Moving diagnosis

Child psychologist has a simple solution to boys’ hyperactivity and learning issues: Give them a break.

(Paul Napper)
By Linda Matchan
Globe Staff / September 30, 2010

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Lexington child psychologist Anthony Rao is author of “The Way of Boys: Promoting the Social and Emotional Development of Young Boys.’’

Q. You write that young boys are overdiagnosed much of the time and labeled with ADHD, bipolar disorder, and learning disabilities. That our problem isn’t always boys, it’s our expectations of them. Elaborate?

A. Because when boys enter into preschool or any learning situation, the expectations to succeed or perform don’t really match where they’re at. They don’t make eye contact very well. They don’t listen as well. Their hearing is not as acute as it is for girls, so they don’t develop language skills as quickly. And they have high motor activity. You have boys being asked to sit longer or be indoors, and teachers who are at the front lines saying your child is having a problem fitting in. That translates quickly into a diagnosis and a medication.

Q. How quickly?

A. Parents can get a diagnosis and medication within a 10- to 15-minute pediatric visit.

Q. You use the word “madness’’ to describe this situation. Why such a strong word?

A. I have a lot of emotion and deep feeling around this issue. I wanted to select a way of saying it that woke people up. I am not an anti-medication person at all. But we have a tendency to first think there is something wrong neurologically or psychiatrically and offer a quick-fix solution.

Q. In the past, how did families and schools account for this kind of behavior?

A. They called them “spirited’’ or “mischievous.’’

Q. Have you seen girls like this, too?

A. Absolutely yes. But boys need to push boundaries and are more likely to flip our switches. While it’s a stereotype, girls show their power more emotionally.

Q. How do you account for the change in attitude?

A. There’s a bigger social picture here. There’s been a major psychopharmacological revolution. About half of us in the US are on prescription meds and now lots of kids are, too. There have been changes in education — more standardization, longer days, more sitting, teaching to the test, and that really frustrates children, boys in particular. And there’s been a major technological revolution. Kids are not as physically active and everything is moving faster. Kids are just being asked to do more at younger ages. There are some nice studies with boys diagnosed as having hyperactivity. Give them 20-30 minutes outdoors and they can settle, sit, and attend to their schoolwork. I recommend taking a lot of breaks.

Q. That sounds simple.

A. You and I do it. Right after this, you’ll go and get a cup of coffee. You need to digest the material, and you’ll come back refreshed. What’s happening with kids is that children are reporting teachers who are anxious, and pulling out a lot of material early in the year. Sitting is really, really tough and it doesn’t take much to get in trouble. All you have to do is stand out, don’t look up, and be fidgety. There’s a lot less tolerance for boyhood in childhood in general.

Interview was edited and condensed.

Linda Matchan can be reached at