (Lily pharmaceuticals) has forced us all to wear their glasses. But that is not what I want him to learn. I want him to know about a more natural life.

    That life is not about fitting into a prescribed behavioral pattern but rather it is waking up to the natural world every day and discovering a little bit more about yourself and how your talents can make this world a better place. The presumption of the Dr’s that prescribe this medication is even the psychologists that diagnosis the ADHD is that there is something biologically wrong with our generation of children. I think that maybe we need to stand in front of the mirror or along the edge of a lake and view our own reflections with a little more wisdom and humility. Maybe the problem is not our children’s behavior, maybe the answer to our societal problems is indeed our children’s behavior. They are trying to tell us something about ourselves. We set the example. WE are their mentors and their leaders. Where are we leading them? What are we telling them about ourselves and the planet we live on?

  4. Suzanne Salerio says:

    I would like to thank and applaud all of you for your time to look at the research and then put it out for all to see. I only wish that more people could read the research and your ideas.
    I have been a public school teacher for many, many years. I have seen many changes. And the most disturbing are the 2 issues that are addressed above, lack of parenting, and lack of nature. This is a very disturbing tread. Television, and video games are not a way to help a child learn the values of being able to concentrate, focus, initiate curiosity about the world and ask questions. They are simply babysitters. Parents must initiate these important values.

    Teachers always get the bad wrap for informing parents about their child’s behaviors in school. We do not diagnose ADD or ADHD or Autism. These are a medical diagnosis only. We strive only to maintain communication with parents, giving them observations and concerns. Parents must use this information to help their child. Perhaps new guidelines for physicians should include questions about outside play activities, and the types of child and parent interactions that occur at home? Maybe that could begin a very simple wakeup call to all.
    I truly believe in the power of nature. I appreciate all your work, and look forward to the day when playing outside is the norm again.

  5. Mary Ibe says:

    My son was diagnosed with ADHD in third grade, after struggling every year in traditional school. In fourth grade, we opted to home school him. We never put him on meds., opting instead to start each home school day with a long walk outside with the dog. After five years of home schooling and much outside play, he went back to traditional school. He still struggles with academics, but now he knows how to self-medicate…which for him means taking off to the woods for awhile when he gets home from school. I probably have one of the only high school children who still goes outside ‘to play’ and I’m thankful for it!

  6. Amelia says:

    Great article! It brings a new perspective to this troubling phenomena. I hope that enough people will get exposed to this article so we as society can have an objective look at adhd and natural treatment. Thank you very much for your time and research.

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