Evolution of the Pathology Paradigm

Although we are seeing some slow changes in attitudes, we, as a society, generally look at ADHD, Asperger's Syndrome, etc., through the pathology paradigm lens. Why is that and how did we get here?

In the early eighteenth century and before, young men and women were taught by their parents or elders. Most of these "teachers" were farmers or artisans. The learning process was either one-to-one or perhaps one-to-a-few. Students learned by doing, which often involved physical movement. Because education was not regimented or standardized, learning style variations were not necessarily problematic.

Then came the Industrial Revolution (1760-1840), which created a huge demand for factory workers. An article on the business website qz.com ("The Modern Education System Was Designed to Teach Future Factory Workers To Be Punctual, Docile, and Sober") describes it this way:

Factory owners required docile, agreeable workers who would show up on time and do what their managers told them. Sitting in a classroom all day with a teacher was good training for that. Early industrialists were instrumental, then, in creating and promoting universal education.

This led to the creation of "Factory Schools," a concept that originated in early 19th-century Prussia. Regimented education was provided by the state with dozens of students in each class. The classroom atmosphere was standardized and often impersonal.

Imagine the effect that had on learning. Higher numbers of children required rules, standardization, and conformity. Teachers had little time to support individual learning styles and those who were not mainstream thinkers became outliers. Their difficulties with standardized curricula led to diminished self-esteem, feelings of failure, and social ostracization.

What Can Be Done?

The point here is not to bash the teachers or even the administrators, but to recognize what has happened and how it has painfully affected many millions of lives. Many individuals who have either ADHD or Asperger's Syndrome are either very bright or exceedingly bright and highly creative. Typically they do not see their strengths or believe in their abilities because they received constant negative feedback in their formative years. The negative feedback may have come in the form of low grades on standardized tests, undue focus on their weaknesses instead of strengths, or countless corrections for exhibiting non-conforming behaviors. Regimented education demands academic conformity, which, in turn, encourages students to value social conformity. That is to say, the "Factory School" model creates outliers both academically and socially. This marginalization can and does crush the self-esteem of non-mainstream students to the point they do not value themselves or feel as though their strengths are worth developing -- when instead, these bright and creative people could be flourishing and contributing to society.

The following sections will lightly touch on two of the neurodiverse conditions, ADHD and Asperger's Syndrome -- along with suggestions for helping by creating new strategies and perspectives.

ADHD

Just as was discussed above, ADHD can be viewed through a lens of pathology or neurodiversity:

• According to the Center for Disease Control, "ADHD is one of the most common neurodevelopmental disorders in childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without considering what the result will be), or be overly active."
• The ADD Coach Academy defines ADHD this way, "Attention Deficit Hyperactivity Disorder is a unique brain wiring which requires engaged interest with a clear, purposeful intention in order to activate and access attention so an individual can manage the brain’s executive functioning."
• Instead of the term ADHD, author Edward Hallowell (in his book ADHD 2.0) uses the acronym VAST: variable attention stimulus trait. He chooses to avoid the words "deficit" and "disorder" and for every problematic trait, he describes a useful counterpart (see the ADHD Traits.

You can see that the CDC description favors toward the pathology lens. Although the second description does not mention the benefits (e.g., heightened creativity and the ability to hyperfocus) it frames ADHD more positively as an issue of "interest" rather than "focus." Tom Brown, PhD., in his book, A New Understanding of ADHD in Children and Adults: Executive Function Impairments, says:

Virtually all persons diagnosed with ADHD have a few domains of activity in which they demonstrate none of the executive function impairments that they suffer in most other situations. Typically these individuals report that they have no difficulty in focusing and working effectively on tasks that interest them. They tend to be unable to mobilize such interest voluntarily or upon direction from others. It is activated spontaneously or not at all.

But regardless of which lens you choose, those who have ADHD traits can be helped by the Growth and Transformation Model. That is, by building an awareness of strengths, creating a sense of values, meaning, and purpose, and developing a sense of metacognition and mastery, all in a very structured way, individuals will begin to feel more organized from the inside out. It can, and usually does lead to increased motivation and development of "wherewithal" to put time-management and organization strategies into place -- strategies that were previously difficult to implement. With regard to "metacognition and mastery," a logical approach is to develop techniques that make mundane activities more interesting. Increased interest leads to better focus. For example, "How can you gamify this? How can you make it fun? What can you do to put yourself in the manager's seat and do the best job possible?"

Another approach to stimulating interest comes from an exercise suggested by the ADD Coach Academy, one that is helpful for neurotypicals and neurodiverse alike. It begins by looking back at past successes. Start by creating a "Rainbow List" of things you have done well, things that have made you feel good. Then, ask yourself, or discuss with someone else, the following:

1. What caused you to begin that activity?
2. What was your goal?
3. Why was that goal important to you then?
4. What did you have to know to accomplish that?
5. What did you learn from doing this activity?
6. What did it take for you to complete the goal?
7. How did you feel while you were doing the task?
8. How did you feel right when you completed the task?
9. What qualities and strengths did you employ to accomplish the goal?
10. What was easy or hard about accomplishing the goal?
11. What did you enjoy about the process of doing it?
12. How were you able to replicate this accomplishment? How often?
13. What have you learned about the unraveling process that has allowed you to appreciate yourself?
14. How can that past accomplishment motivate you to create new accomplishments?

Looking at your rainbow moments in this analytical way is called "unraveling" and will build confidence as well helping you understand how best to approach your goals.

And finally, a good place to get started in your understanding of the various ADHD traits, along with their usefulness and associated problems, is by viewing the "ADHD Traits" chart below. The chart will help you to understand the paradoxical opposites ADHD minds contend with. These opposites can be challenging and confusing but also, as ADHD 2.0 authors Hallowell and Ratey put it, "exciting and groundbreaking."

Asperger's Syndrome

According to the Asperger's page on the autism-society.org website,

There are still many professionals who consider Asperger’s Disorder a less severe form of autism. What distinguishes Asperger’s Disorder from classic autism are its less severe symptoms and the absence of language delays. Instead of aloofness, individuals with Asperger’s Disorder usually want to fit in and interact with others, but often they don’t know how to do it.

This is an important distinction. It is important to understand the frustration children experience when they want badly to fit in but can't. Just as with ADHD individuals, Asperger's individuals can benefit from clearly understanding their strengths, and establishing a sense of values, meaning, and purpose. However, with Asperger's individuals, it may be more challenging to break out of rigid thought patterns that are not serving them. In a coaching relationship, this requires compassion, trust-building, and conveyance of "best possible life" knowledge in a structured and rational way.

ADHD and Asperger's Syndrome

There are differences between ADHD and Asperger's Syndrome but also large degrees of overlap in both the traits and the difficulties they pose. According to CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder),

More than half of all individuals who have been diagnosed with ASD also have signs of ADHD. In fact, ADHD is the most common coexisting condition in children with ASD. On the flip side, up to a quarter of children with ADHD have low-level signs of ASD, which might include having difficulty with social skills or being very sensitive to clothing textures, for example.

For a coach, what is important is not whether there is a formal diagnosis or even one label or another -- although diagnoses can be both important and necessary when trying to find support services. Instead, a positive approach might be asking, "What are your personality traits, both strengths and weaknesses? What can we do to build on the strengths? What can we do to navigate or minimize the weaknesses? How can we boost your self-esteem so you feel like making the effort? What knowledge will help you grow?"

Diversity does not necessarily equal disability. In her talk, Elisabeth communicates how it is to be autistic yet lead an independent and successful everyday life. Although parts of her talk about Asperger's Syndrome, it generally applies to all forms of neurodiversity.