ADHD as a Systemic problem, not an individual one

Why Diagnosing the Child Without Examining the System Is a Clinical Oversight

There’s a growing chorus of voices- therapists, educators, and parents- who are starting to say out loud what many of us have sensed for years: ADHD is not just about the individual.

It’s not just a brain-based disorder. It’s not just executive dysfunction. It’s a systemic problem. One that reflects a mismatch between human needs and the environments we are expected to adapt to. And more often than not, it’s the child who carries the diagnosis, while the system around them remains unchecked.

We Call It a Disorder. But Disorder of What, Exactly?

When a child is diagnosed with ADHD, the focus zooms in-quickly-on attention, impulse control, hyperactivity. But rarely do we widen the lens to ask why a child might be dysregulated in the first place.

• What if the child’s so-called inattention is actually attunement to emotional undercurrents in a chaotic home?

• What if their impulsivity is a biological response to inconsistent caregiving or unclear boundaries?

• What if the school system they’re in is fundamentally unfit for neurodiverse ways of learning, moving, and processing?

In family therapy, we talk about the identified patient-the person in the family who shows the symptoms, who "acts out," but often just reflects the deeper dysfunction of the whole system. In many ADHD cases, especially in children, the child is this identified patient.

The Myth of the Broken Brain

The medical model loves individual responsibility. A child can’t sit still? Must be a chemical imbalance. An adult can’t manage time? Must be faulty wiring. Cue the stimulant prescription, the productivity hacks, the shame when the strategies don’t “work.”

What’s missing is context. Because here’s what we don’t always say out loud:

• ADHD traits are more likely to emerge in families facing trauma, poverty, intergenerational chaos, or systemic oppression.

• Schools are designed for still bodies, compliant voices, and standardised output-not divergent thinkers.

• Adults with ADHD are often those who were unsupported as children, punished for their sensitivity, and misunderstood as defiant.

So is it the brain that’s broken, or the systems that keep asking square pegs to fit into round holes?

ADHD as a Response, Not a Deficit

Let’s consider ADHD not as a disorder, but as a relational response to environments that are too fast, too punitive, too disembodied.

• What if difficulty concentrating is a nervous system in defence mode?

• What if task avoidance is an unconscious protest against meaningless, disconnected work?

• What if hyperfocus is not pathology but the refuge of a mind starved for stimulation or safety?

The issue isn’t just how a child functions, but how the environment responds to that functioning. The classroom. The family dynamics. The cultural values. The digital overload. The economic stress. The legacy of trauma.

Why Family Therapy (and Systemic Practice) Matters

In systemic work, we stop asking “What’s wrong with you?” and start asking “What’s happened to you?”, “What are you adapting to?”, and “What are you carrying for this family, this culture, this time?”

When a child presents with ADHD-like traits, we zoom out:

• What’s the emotional climate of the household?

• Are caregivers emotionally available, or are they drowning in their own unprocessed stress?

• What narratives about success, compliance, or identity are being unconsciously enforced?

• Is this behaviour a signal, not a symptom?

We Don’t Need More Labels. We Need More Listening.

The rise in ADHD diagnoses is not simply a diagnostic triumph-it’s also a cultural red flag. Children are telling us something, with their bodies, with their fidgeting, with their refusal to conform.

And maybe instead of medicating the message, we should start listening. Not just to the child, but to the system they’re a part of.

Because ADHD isn’t just in the brain.

It’s in the home.
It’s In the school.
It’s in society.
It’s in the legacy we inherit and the culture we maintain.

Until we name this, we’ll keep treating the messenger and ignoring the message.