The Daily - Have We Been Thinking About A.D.H.D. All Wrong?

Episode Date: June 17, 2025

Over the past three decades, A.D.H.D. diagnoses in the U.S. have been climbing steadily, and so have prescriptions for the medication to manage the symptoms.As the field booms, some longtime researchers are starting to question whether much of the fundamental thinking around how we identify and treat the disorder is wrong.Paul Tough, a contributing writer for The New York Times Magazine, explains.Guest: Paul Tough, a contributing writer for The New York Times Magazine who, for the last two decades, has written articles and books about education and child development.Background reading: Have we been thinking about A.D.H.D. all wrong?For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday. Photo: Bill Truran/Alamy Stock Photo Unlock full access to New York Times podcasts and explore everything from politics to pop culture. Subscribe today at nytimes.com/podcasts or on Apple Podcasts and Spotify.

From the New York Times, I'm Rachel Abrams, and this is The Daily. Over the past three decades, ADHD diagnoses in the United States have been climbing steadily, and so have prescriptions for the medication to manage the symptoms. But as the field booms, some long-time researchers are starting to question whether much of the fundamental thinking around how we identify and treat the disorder is wrong. Today, magazine contributor Paul Tuff explains. It's Tuesday, June 17th. Paul, welcome back to The Daily. Thank you. Great to be here.

Paul, you recently wrote a story about ADHD that got a lot of people's attention, including here on The Daily. And it might be because ADHD and the medications to treat it are something that frankly, I think a lot of people seem to have kind of a personal experience with, either themselves or people that they know. And so my first question to you is just, how did you personally come to this story?

So yeah, it's a lot like what you're describing. I have two boys, one who's 10 and one who's 15. So they are both in the key ADHD demographic. And I think a few years ago, I just started to have this sense that, like, ADHD was all around me, that every conversation I was having with parents and with teachers, that this was a big part of what they were concerned with and what they were trying to figure out. But it felt like there were a lot of puzzles in this diagnosis, that on the one hand, it seemed like something that was very clear and straightforward, like a

friend would say, yeah, we didn't know what was wrong, but then we found out it's ADHD. But at the same time, it felt like the boundaries between what was ADHD and what was not ADHD were kind of fluid and porous. And so I wanted to try to understand this disconnect. And I figured the place to start was to talk to the scientists who study ADHD. So when you started diving into this field, that it sounds like seemed both everywhere, but also a little bit hard to pin down.

What did you find? What did these researchers tell you about the landscape of our understanding of this condition? Well, I found that they were a little confused as well. Hi. Hey, is that Edmund? Hey, it's Edmund. Yeah, how are you? One whose work and whose thinking I found that they were a little confused as well. Hi. Hey, is that Edmund? It's Edmund, yeah.

How are you? One whose work and whose thinking I found most interesting was this British researcher named Edmund Sanuga-Bark. I've always had an inquiring mind about everything in life. I tend to be on the side of the questioner rather than the conformist, for sure. He was always a really fascinating guy to talk to. And I think partly because he's kind of an iconoclast.

Like when he was a teenager, he was in one of the first English punk rock bands. And he still is really someone who just questions the conventional wisdom. I was at the pub last night. Our conversations would sometimes go off on these long tangents. Our cricket team played. We went to the pub. I. Our conversations would sometimes go off on these long tangents. Our cricket team played, went to the pub.

I like to smoke cigars. So I got smoking my cigar and the lady from the bar who I know very well came out and she said, we can't smoke here. I said, why not? She said, there's a big sign. It says no smoking. And I said to her, the bigger the sign,

the more likely I am to ignore it. And I'm afraid that's the way it's been in my career. Edmund has spent his whole life trying to understand ADHD. And part of that is professional, but part of it is personal. He was diagnosed with ADHD back before they were even calling it that. They called it hyperkinesis. There was no real treatment for that in them days. Not in the UK anyway.

People weren't taking medication for hyperkinetic disorder. This is around 1970. He was living in this working class town in the English Midlands. He's eight years old, misbehaving young kid, couldn't really sit still. And at that clinic anyway, they just sort of told him, you've got this, but they didn't do anything to help him. And so I just went to school and they put me in the remedial class. And I've got this memory, I've got this image, this memory of them giving me shapes to draw around,

like squares and triangles, because I couldn't really write, so they just gave me things to draw around. He just had a kind of miserable time in school. Looking back, I was always in trouble. I was quite a naughty boy and a naughty adolescent. And I think that was a mask. That was a camouflage.

I found the setting where I could hide my weaknesses. EDMOND SAYS IT WAS A MIRACLE THAT HE EVER MADE IT THROUGH HIGH SCHOOL. BUT THEN AFTER HIGH SCHOOL, BECAUSE OF A FEW LUCKY BREAKS, HE GETS INTO A UNIVERSITY, TO BANGOR UNIVERSITY IN WALES. AND FROM THERE, EVENTUALLY HE DEVOTES HIS LIFE TO STUDYING ADHD, TO TRYING TO FIGURE into a university, to Bangor University in Wales. And from there, eventually he devotes his life to studying ADHD, to trying to figure out exactly how it works. I mean, I've invested 35 years of my life

trying to identify the causes of ADHD. And what we've found is that somehow we seem to be further away from our goal than we were when we started the journey. But in recent years he has really begun to rethink a lot of the work that he's done and rethink the way that we think and talk about ADHD. And what I also found out was that he's not alone. There are other researchers who are also rethinking the research that led us here.

researchers who are also rethinking the research that led us here. This sounds like some pretty profound and personal soul-searching from Edmund and his peers in the field, potentially with broad implications for how we're thinking about ADHD. So I'm curious, what are they actually rethinking? Well, I would say they fit into two big categories. Some of them are rethinking some of the basic questions of what the definition of ADHD is. Is it something that is a categorical, biological condition where we can clearly say like, this person has ADHD and this person does not?

Or is it something that's more like a continuum where the lines between a person with ADHD and a person without are not so clear and distinct? And then the other group is thinking about our treatment and specifically the treatment with stimulant medications like Ritalin and Adderall. Okay, so it sounds like treatment and diagnosis. So kind of the whole thing. Let's start with how they're thinking about diagnosis. First of all, can you just walk me through

how do we diagnose ADHD? Sure, so there is this checklist of symptoms that doctors look at when they wanna diagnose ADHD. And these symptoms are laid out in the Diagnostic and Statistical Manual of Mental Disorders. And in order to diagnose ADHD, a clinician has to count a certain number of symptoms in a certain number of settings over a certain number of months with a certain level of impairment. Can you give us a little flavor of what's on that checklist?

One of the things that is complicated about the ADHD diagnosis is that there are two large categories of symptoms, and they often seem pretty different. So there is one category that's about hyperactivity and impulsiveness things like not being able to wait your turn, not being able to sit in your seat, interrupting people, and then the other category is inattentive ADHD and those often look very different than the hyperactive and impulsive kids. Those are often like they don't say anything when you speak to them. They're sort of dreamy.

They are losing things. They're not able to sustain their attention. And so you can often have two kids who are diagnosed with ADHD who might, from appearances, seem very different. And to me, what that does is it highlights this conflict within the field, which is that on the one hand, these are supposed to be really clear, empirical, objective definitions

of a certain disorder, something that you either have or you don't. But on the other, there's a lot of subjectivity involved. So put it another way, it sounds like this is actually not a simple diagnosis to make, because these children can have the same condition but exhibit very different behaviors. That's right. And there are other reasons, I think, that it is difficult to diagnose, including the fact that some of these symptoms are actually also symptoms of other things.

They can be symptoms of anxiety. They can be symptoms of early trauma. And I think that makes for a really challenging diagnosis, and that challenge is part of why the field has been looking for what they call a biomarker, a biological indicator of whether a child has ADHD or does not. And I think there were a couple of motivations behind this search for an ADHD biomarker, in part, like as a

diagnostic tool, right? If you could just put a kid in an MRI or something to measure their brain waves and say this child has ADHD, that would be really helpful. It would eliminate a lot of the subjectivity that we've been talking about. But the other reason I think was to shore up the legitimacy of the diagnosis. There always have been skeptics who just say like,

ADHD is not even a thing. Like it's just a made up diagnosis. These are just rambunctious kids, there is no such thing. And that's very frustrating, I think, for researchers who can see the great problems that a lot of kids have and see the medications are really helping them. And so to find a biomarker, to find something where they could say, look, it's real,

it's something very specific that you can see in this brain, this is a brain disorder and it's something with clear boundaries. I think that was very appealing to the field as well. Like this is a brain disorder, this is not just kids behaving badly, this is not just bad parenting. Exactly, it is something deep in the brain

that we can track, we can measure, and we can diagnose. So tell me about the search for that biomarker and how it has contributed to the soul searching in the field. So in the very early 2000s was the period I think of the greatest optimism about this. This was an era in a lot of breakthroughs in genetics especially and in lots of different conditions there was this belief that we were going to find the one gene that predicted each of these disorders and certainly including ADHD. There were early signs that there were these

electrical signals that seemed like they predicted ADHD, signs from MRIs as well. But then as the 2000s went on, a lot of those early experiments didn't hold up when a lot of those early experiments didn't hold up when larger, better studies were done with more sophisticated technology. And one by one, each of those early indications of potential biomarkers sort of fell apart. So the brainwave studies, when we got better equipment, no, there were no real brainwave differences between kids with the diagnosis and kids without. Genetics, as happened with lots of other psychiatric conditions, it was clear that there was no single gene that predicted ADHD. And then there was this really ambitious attempt to confirm those early MRI studies. It was done by this big international network of neuroscientists and psychiatrists called the Enigma Consortium. They had this database of 4,000 brain scans that they were able to look at. And they were able to, in this really detailed way, compare the brains of people

with ADHD diagnoses and people without. But when they finished looking at all of the data from all of those scans, they found that actually they weren't seeing much of anything. In adults and in adolescents, they didn't see any difference in the brains of people with and without the diagnosis. And in children, there was a small difference, but a really, really small difference. And just to be clear though, what you have just described, does that mean that there is no biomarker or does it mean that we just haven't found one yet? It means we haven't found one yet, but it also means we probably won't find one that

is as simple and clear as we'd hoped. Basically what we thought was there isn't really there. And this is frustrating for the researchers involved, including Edmund. He devoted many years to looking for biomarkers, and he basically thinks now that it was all a mistake. Chasing this biomarkers has been such a red herring for the field that it's taking us in the totally wrong direction.

And now he's really, I think, turned away from just focusing narrowly on the biology of ADHD. I'm not saying it's not biological. I'm just saying I don't think that's a proper target, really, to be honest. So basically, we're no closer to understanding what ADHD is now than we were back when we first started searching for a biomarker.

That's right. And the other place I think that started to have an effect is in our thinking about treatment. I mean, if this is not a clear, you know, black and white medical condition, is a medical treatment, a pharmaceutical, the best way to treat it? We'll be right back.

So Paul, before the break, you mentioned that researchers were just starting to reexamine the role of medication in treating ADHD. I'm very curious about the medication itself, though. Can you talk a little bit about what medication we're talking about and how we even came to it? Sure. So, the main medications that are used to treat ADHD are stimulants, Ritalin and Adderall and other similar medications. And there are some chemical differences, but basically they are all derived from amphetamines. And the way that scientists first got the idea

that these might be useful as a way to treat ADHD-like symptoms came way back in the 1930s before anyone had thought of the initials ADHD. And there was this doctor who ran his own home in Rhode Island for misbehaving kids. And he was trying to figure out what he could do to help them behave better. And amphetamines at the time were this kind of recreational drug, benzadrine, was the popular version. And so he just started giving daily doses of benzadrine to 30 or so kids who were in his home. And he noticed immediately this kind of miraculous change in these kids, that overnight their

behaviors improved, their mood improved, they followed the rules better, and it just felt like this kind of miracle cure. But what Bradley was doing sounds a bit informal, right? Like he's giving amphetamines to kids in this home essentially, which sounds pretty small scale, especially when you compare it to the amount of prescriptions that we see out in the world today. So I'm just sort of curious how we go from what he was doing in the 30s to this explosion that we see in the year 2025.

So we do know a lot more about these stimulant medications than we did back then. And there have been some much more sophisticated studies. And the one that I think is the most significant one started out in the early 1990s. Between 1990 and 1993, we went from having 1 million kids diagnosed with ADHD to 2 million, a huge rise. We're now up to 7 million, so things are a lot bigger than they were then, but this is like doubling in just a few years. And Ritalin was the big stimulant medication, and so it was what was being used to treat kids. But scientists didn't really know how effective it was.

They were seeing the same sort of thing that Charles Bradley saw, that it looked like when you gave this to kids that their symptoms improved often almost overnight, but they wanted to be more scientific about it. So, they devised this giant randomized controlled study in which they divided hundreds of kids up into different treatment groups. Some would get a daily dose of vertilin, some would get different sorts of behavioral treatments, some would get a combination, and then there was a fourth group where they didn't give them any particular treatments, they could just figure out their treatment on their own. So, you have a stimulant group, a therapy group, and a kind of control group that was not prescribed

any specific treatment at all, right? Exactly. So they studied it over 14 months, and at the end of the 14 months, the kids who had taken Ritalin every day were clearly doing better. Their symptoms were more reduced than children in any of the other groups. And so that was interpreted as this very clear message that Ritalin worked. It's the first thing that we should go to. And that message, I think, went out to doctors' offices and clinics all over the country and

all over the world. And it certainly seems that that message was well received just based on the number of prescriptions alone. Yeah. So during that era, this is now sort of the early 2000s, diagnoses continue to rise and prescriptions continue to rise as well. But those scientists who had been carefully studying Ritalin compared to these different other treatments, they actually continued to follow these children in this study for many years. And what they found was that after three years, the relative benefits of Ritalin

faded. And by the end of those three years, the children in each of these treatment groups were doing exactly the same. So the kids with Ritalin didn't have any advantage in terms of their symptoms over the children who had had the behavioral treatment. They didn't have any real advantage over the ones who had just been left alone to figure out their own treatment. All of the clear benefits that were there at 14 months had disappeared by 36 months. That really seems pretty stunning, this idea that this medication that has seen an explosion in prescriptions seems to have no discernible impact. Yeah, I mean it clearly does have an impact in the short term. But over the long term, this most reliable study found no relative benefit to Ritalin.

And there were other things that scientists were discovering at the same time. So one researcher described to me that the really sort of puzzling and discouraging thing for him is that even when we see the effect on symptoms, like that you can sit still in class, that you can like pay attention in class, that when you look at academic results, that when we look at sort of cognitive ability, there doesn't seem to be any corresponding impact, that the kids who take stimulant medications seem to be learning more, but that when you measure their results, they haven't actually learned any more than the kids who didn't take any

medication. But can I just ask, I'm curious, like, if the medication is getting kids to do more work, like, I don't know, for example, just filling out worksheets or multiplication tables or whatever, I mean, isn't part of learning like repeating something over and over again, like I'm just sort of curious how the exercise of just doing more work that is intended to get you to absorb and learn stuff doesn't actually have that effect.

Yeah, I think to a lot of researchers, it is a real puzzle. The research that helped make sense of this for me was another series of studies where researchers gave stimulant medication to a bunch of college students, had them do a bunch of cognitive tests. Their scores were no better if they had taken the medication or not. But then when they asked them, how did you feel about the work that you just did, the ones who had taken the medication said that they did better. They felt better about themselves. They felt

better about the answers that they had given. And that connects with other research that shows that the main impact of stimulant medication is on our emotions more than on our cognition. It makes us feel more motivated, feel more connected with the work that we're doing. Even if it's boring. Yeah, especially if it's boring. But I think what this indicates is that even if we think of these sometimes as smart pills, as things that are affecting our cognition, in reality what it's affecting is our emotional state. I mean, it sounds like what you're telling me is that there's no long-term measurable benefit from these drugs

and that even in the short term, they don't really work to improve academic performance in the way that we thought they did. Yeah, I mean, when you put it that way, it does sound kind of bad. But one of the things that strikes me when I talk to these psychiatrists is that they say that compared to other psychiatric medications, these are so good, right? Like they do a pretty good job, at least in the short term, of helping kids manage their symptoms,

remain calm in class. And they're so much more effective than, you know, antidepressants or a lot of anti-anxiety or anti-psychotic medications. They have fewer side effects. And most importantly, I think they're easy to stop. So a lot of psychiatric medications, when you take them, it takes a while for them to start working in your brain.

And then if you want to stop, it takes a while to wean off them. But if Ritalin or Adderall isn't working for you, you can just stop and it leaves your system almost right away. So from their point of view, low risk, high reward. Yeah, exactly. But there must be some side effects, right? Like every medication has side effects.

So did these researchers find any downsides? Yeah, so in this big randomized controlled study, they did find some significant downsides. And the main one was about the effect of stimulant medications on height, on growth. So this was something they weren't expecting, but in that first study, when they looked at the different groups after 36 months,

the ones who had taken stimulant medication consistently were about an inch shorter than the ones who had either started and stopped or hadn't taken the medication at all. Oh, wow. And now, you know, the same scientists have continued to follow this group for decades, and that height disparity hasn't gone away. I feel like most people would want that inch.

And I have to say, Paul, that's actually not what I thought you were going to say the downside was. Like, I thought you were going to talk about these drugs being addictive, because frankly, I just feel like I know people who, maybe in college or law school or whenever, they became really dependent on these medications and they did have a hard time getting off of them. And I know that that's just very anecdotal and not data, but is that an issue here? Do researchers think that these medications have addictive properties at all?

I think we're not sure. So I think, you know, absolutely for certain people, for certain personalities, certainly recreational amphetamines can be addictive. And I think for some kids and teenagers, even prescribed Ritalin or Adderall can be habit forming. When you look at the data as a whole, these medications don't lead to more addictive behaviors. And in fact, one of the things that I really heard when

I talked to teenagers who had been taking Ritalin or Adderall for a while is that it was kind of the opposite. It wasn't that it was habit-forming. They didn't really like it. They just didn't like the way that it made them feel. They would take it because they saw benefits nor because their parents or their teachers were telling them that they should. But most of them just couldn't wait to get off it. And when they had an opportunity, they would. So Paul, where does the research and the work go from here?

Like how are the people who are studying this condition right now thinking about ADHD and how to treat it, given everything that you've just laid out? But one of the things that's interesting to me is that they're often not saying that we need to diagnose ADHD any differently or treat it any differently.

They're just saying we should think about it differently. And a lot of that starts with thinking about the world surrounding kids more than just thinking about what's going on in their brains. And that gets me back to Edmund. So he is the scientist who I think is thinking about this stuff in the most interesting ways. And for him, this idea links back to his own childhood. I wish Moong was thinking, why don't people think like me? When I was was thinking, why don't people think like me? When I was at school, why don't people think like that?

I mentioned at the beginning, he was a terrible high school student, terrible at the kind of sitting still, switching from one topic to another, doing exactly what you're told. But it turns out he's actually kind of a great university student. So it was like day and night compared to what I was like four. He had this thing that he now calls hyper-focus that to his teachers back in Darby just looked

like, you know, mind-wandering, but that actually when you're trying to get deep on a subject, the way you do in university, it was really functional. And I did nine to five every day. So I'd go to the library, you know, even half eight in the morning, I'd sit in the library, get all the books out, all the journals out, and I'd work through to five o'clock. And so he would just start going to the library and studying hard and suddenly found his identity as a scholar. So instead of feeling like the failure, the bad kid, the kid who was always in trouble, he suddenly was getting positive reinforcement and good feedback and

like, oh, this thing that happens in my brain turns out to be really useful in this particular setting. He thinks that maybe the best way to think about ADHD is as this mismatch, this misalignment between the specific brain of a young person and the environment in which they're living. The idea of ADHD that you are describing sounds kind of situationally dependent, like something that works for you in one context could work against you in another context. Yeah, that's right. Not this kind of fixed idea of a condition you just

have or don't have, but something more transitory or mutable. And looking back on this experience now, even including being really miserable in school when he was a kid, he thinks that if he had received medication as a kid, his life might not have turned out this way. This must be a question for you.

Like, how would life be different if you had grown up in a different era or in a different town and had been diagnosed and prescribed Adderall or Rillam? Yeah, I think it's a very interesting question. What would be gained, what would be lost? I think I couldn't have gained anything. Wow. I might have gained peace of mind.

Oh, I'm a worrier, you know, I got all these, I have a lot of mind. I'm a worrier. I've got all these... I have a lot of... My mind is constantly... I mean, that thing is exhausting. Constantly churning away, thinking of things. And I never relax. So I suppose that's the thing. I'd like to be able to relax.

The only time I relax is when I'm dancing. Wow. I love dancing. I'm a big dancer. I still like dancing. So I would have liked to be able to relax a bit more. Maybe that would have done that. Maybe it wouldn't have done that. What do you think you would have lost? I don't know. But in my particular case, there's a lot of characteristics that have helped. I do believe the speed at which I think about things, the amount of things

I think about, my ability. And we didn't mention it last time, but you were saying... What he says is that he thinks that he learned some skills, some different ways of coping that have turned out to be really helpful for him. I am curious though, how Edmund feels about medication, given all of this. Like, does he think that there is a role for medication? Yeah, he absolutely does. All the people I know, whose kids have taken medication for ADHD, it was appropriate and it's helped improve outcomes. He thinks that the problem is seeing ADHD as a medical problem with a medical cure and that cure is stimulant medication? It's not a silver bullet. It never will be. One of the things that he says

is that for young people, for kids and for teenagers, one of the best things that medication can do is it can give a family a kind of a break. The way I see medication really, I suppose, is some, it's a window for parents then to engage, re reengage with their kids or to teach it to reengage with the child and to do the important work from there rather than as a medical solution to a medical disorder. That when you're in a family that is in a crisis, when a kid is just constantly losing lunch boxes and forgetting homework and that's all you talk about. All you're doing is just yelling at each other about these things.

But medication, because it does, for most kids, have this powerful effect, at least in the short term, on symptoms, it can give you a break from those quarrels and it can allow you a little bit more space to say, like, how do we wanna deal with this? It kind of just creates a space where people can reconnect, redevelop relationships, so forth and so on. And I think what he would say is that the problem is that a lot

of families stop their conversations there, that they look at the medication as the cure, as the end point. And he wants us to think of it as the beginning of a conversation, to think about what is going on with the misalignment between this young person's brain and the environment that they're in and to figure out what the path forward is. And maybe that continues to be medication. Maybe medication is the answer for the long term,

but maybe not. Maybe there are other changes that you can make now that things are a little calmer that will help better in the long term. Like what? that things are a little calmer that will help better in the long term. Like what? What he says is that what matters is the actual experience that people with ADHD symptoms are having. See, I think the biggest thing, and this is heartfelt, is self-hatred and low self-esteem.

He doesn't deny at all that kids are in all sorts of distress, that they're having a really hard time. But he thinks that's where our focus should be, rather than trying to figure out a very precise biomarker, let's look at the experience these kids are having and figure out how to help them. Because your mates, you know, your school, you know, this kind of sense of shame when you fail. Those are the things I think are crucial

in terms of the long-term well-being of not necessarily success in life, but you know getting a good job or anything just just being happy with in yourself. And instead of just trying to fix them by fixing the chemistry of their brain we can think about how to make their environments more amenable to them and also how to help them deal better with the parts of their environments that are not a good fit. The goal is to add skills and resilience rather than to reduce ADHD. Do you see what I mean? So it's the goal that changes. So I can totally see the case for changing a kid's environment rather than their brain chemistry in theory.

But in practice, you know, if you're busy and your kid is struggling and there's a prescription available to you, I can also just see why that is the option that you'd want to choose. And so I guess I'm having trouble envisioning, practically speaking, what does a change to a child's environment look like? Like, how would that actually play out in somebody's life? Well, I think that's something that he and a lot of researchers are still trying to work out. There's this one study that I found really affecting. It's actually with the same kids who were in that original Ritalin study back in the 1990s. When they reached young adulthood,

for the first time they were able to make decisions about their lives and what their environment was. And a lot of them had put themselves in places where they fit better. And what they were finding was that their problems with ADHD were going away. So there was one young person who was in film school, another who had started cutting hair,

another who was working on cars. And they all described that when I'm doing something I'm interested in, it's so much different than it was when I was in high school. This is stuff that I actually like, that I actually care about. And one of the things that I loved about that study was that it helped me understand Edmund Sanuga-Bark's experience as well, because he was a kid who in high school, he was just

in the wrong fit, in the wrong place for his particular brain, and he was miserable. And then he gets to university, this very academic environment, where suddenly his ability to think deeply about things for a long period of time was perfectly well suited. And suddenly he's in an environment where his brain fits. I mean, it's not like these kids are doing something similar to what Edmund did, right? Like finding environments where they could focus. So I wonder, Paul, how much of the way that Edmund is reconsidering all of this understanding about ADHD, how much of that reconsideration has broken through to the mainstream? I think it's kind of hard to measure. I mean, one of the things that is complicated about what he's

doing is that he's not really saying, you know, we should stop using stimulant medications or stop diagnosing as much as we are. He is talking about changing the way that we think and talk about ADHD, but I do think that that really makes a difference. And I think what a lot of people are coming to believe is that telling kids that there is this absolute, essential, inherent thing in you that is disordered, that you have this deficit, that that is not actually a helpful message you have this deficit, that that is not

actually a helpful message to give to kids, that that can often make them feel like they are stuck in this thing that is just broken in their brain. And that if instead you can say to kids, you know, right now you have got this problem and maybe medication is the right thing to do to help with that, but maybe there's something that can change in your behavior or something that can change in the environment that can help you. And next year, this symptom might not be there at all. I mean, in some ways, I think it's harder for a family to not have this sort of clear,

sharp definition of what the problem is. But instead, I think it gives the family a place to build on. Paul, thank you so much. Thank you. We'll be right back. Here's what else you need to know today. Israel continued to strike targets in Iran on Monday, including the headquarters of a state television broadcaster while an anchor was live on the air. While she spoke, an explosion shook the building, followed by the sound of breaking glass and

screams. And elsewhere throughout Tehran, residents weighed whether to take shelter or flee as gas stations ran short of fuel, internet and phone services were disrupted, and traffic snarled along a major highway leading out of the city. And a federal judge on Monday declared some of the Trump administration's cuts to the National Institutes of Health grants, quote, void and illegal, accusing the government of racial discrimination and prejudice against LGBTQ people. Ruling from the bench, Judge William G. Young of the Federal District Court for the District of Massachusetts

ordered the government to restore much of that funding for now, pending an appeal. Today's episode was produced by Alex Stern and Nina Feldman, with help from Ricky Nowetzki. It was edited by Brendan Klinkenberg and Michael Benoit, with help from Liz O'Balin. Research Help by Susan Lee. Contains original music by Marian Lozano, Sophia Landman, Rowan Nemisto, Alicia Beatupe, and Dan Powell, and was engineered by Chris Wood.

Our theme music is by Jim Brunberg and Ben Landsberg of Wonderly. That's it for the Daily. I'm Rachel Abrams. See you tomorrow.