There’s a fascinating new study out of Denmark — which can easily do these kinds of analyses because they have a national healthcare system that leaves nobody out — on kids and teens who were diagnosed with ADHD or autism between 2012 and 2022, a ten-year period, comparing them to those kids who avoided either diagnosis. They looked overall at 2.1 million Danish kids, with roughly 71,000 having gotten a diagnosis.
For decades, kids with an ADHD or autism diagnosis were more likely to have been preemies, have low-income and/or low-education parents, a parent with a psychiatric history, and were frequent visitors to the doctor (often for accidents).
What’s fascinating is that the Danish team found that this “classic” profile is disintegrating. At the start of the decade, a child born at low birth weight was 54 percent more likely to end up with an ADHD or autism diagnosis than a child born at normal weight. But by the end of the decade, that gap had shrunk to 17 percent. The same collapse showed up for premature birth and for nearly every measure of family disadvantage they checked. The first author, Magnus Elias Tarp, put it plainly:
“What we found is that people diagnosed in recent years resemble the general population more closely than those who received the same diagnoses a decade ago.”
And this isn’t just a weird one-off. In June, a companion study from the same Danish research network, also in JAMA Psychiatry, examined the polygenic risk scores of more than 20,000 people diagnosed with ADHD between 1994 and 2016. The more recently someone was diagnosed, the lower their genetic loading for ADHD, and for autism, bipolar disorder, and schizophrenia as well.
The authors concluded that their data “support broadening diagnostic criteria as an explanation for increasing rates.”
I read both of these and thought about the kids I knew decades ago.
In the late 1970s, Louise and I were running a residential treatment and educational program for abused children. Instead of ADHD, the word was “hyperkinesis,” and the children who carried that label were generally the same ones that old risk profile would have predicted.
Many of these children had been born prematurely or at low birthweight to mothers who’d had no access to affordable prenatal care. The vast majority came from families where poverty, mental illness, and violence had been passed down for generations. They arrived with files an inch thick, and every single one of the kids we saw in the 5 years we ran that program were labeled as “suffering from hyperactivity” or the “hyperkinetic syndrome.”
I spent a week with Dr. Ben Feingold in his San Francisco apartment learning about his diet, ran a study with our kids, and published the results in 1981. It was my first published work on what we now call ADHD, and every child in it fit the profile the Danish researchers say is now somehow magically going away.
I didn’t get all this until almost a decade later — when my son and I were both diagnosed with ADHD — helping me realize that the wounds those abused kids carried weren’t the things that made them into hyperactive Hunters, or what “caused” their “hyperkinetic” diagnoses.
Instead, because they’d been both the victims of poverty and abuse (and the way they were treated in school because of their ADHD), their “Hunter-ness” was far more visible. A Hunter kid born into a broken home who can’t sit still in a classroom gets a file and sometimes a criminal record or beaten up by a short-tempered parent. A Hunter kid born into a stable, wealthy home gets called “spirited,” has a tutor and private college-prep class, and after doing his or her homework is simply sent outside to play.
For roughly three decades I’ve been arguing that what we call ADHD is a set of traits that were essential in hunting and gathering societies but became a liability when the Agricultural Revolution moved most of us humans into the Farmer’s world of fields, factories, and classrooms.
In this way of looking at ADHD, it becomes part of a distribution rather than some random disease that hits some kids and misses others. It’s like height or weight; there’s a bell-curve that it falls on the ends of, and that’s what these two Danish studies are pointing out.
When you think of ADHD kids as damaged or incompetent, that throws them into the far edges of that bell-curve, but was the threshold for diagnosing ADHD moves closer to the middle of that bell-curve you’ll suddenly start noticing the “ordinary Hunters,” the ones who’ve never been seriously injured by birth or life circumstances.
The result is that ADHD starts to look less like an illness and more like a normal part of the curve distribution of humanity overall.
The American numbers are increasingly telling the same story. Parent-reported ADHD diagnoses in this country rose to 10.5 percent of children by 2023, but the increase came almost entirely among kids who were rated as having “mild” or “moderate” ADHD. Most came from families with the means to carry private health insurance that covered mental issues.
The “severe” cases weren’t going up in number here in the US any more than in Denmark; in fact, the opposite was happening. More and more Hunter kids are being diagnosed yet also falling closer and closer to the “normal” middle of that curve’s distribution.
In other words, the entire notion of what is or isn’t ADHD and who does or doesn’t have it started, years ago, with the wrong assumption. It asserted that the classroom and cubicle are just fine for all of us, and the variable that made Hunters pop out was that they were broken or defective.
But what if it’s the classroom or the cubicle that’s the problem, not the Hunter? That’s the essence of my argument, and over and over again I’ve seen (and documented, and seen in my own life and family) cases where when you change the environment for the ADHD child or adult, suddenly the ADHD is no longer a problem.
The label describes your wiring, in other words, but not your worth. Hunters do fine when they can make use of their scanning and free thinking and energy; they crash and burn when they’re told to sit down and shut up for hours at a time.
That’s the conversation I want to be having as ADHD Awareness Month begins this week. Not about how many of us there are, but let’s discuss what kind of a world we’re going to build for the Hunters among us who we’ve finally learned to see.
If this resonates with you, forward it to the parent who just got the diagnosis and is wondering what they did wrong and let them know that they didn’t do anything wrong, they just gave birth to a noble Hunter.
These articles are just what is needed today. We are not exactly alike but we all have the same value.
I am telling all that I have ADHD and am proud of it.
75 years old and never diagnosed when a child. I was smart and bold enough to push through.
Now I’m grateful that I am aware of how capable I truly am.