Why attention deficit may be a clinician disorder rather than a patient disorder
As I am aware of the dropping attention span of all of you, my case will be demonstrated in points with references for further reading.
· Humans in the last 50 years had to adjust to an exponential growth in stimuli processing due to the rising number of media outlets consumption (TV, Radio, Phone, Mobile phone, Tablets, Computers and so on)
· In a classical metaphor, if 1,000 years ago we had to process how to escape the tiger that is chasing us to survive, today young adults must escape fashion police, daily emerging social norms, stay up to date in plenty of different subject areas and yes, go to school and study.
· Attention span has dropped from 12 seconds to 8 seconds and students now barely can retain attention for 10 minutes in a classroom (Bradbury, 2016).
· Exploring this field of human beings managing their lives, not only through the usual combination of 5 sense plus reality, but multiple media devices that help them navigate a thousand times higher threshold of input, resulted in a new concept: The Heavy Media Multitaskers (Minear, Brasher, McCurdy, Lewis, & Younggren, 2013), those are people that use more than one device for more than a couple of hours a day.
· At the early wake of Heavy Media Multitaskers concept (HMM), researchers have evaluated patients with all the classic cognitive tests, realising that they were performing worse. A deficit in implicit learning and in general perform worse than light media multitaskers (Edwards & Shin, 2017).
· The tests used are old-school classic contextual cueing and n-back tests. It is very challenging as we acknowledge that the attention cycle and CNS processing should have changed to accommodate the exponentially increased number of external signals we have to process. It is almost like giving an experienced F-16 pilot an old dial phone and suggesting that they have a cognitive problem if they don’t know how to use it in less than 5 seconds.
· The prevalence of ADHD has significantly grown in between 1997–2016 from 6.1% to 10.2% (Xu, Strathearn, Liu, Yang, & Bao, 2018) and it feels like a vicious cycle was created, as medicated kids with ADHD tend to perform better, putting their classmates with an underperformance impression and a potential pseudo-ADHD.
· When we deploy standards of 1980s or even 1960s to kids that have to operate multiple devices and absorb 1000X more data than we used to, we are actually setting them to fail. When we drug them to comply with our standards, we also set them to fail. What if they are the normalized processing mechanism, and the classic 45-minutes-in-a-class attention span is just not relevant?
· By over classifying and over diagnosing attention issues, but not fixing the educational system to the HMM wired brain, we are pushing more teenagers into mental disorders as they constantly feel underperforming or alternatively anxious or stressed due to medications.
· To end this short piece with some optimism, lately more research is showing that there are growing benefits for heavy media multitasking. HMM tends to be better in multisensory integration (Lui & Wong, 2012). New studies with bigger cohorts show no statistical differences in distraction tests, and no lesser attention was measured (Wiradhany, van Vugt, & Nieuwenstein, 2020).
· I believe that we need to start inspecting HMM in an evolutionary way, to learn what benefits it gives us in the new reality where screens are abundant, and stimulations are all over.
· On a personal note, I was diagnosed twice with ADHD. I’ve completed two master’s degrees with no medication or help. I was probably the most annoying student in my class because I had to process everything in my way, and not “their” way. At some point in my life I was running three profitable businesses. My advice to you, before you run to diagnose and treat attention deficit in kids, ask yourself very sincerely and with a 2022 point of view, what benefits do these short attention spans and multitasking ability bring tomy child?
Bibliography
Bradbury, N. A. (2016). Attention span during lectures: 8 seconds, 10 minutes, or more? Advances in Physiology Education, 509–513.
Edwards, K. S., & Shin, M. (2017). Media multitasking and implicit learning. Attention, Perception & Psychophysics.
Lui, K. F., & Wong, A. C.-N. (2012). Does media multitasking always hurt? A positive correlation between multitasking and multisensory integration. Psychonomic Bulletin & Review.
Minear, M., Brasher, F., McCurdy, M., Lewis, J., & Younggren, A. (2013). Working memory, fluid intelligence, and impulsiveness in heavy media multitaskers. Psychonomic Bulletin & Review.
Wiradhany, W., van Vugt, M. K., & Nieuwenstein, M. R. (2020). Media multitasking, mind-wandering, and distractibility: A large-scale study. Attention, Perception & Psychophysics.
Xu, G., Strathearn, L., Liu, B., Yang, B., & Bao, W. (2018). Twenty-Year Trends in Diagnosed Attention-Deficit/Hyperactivity Disorder Among US Children and Adolescents, 1997–2016. JAMA Network Open.
