02 Oct ADHD: Controversy, Diagnosis, and Critiques
Robert Spillane presents a controversial view that ADHD may be overdiagnosed and over-medicalised.
When I was studying clinical psychology in the 1960s, my teachers were adamant that when it comes to children, ‘hands off’. In those halcyon days, children misbehaved; they did not suffer from mental disorders or chemical imbalances in the brain.
Parents acknowledged and confronted the challenge posed by extroverted, energetic youngsters without resorting to doctors, psychiatrists or drugs.
Emeritus Professor Robert Spillane, a clinical psychologist and philosopher at Macquarie University, presents his view that ADHD may be overdiagnosed and over-medicalised. He argues that behaviours labelled as ADHD—such as inattention, impulsivity, and restlessness—are often normal childhood variations, misinterpreted as medical problems.
While a small minority of clinicians and researchers share Spillane’s perspective, the majority of medical experts and families recognise ADHD as a legitimate neurodevelopmental disorder requiring careful support and, in many cases, medication. Spillane’s work highlights the ongoing debate about the line between normal behaviour and medical diagnosis.
From Misbehaviour to Medical Labels
In the 1960s, misbehaviour in children was handled through discipline, structure, and encouragement, not medication. Over the decades, psychiatric records show a dramatic rise in childhood mental disorders, and today, Australia has some of the highest ADHD diagnoses and medication rates globally. This reflects a shift from moral or behavioural management to medical intervention.
The ADHD Checklist: Ordinary Children or Pathology?
DSM‑IV* and DSM‑5 lists included ADHD symptoms of inattention and hyperactivity–impulsivity: forgetfulness, distractibility, fidgeting, excessive talking, interrupting, restlessness, and difficulty completing tasks.
Diagnosis required six or more symptoms for at least six months, raising key questions: disruptive to whom? Inappropriate by whose standard—teachers, parents, or clinicians? Many behaviours are common in children, so pathologising them risks medicalising ordinary childhood variation.
Critiques: Attributed, Not Assumed
Some critics, including Dr Mary Ann Block (No More ADHD ) and Dr Fred Baughman (The ADHD Fraud: How Psychiatry Makes “Patients” of Normal Children), argue that ADHD lacks objective diagnostic tests and caution about widespread stimulant use. While these perspectives have sparked debate, mainstream medicine recognises ADHD as a valid neurodevelopmental condition. Evidence supports the combination of behavioural therapy and, when appropriate, medication to help children manage attention, impulsivity, and emotional regulation.
The mass drugging of children is the price we are paying for the progressive medicalisation of moral behaviour, in which children are treated as victims of their brain chemistry and brought under medical control. It is a crime against humanity, writes Robert Spillane.
*Footnote: The DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) was published in 1994 by the American Psychiatric Association. It defines ADHD using standardised criteria for inattention and hyperactivity–impulsivity. Around 6–7% of Australian school-aged children are estimated to meet these criteria at that time.
This Part of the discussion has been edited for the web and outlines the controversy surrounding ADHD diagnosis and critiques of over-medicalisation. In Part 2, we focus on Australia today, recent policy changes, and the new Thriving Kids program, offering guidance for parents and teachers.
See Part Two, ADHD in Australia Today: ‘Thriving Kids’ and What Parents Should Know. Here
