ADHD As An Advantage/Adaptation Revisited

Dr. Sam Goldstein

It is romantic and intriguing to believe that great hunters, explorers, inventors and politicians may have experienced ADHD and in fact the qualities of ADHD were in part responsible for fueling their success. Though many intelligent, well-meaning individuals are seduced by this belief, new data has not been generated in the past three years to support this theory. In fact, just the opposite; volumes of new data have been collected and analyzed refuting this idea. In this month’s article I re-visit this theme and begin with a metaphor – the “Just So Story” which I’ve offered in past years as a common sense basis to consider the supposed adaptive advantages of ADHD.

The fanciful tales of Rudyard Kipling, including how the zebra got his stripes or the elephant her trunk are entertaining. Yet few would interpret these “Just So Stories” as truth or for that matter even testable theory. There is, however, a popular view that all human qualities, including anatomical features, behaviors, quirks and idiosyncracies, arose and developed through a process of natural selection. Supposedly these factors provided the organisms that possessed or exhibited them with an evolutionary advantage.

Thus, it is not surprising that there is an increasingly popular and seductive trend among the public and some professionals to view the symptoms of ADHD as adaptive behaviors. It has been suggested that these behaviors evolved to serve a functional purpose in the distant past but may not fit well within current culture and expectation. Through some unexplained process, these qualities were selected for their adaptive advantages, providing carriers of the genes for these qualities with either greater reproductive or inclusive fitness over others. However, readers pursuing a brief introduction to evolutionary theory or evolutionary psychology will quickly realize that it is implausible to perceive symptoms or behaviors related to ADHD as being advantageous regardless of the time or cultural context in which one examined the data. The model of ADHD as adaptive does not appear to fit what is known about ourselves, our ancestors or about ADHD. In fact, a better fit is to suggest that those who do not suffer from ADHD clearly have an adaptive and likely selective advantage across multiple generations given that they represent the current norm. A much more plausible argument is that ADHD rather than representing an adapted or evolved set of valuable qualities reflects weaknesses in the development of efficient self-regulation and self-control. These functions likely fall on a normal curve similar to height or weight. Readers taking the time to understand evolutionary concepts will quickly conclude that falling to the bottom of a normal curve in the development of self-control rather than representing an advantage represents a disadvantage.

It is important for readers to keep in mind that by definition the diagnosis of ADHD is provided not just because an individual meets symptom count but because those symptoms cause chronic and significant impairment across multiple life domains. The diagnosis is pervasive. When children are provided with the diagnosis in research studies most still meet the diagnostic criteria many years later. Even in adult outcome studies, though at least half of adults may not meet the full diagnostic criteria for ADHD they still report daily impairments. In the nearly 4,000 peer reviewed, scientific studies dealing with ADHD over the past thirty years, there hasn’t been a single study in which the group with ADHD performed better on a valuable trait, asset or behavior than those without ADHD. This is not to moralize, demonize, nor pathologize children with ADHD. It is to suggest that being delayed in the development of self-control in our complex society is no picnic. It is no blessing for the children who struggle with this problem nor for their dedicated teachers or parents who live with and love them.

Although it has been suggested that some individuals historically and currently who have achieved success have done so because they are inattentive or novelty seeking, it is yet to be scientifically demonstrated that the symptom qualities of ADHD by themselves lead to positive life outcome. It is my belief that if in fact many great men and women struggled with ADHD, their greatness was obtained because they possessed other skills and abilities and were afforded opportunities to overcome this condition. Fortunately, the symptoms of ADHD can be treated and managed effectively leading to more successful and happier lives for those who may struggle against it’s diminished capacity for self-control. We must turn our attention to the multiple forces and critical problems that appear to be increasingly creating a vulnerable youth as we enter this new millennium. I continue to not believe we do not need to create myths or “Just So Stories” to help children with ADHD and their families feel better about this impairing condition. Rather, I believe it is time that we begin focusing on the strengths and assets of all children while managing those liabilities that impair their ability to succeed in the world we have created for them.