Cultural-Historical Neuropsychology and ADHD: Commentary on the Article “ADHD Diagnosis from the Perspective of Cultural-Historical Neuropsychology” by Athanasios Koutsoklenis, Yulia Solovieva, and Luis Quintanar Rojas

Abstract

This article presents a commentary on the paper “ADHD Diagnosis from the Perspective of Cultural-Historical Neuropsychology”. The authors of this paper, Athanasios Koutsoklenis, Yulia Solovieva, and Luis Quintanar Rojas, strongly advocate for a paradigm shift from the traditional diagnostic approach to cultural-historical neuropsychology (CHNP). According to the authors, the CHNP approach allows us to reject ADHD diagnosis when assessing the corresponding syndrome. The authors suggest that such a departure from an intermediate level of abstraction (in the form of a diagnosis) in favor of the results of neuropsychological evaluation of a particular child will enable a direct transition to personalized recommendations for corrective and developmental support for that child. Despite the commonality of our initial theoretical positions, namely the principles of cultural-historical psychology and neuropsychology developed by Lev Vygotsky and Alexander Luria, I do not agree with the solution proposed by the authors regarding the issue of diagnosing ADHD. The proposal to renounce the diagnosis of ADHD does not address the issues of providing support to children and their stigmatization. These problems are either resolved or left unresolved depending on the resources available to help a child in a given social context. The solution lies in enhancing the efficiency of the support provided to children, including the neuropsychological support. The rejection of the diagnosis and the attempt to justify this through CHNP involves overlooking several of its key principles, which could ultimately lead to discrediting of CHNP. Furthermore, while rejecting the ADHD diagnosis we simultaneously refuse the necessity to further investigate the mechanisms of the syndrome via current and future scientific tools.