Hi Jeannie:

Thank you for your comments!  Having conversations is a real gift!  So, yes, you may have actually read one of Hartmann's books back in the 90's where he talked about the upside he had noticed about what we call ADHD.  He was way out front with conceptualizing and discussing the evolutionary mismatch in the ADHD situation.  However, the term evolutionary mismatch did not gain popularity until the late 1990's and early aughts. 

I write about how threat response in ADHDers is why that brain type is the best for survival (the jungle) and nonADHD is not.  However, nonADHDers are at a perfect baseline dopamine (working memory) to be good at academics.  Since academics is actually a recent development in the history of humans, you can understand how the thousands of years of changes in the human brain to produce the best survival thinking and skills would end up being challenged by the "new" brain demands brought on by academics and so-called "civilization." 

As you note, docs have been put in a position of "needing" to make a diagnosis due to the way insurance has been structured around so-called official diagnoses.  In the mental health arena, those diagnoses are primarily based on behaviors, moods, self-reports.  Only certain things can be diagnosed by valid tests, and that is still open to interpretation. 

The pressures of the money makers on docs to be "efficient" and to go by so-called "best practices" is huge.  Medication can be useful if you understand how to find the correct one at the correct dose.  However, for those who benefit from increased working memory for academics, may wish to not use meds on days they are going to rock climb, or skydive, or do any sustained threat related activity.  You can learn a lot about why I say this when you read my book. 

I will say this:  If you wish to give your grandkids the best chance at utilizing what they have, you may need to do a lot of advocacy for them.  It sounds like you are getting ready for that.  Good for you! Take care, Ron