Who is to blame for boys struggling at school?

But not too much information. For a time, teachers, backed by eager drug company marketers, were playing too big a role in getting kids identified, diagnosed, and put on medication. In 2003, when Jonah Hoover attended first grade in Memphis, his teacher called in his par­ents, Brian and Kate, to discuss Jonah’s pattern of behavioral infrac­tions: horsing around in the hallways, talking out of turn, and poking other kids. Recently, he’d gotten two half-day suspensions: one for squirting a ketchup packet at another kid, another for jumping in a puddle. “Exactly the same kind of stuff I did when I was a boy,” says Brian, who works in retail. The assistant principal was there, too. He lectured the Hoovers on the school’s code of behavior, then concluded their brief meeting by handing Kate and Brian a promotional pamphlet and DVD about Ritalin. “I had a pretty emotional reaction,” says Brian. “My son was six. I think long and hard before I give him an aspirin.”

This scenario was repeated so many times in so many schools that in 2003 a federal law was enacted to prevent schools from discussing ADHD medication with families — or risk having their federal funding yanked.

Bryan Goodman, the spokesman for CHADD, says, “We hear ru­mors about [schools pressuring parents to drug their children] all of the time, but we rarely find cases of it. What we do find are parents who spend years trying to figure out what the teachers are trying to commu­nicate because of the rules of what teachers can and cannot say.” To that end, many teachers and school administrators point out that they have been carefully trained NOT to suggest to a parent that a child might have an attention problem or require medication. But the Farquhars and Hoovers and scores of parents like them from all over the country are not hard to find. They tell harrowing stories about teachers who re­peatedly hint, suggest, insist, and even demand that parents give their kids — usually their sons — drugs.

What gives? I’m not sure. Some principals, school nurses, and teach­ers may be going out on an ethical limb, violating federal law and school policy because they have very real concerns that a child has a serious lifelong mental condition and they feel compelled to help. But what teachers and principals see as a gentle suggestion might be being inter­preted by parents as a requirement.

“Parents really see teachers as having a medial authority,” says Dr. Ilina Singh, a lecturer at the London School of Economics, who studies ADHD. “Parents find it hard to resist a statement from a teacher con­cerning the normality of their child. In my experience, parents take it very seriously.”

What parents, psychologists, and physicians forget is that when a teacher checks off “Often” next to “Climbs excessively” she is say­ing something about your son but she is saying more about her expec­tations for your son’s behavior in her class. As schools ratchet up their expectations, says Lawrence Diller, a psychiatrist in the Bay Area who has been an outspoken critic of the ADHD industry, “more kids — and particularly more boys — look as if they might have a problem. Teach­ers now demand a standardized level of performance from all students. Many can’t tolerate too much motion, too much noise, too many questions — even within the range of normal — if it interferes with the pace of their class. They forget what’s normal.”

Then there are kids who won’t pay attention. Diller says, “For most kids, there is a natural downturn in motivation as they approach middle school. Kids who have been trained in good habits weather the change with no problems in school. For others, who by nature or nurture have not developed good habits” — Diller estimates their numbers to be about one in five — “school performance plummets.” And that puts them under stress. “When girls are under increased stress, they fold their hands and get quieter. When boys are under stress, they become a behavior problem.” If their parents are wealthy enough, the boys end up in Diller’s Walnut Creek office, where Diller says he produces medically enhanced compliance in those boys by providing them with  attention-enhancing drugs.

“Do I like it?” he asks. “No. But I do it. And as a consequence, I feel compelled to speak about it publicly.”

A teacher’s opinion of your son’s behavior is a subjective one. When it comes to identifying boys with ADHD, it turns out the teacher is often wrong. In 2005, psychologist J. Michael Havey and his team from Eastern Illinois University surveyed 52 regular K–6 classroom teachers from eight different rural midwestern elementary and middle schools. Most of the teachers were experienced; 35 percent of them had been on the job over twenty years. Havey asked them to fill out a questionnaire on ADHD in the classroom and then complete a rating scale on 121 randomly selected boys and girls to identify the ones who they thought were suffering from the disorder. In the opinion of these experienced, well-meaning teachers, 24 of the 66 males they evaluated had ADHD. Other studies have found that teachers from private schools, and teachers with large classes where maintaining order in the classroom is key, also report implausibly high rates of ADHD. Guess who gets identified (wrongly) most often? Boys.

Small changes, big results
Some experts say that instead of medicating boys, it may be time to change some of the routines of schooling. Lisen Stromberg, a former ad agency executive from Northern California, says she’s trying. A few years ago, she founded an advocacy group called Save Our Sons in Northern California in an effort to encourage schools to be more tolerant of typical boy be­havior. “All my friends who had active boys were being told, ‘This boy is out of control. This boy needs to go on Ritalin right away,’ ” recalls Stromberg. So she began to raise money — almost $600,000 in all — and launched a series of training sessions for teachers hoping to get the best out of their young male students. One hundred  forty-six teachers from public and private schools in Northern California attended. “We started with the idea of helping teachers understand the gestalt of a boy — what makes up the boy dynamic, the bandwidth of boy behaviors, how boys interact, and about boys’ cognitive and physical needs,” says Stromberg.

The training continues to have a big impact on teachers at the Ohlone Elementary School, a public school in Palo Alto, California. As is so often the case in any discussion of schoolboys, the link between well-being and movement was front and center. “The way schools are run we have kids sitting at desks for a very long time,” says principal Susan Charles. So Charles and her teachers began changing how things were done. If a kid wanted to stand instead of sit while he wrote, no problem. If he was wiggly during circle time, he got something to lean against. Poor fine motor skills? He got a fat pencil to hold instead of a thin one. The changes cost nothing, says Charles. “Sending a child out for a run break costs nothing. Allowing them to work outside instead of at a hard table costs nothing. You have to change the  mindset of the school and what it should look like.” Does ADHD exist there? Sure. But the principal and teachers at Ohlone want to make sure the school en­vironment isn’t part of the problem.

Of course, you want to give your son the tools he needs to do well in school — and that’s especially true if your child is struggling. Your son may be suffering from ADHD, but remember that teachers aren’t always the best people to make that diagnosis. Sometimes, the school, not the boy, needs the overhaul.

Excerpted from "The Trouble with Boys" by Peg Tyre. Reprinted with permission from Crown, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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