Channel 4’s ADHD documentary: could it have asked a more nuanced question?

I’ve read with interest the reaction to the news that Channel 4 is to broadcast a documentary about neurodivergence, The Great ADHD Myth?, which it says will explore whether ADHD is a genuine form of neurodevelopmental disorder or a social construct.

Predictably, there have been strong reactions from people diagnosed with ADHD, as well as from the broader neurodivergent community – out-and-out anger in some quarters.

Until it’s been broadcast, it’s important not to assume too much. However, the show’s webpage poses a strikingly binary question: Are ADHD symptoms the result of a genuine neurodevelopmental disorder, or a consequence of environmental factors?

In other words: nature or nurture?

A false binary?

I wonder whether a more balanced, nuanced documentary might instead explore whether similar behavioural profiles could, in some cases, be attributed to ADHD but in others may reflect the impact of environmentally driven psychological factors, such as adverse childhood experiences (ACEs).

The same question could be asked of autism.

Where lived experience meets complexity

I know someone whose behavioural profile is consistent with ADHD, but who also experienced significant childhood trauma. She’s open-minded about the possibility that her challenges could stem from either factor – or indeed a combination of both. She’s currently awaiting assessment.

From what I’ve read in psychology books – a subject I studied at A Level and have remained deeply interested in – ACEs can impair the development of executive functioning. This can result in impulsivity, challenges with planning, and attention difficulties.

ACEs can also affect social development and confidence. In some cases, this may lead to symptoms that resemble autism, such as difficulty forming friendships or reduced communicative reciprocity. Carefully exploring whether social development was impaired before or after the traumatic experiences is diagnostically key.

Why diagnostic rigour matters

With the well-documented rise in diagnoses of neurodivergent conditions, the credibility of diagnosticians is, arguably, under increasing scrutiny.

For me, it’s vital that assessments carefully consider:

• whether symptoms were present in early childhood;

• and whether alternative explanations – known as differential diagnosis – have been rigorously explored.

In my daughter’s dyspraxia assessment, the diagnostician took a detailed developmental history. They clearly established that there were a number of indicators visible before and during my daughter’s years at infant school. They also explored potential medical causes. I was satisfied that differential diagnoses had been considered.

The risk of getting it wrong

The system would fail if it did not take differential diagnosis seriously.

If someone is diagnosed with a neurodivergent condition when their symptoms are rooted in childhood trauma, they may receive support that doesn’t meet their needs, maybe missing out on therapies that address underlying experiences.

A better question to ask

In conclusion, I do think the increasingly vocal scepticism around neurodivergence needs to be addressed.

But, writing as someone with a neurodivergent diagnosis, perhaps the most constructive and respectful way to do this is not to frame the issue as ‘either/or’, but to ask are diagnosticians consistently and thoroughly exploring environmental factors – such as childhood trauma – alongside neurodevelopmental explanations?

This is where meaningful reassurance lies.

The system’s credibility is at stake.