Hinshaw and Scheffler draw connections between education policy—the No Child Left Behind (NCLB) law—and other state accountability measures that fueled the push for higher test scores and performance, tied in funding, salaries and promotions, leading to a rise in diagnosis. In an interview with Los Angeles Times, they remarked that NCLB took effect in 2003 and by 2007, states that came under the accountability umbrella first saw a “59% increase in ADHD diagnoses among their poorest kids, but under 10% in kids from middle—and upper—income families in those states.” The roles of policy, resultant expectation of performance and subsequent medicalization also find ground in “individualization of social problems” and “depoliticization of deviant behavior” (Conrad and Schneider, 250). Individualization of social problems posits that we look at the problem as an individual's problem, not as one that might have its cause in "social systems." This is an important perspective, especially if we look at the factors that lead up to diagnosis of ADHD and a favorite solution—that of medication—which reduces behavioral problems and makes the child more acceptable in school and home thus marking the treatment as a ‘success.’ As an alternative, Schneider and Conrad suggest, "by focusing on the symptoms and defining them as hyperkinesis, we ignore the possibility that the behavior is not an illness but an adaptation to a social situation” (250). Moreover, “it diverts our attention from the family or school and from seriously entertaining the idea that the "problem" could be in the structure of the social system." Medications, they assert, “support the existing social and political arrangements” and ADHD becomes a "symptom" of an individual disease rather than a possible "comment" on the nature of the present situation,” thereby making “medicine a de facto agent of dominant social and political interests" (250). 

Given this historical and sociological perspective, how can we look at deviance/disability or, difference/disability? How do we perceive disability? Susan Wendell draws the distinctions between “difference” and “otherness” saying the former is generalized while the latter bears the weight of stigma. Wendell also names “difference” as “value-neutral” as it “leaves open the question of value” (66). Those values maybe negative, such as stigma, or, exotic and interesting, even desirable. Such views color the “cultural representations” of people with disabilities and can lend themselves to making the difference more interesting. For people with disabilities though, these differences would play out as a difference in perspective, knowledge and experience—such as Kim’s observation about people who learn differently and, when she explains that understanding the rhythms of the child’s brain, and “going in an out with the flow” of thought helps a child feel heard and thus make them more amenable to learning. Wendell, narrating Oliver Sack’s research and findings says that “if one looks at disabilities as forms of difference and takes seriously the possibility that they may be valuable, one begins to notice the lived reality of people one may have assumed were simply less able and less fortunate versions of oneself” (68). I discuss disability in greater detail later; with respect to ADHD, Oliver Sacks’ thoughts on one his patients may well be applied here:

"We are in strange waters here, where all the usual considerations may be reversed---where illness may be wellness, and normality illness, where excitement may be either bondage or release, and where reality may lie in ebreity, not sobriety. It is the very realm of Cupid and Dionysus" (Sacks, 1987, 107, qtd. in Wendell, 68).