Castles in the Sand
If it feels true that children with ADHD hear 20,000 more critical comments, why is the lack of evidence important?
Last week I posted about the oft-repeated claim that children with ADHD hear 20,000 more critical comments than other children during their childhood - and said that it turns out there is no data backing this up. It was just a thought-experiment by a psychiatrist back in 2010, and it has ricocheted around the internet ever since.
I had lots of responses, but one was from people who said, why did that matter? They said that it felt right to them, that children with ADHD are more criticised than other children, and so why was I spliting hairs? Surely the point holds, because children with ADHD may well hear more critical comments than others? Surely we should be trying to change that, rather than criticising the claim?
It matters to me because we are building narratives on sand.
In 2010, a time when most people diagnosed with ADHD were hyperactive boys, a psychiatrist suggests that they might hear 20,000 more critical comments than other children.
In 2016, as more women are being diagnosed in adulthood, another psychiatrist suggests that women with ADHD are more sensitive to rejection than others.
Both just ideas. Not based on research.
The two suggestions were then combined, so the story becomes ‘children with ADHD hear 20,000 more critical comments than others, and then this turns them into rejection sensitive adults’. Even though one suggestion was about early-diagnosed boys, and another about late-diagnosed women. No real reason to assume they have the same experience.
Many influencers leant heavily into this – with Alex Partridge, for example, referring constantly throughout his book to the extra 20,000 critical comments he feels he received in childhood, which, he says, turned him into a rejection sensitive adult. So much so that he says he is (literally) paralysed by his rejection sensitivity. He posted a picture of himself lying on the floor outside an event venue, unable to move, and told us to buy tickets to his live event in order to ‘prove his RSD wrong’.
But there are so many assumptions here.
Many children are criticised, not just those with ADHD – in which case, why do they not all become rejection sensitive? Extra critical comments are not, sadly, confined to those with ADHD.
Many people are highly sensitive to rejection and yet describe a childhood of people-pleasing and being ‘good’ – so how does that happen?
Many people says they spent their childhood masking – which implies others did not notice – so how did they also attract 20,000 extra critical comments?
Can we conclude that one really leads to the other, because we know there are many different ways for children to react to criticism (and for adults to become highly sensitive)?
These are the sorts of questions that scientists have to ask, because assumptions like this have real world consequences and they aren’t all positive.
They can make parents feel terrible even though they know they were not constantly critical. They can make people think they have ADHD when in fact they are just sensitive to rejection (which is extremely common). They can make people look back on their childhoods with a highly negative lens, discounting the good and accentuating the bad. They could even make people more sensitive to rejection, by the nocebo effect. That’s the opposite of the placebo effect. Tell people they are likely to experience something negatively and many of them will.
And they can stop us asking important questions about the individual and what happened to them. These are explanations built on sand. They may feel true for many, but that doesn’t mean we should just all nod along. People deserve better than this
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I think there is such an important conversation sitting underneath this.
Because I agree — evidence matters.
We absolutely need to understand where claims come from, especially when they begin shaping identity, support, interventions and the way people understand themselves.
Building understanding on information that has never been properly examined can create unintended harm.
And yet I also understand why conversations like this can feel difficult for many families.
Because for so many parents navigating neurodivergence, SEND or support systems, evidence has not always felt like exploration.
It has often felt like defence.
Prove your child needs help.
Prove you are not exaggerating.
Prove they are struggling enough.
Prove it isn’t something you are doing wrong.
So when new questions arise, even important scientific ones, they can land into an already exhausted nervous system.
Not because people don’t value truth.
But because many have spent years having their truth questioned before support arrived - usually very late.
I think perhaps the bigger challenge for us now is creating spaces where we can examine evidence without people feeling erased.
Where science and lived experience can sit together. Where changing our understanding doesn’t feel like another loss of safety.
Because curiosity is essential.
But so is recognising why, for many families, being questioned has rarely felt neutral.
But what about when the critical comments are coming from the child themselves?
Many high-performing kids who mask well have internalised impossibly high standards and judge themselves relentlessly.
When we focus on external criticism, we miss the child silently damaging themselves with their own voice.