It’s often repeated that children with ADHD receive 20,000 more critical comments over the course of their childhood than neurotypical children. I’ve been told it at conferences, read it in articles, and most recently, read it in Alex Partridge’s best-selling book Why Does Everybody Hate Me: Living and Loving with Rejection Sensitivity Dysphoria. I may have even referred to it myself in training. It is widely accepted and spoken about as truth.
Partridge has actually made this claim a central part of his book. His first chapter is called ’20,000 Tiny Cuts’ and he refers to it repeatedly throughout the book to bolster his argument that people with ADHD are uniquely sensitive to rejection. Other people, those without ADHD, he explains, are able to rationalise rejection and don’t ruminate on it. They put things in proportion easily and move on with their lives. They don’t see rejection where none was intended. That’s because they didn’t have those 20,000 negative remarks about themselves in childhood.
As a clinical psychologist, I know that this isn’t true. Rumination and intense sensitivity to rejection is common in humans. Growing up in a critical environment is not limited to those with ADHD, and it doesn’t inevitably lead to rejection sensitivity. There are many different outcomes.
But that claim – the 20,000 cuts – I started to wonder. Where did it come down? Who was the comparison group? How did the researchers come to that conclusion – because it’s sure that they did not stick around to count 20,000 critical comments. Partridge said it was an ‘estimate’ – but what sort of estimate? Based on what data? He didn’t include a citation.
I set out to fact check, and what I found surprised me. This figures, as far as I can find, is based on no data at all. It can be traced by to a thought experiment by a child psychiatrist (Michael Jellinek) in a non-peer-reviewed journal (MD Edge Psychiatry) in 2010. He asks us to imagine a hyperactive child at school who could, he suggests be corrected by a teacher an average of three times an hour. Then he multiplies that up and says “In school alone, a child with ADHD could receive 20,000 corrective or negative comments by the time he or she is age 10.”
Yes, they could. But also, they could not. This is an entirely imagined scenario. No comparison with other children, no data collected on children with ADHD. No clear definition of what sort of comments might be deemed to be ‘corrective or negative’. No recognition that children with ADHD are very different to each other, some will not attract negative attention at all. Also no acknowledgement that this happens to other children too – those with learning disabilities, for example. Or those whose behaviour is challenging in a group environment. ADHD is not the only thing that is problematic in a school classroom.
That, as far as I can tell, is the source of the 20,000 critical comments claim which is now repeated all around us.
The thing is, this figure feels right to lots of people. It chimes with lived experience, and so it gets repeated. And the more it is repeated, the more true it feels because it is familiar. We don’t stop to fact-check because we think ‘I’ve heard that before’. I’m not blaming Jellinek, he could not have known that his claim would have the power it had. He was, after all, just asking us to imagine a possibility.
But, it’s become a viral claim, we all accept that it must be true without stopping to ask why.
When we do this, we build our narratives on shaky ground. For Partridge uses that ’20,000 cuts’ claim as the basis for his whole book. This, he says, is the reason why people with ADHD become so sensitive to rejection, why they learn to mask, why they are so full of shame. It all makes sense, he says, if you consider those 20,000 negative comments which other children haven’t heard.
Maybe, but maybe not. Without the data to back it up, we really can’t be sure.
Why does this matter? Because this is building on foundations of sand. Whole narratives are being developed – but there is no firm data underpinning it. It stops us from really understanding people’s reality, because we’re extrapolating instead. Imagining reality, rather than working out what is really happening.
We have to get better at checking our sources. Just because something feels true, doesn’t mean that it is.
Thank you for returning to research to consider the truth of this. This is a very helpful post.
Thanks again Naomi for shining a light on how we frame many of our perceptions of the way society looks at the diversity of human development. Confirmation bias can be such a shaky phenomenon sending us down the rabbit hole of predictive behaviour across society. While rumination can end in shame it's not always the case and we all have different levels of acceptance of criticism indeed much of it is highly contextualised and needs to be seen through that lens. We need to be aware of our own biases. What we really need to do is key into each individuals responses and not blanket the world with the sameness that all ADHD or indeed Austic people recieve signals in the same way.