Has the NY Times been thinking about ADHD all wrong?
A recently published NY Times article, “Have We Been Thinking About A.D.H.D. All Wrong?” by Paul Tough (published April 13, 2025) questions the increasing rates of ADHD diagnoses in children and the effectiveness of ADHD medications to reduce symptoms. I will start with a petty critique: Mr. Tough puts a dot between every letter in ADHD. I have never seen it written that way and I think it looks weird. Now onto the substance.
The article questions the validity of ADHD diagnoses. It is true that ADHD is difficult to diagnose. That is the case for any psychological disorder. Why? The diagnostic criteria are subjective. We cannot use an x-ray or blood test. Diagnosis typically relies on patient self reporting. This can pose concerns because patients are notoriously bad at seeing themselves objectively (even Descartes could not confirm he existed outside his own mind). Diagnosis may also include reports from others who know the patient well and observations by the provider (still subjective—we pretend this is not true but providers are human).
Another complexity to diagnosing ADHD is that many things that look like ADHD are not ADHD. For example, trauma, depression, sleep deprivation, and menopause can all cause symptoms that overlap with ADHD. A diagnosis would need to examine whether any other condition better explains the patient’s symptoms. That inquiry is also quite subjective.
But just because it is hard to diagnose does not mean ADHD does not exist at all. The NY Times article goes on to question the existence of ADHD by noting that after decades of research, scientists still have not isolated the specific gene or genes responsible for passing ADHD to our offspring. I am not a scientist, but isolating specific genes is not a simple task. The fact that it has not (yet) been done does not mean ADHD has no genetic component.
It takes a lot to draw Dr. Russell Barkley out of retirement, but the NY Times article pulled it off. Dr. Barkley, a clinical psychiatrist, devoted his career to ADHD research. He published over 280 scientific articles and book chapters on ADHD, as well as 23 books, rating scales, and clinical manuals. In full disclosure, I use Dr. Barkley’s training materials and assessments in my practice. That is why I took note when he published a four-part YouTube series critiquing the NY Times article for cherrypicking its research to tell a compelling story that leaves out important context.
You can watch them all:
