Psychotherapist Erica Komisar has reignited debate over the causes of Attention Deficit Hyperactivity Disorder (ADHD), arguing that long hours in daycare during infancy may contribute to rising diagnoses by exposing young children to chronic stress during critical stages of brain development.
Speaking on former Deputy Prime Minister John Anderson’s podcast, the New York-based psychotherapist and author claimed that modern childcare practices are placing pressure on infants whose brains are not yet equipped to manage prolonged separation and elevated stress levels.
“First of all, daycare is terrible for children. Absolutely terrible for children and their developing brains,” Komisar said.
She argued that the issue extends beyond childcare settings themselves.
“Daycare is a symptom of a bigger problem, which is that people are not well-versed, policy makers, educators, parents, pediatricians, employers, they’re not well-versed in child development.”
Komisar said research had identified elevated stress markers in some children attending daycare.
“There are studies to show that babies who are put in daycare have very very high salivary cortisol levels,” she said.
She described scenes she claims can occur in some childcare environments where staff are responsible for multiple infants at the same time.
“If you saw what actually happens in a daycare centre when nobody is watching… you would be appalled. Crying babies, babies who cry and scream until they vomit and are not picked up because there is no way… to soothe eight babies at the same time.”
Her argument centres on the role of cortisol, commonly known as the body’s primary stress hormone, and its effect on the developing brain.
“When you raise those levels of stress hormones in the brain, it actually doesn’t allow the brain to develop in a normal way. It ends up forcing the brain to develop in a pathologically adaptive neurologically compromised way,” Komisar said.
“We’re projecting onto very very young human beings that they are more capable of managing stress than their brains actually are. Their brains are not yet wired to manage cortisol levels that high.”
“If you saw what actually happens in a daycare centre when nobody is watching… you would be appalled. Crying babies, babies who cry and scream until they vomit and are not picked up because there is no way… to soothe eight babies at the same time”
She added: “We’re throwing the baby into the cold swimming pool and saying sink or swim, and that baby goes into a survival mode, what we call learned helplessness, and they are chronically in a state of flight.”
Komisar argues that this chronic activation of the brain’s threat detection system may help explain behavioural patterns commonly associated with ADHD.
“The amygdala is the threat-sensing part of the brain… stimulating the amygdala… to be overly active,” she said.
“ADHD is not a disorder. It’s a stress condition. It’s the brain’s response to stress… fight or flight… the flight part of fight or flight as being distractibility, which is what ADHD is.”
She compared prolonged stress exposure to leaving a light switch permanently turned on.
“Chronic stress to a baby’s brain… Think about leaving that light switch on. Eventually… it burns out. And that’s what’s happening when the amygdala is prematurely activated.”
“They are chronically in a state of flight… hypervigilant mode.”
Komisar’s comments challenge a large body of scientific research that identifies ADHD as a highly heritable neurodevelopmental condition. Twin and family studies have consistently found a strong genetic component, with many researchers estimating heritability at between 70 and 80 per cent.
While environmental influences are also widely recognised, including prenatal exposures, early adversity and family circumstances, most contemporary research views ADHD as arising from a combination of genetic and environmental factors rather than a single cause.
Komisar rejects that interpretation.
“There is no genetic precursor to ADHD. There’s no genetic precursor to depression and anxiety. These are disorders of what we call inheritance of acquired characteristics.”
“They actually are environmentally influenced… children don’t develop those disorders because their father had them genetically.”
“ADHD is better understood as a stress response than a disorder.”
The broader research on daycare and child development remains mixed. Some studies have linked extended periods of early non-parental care with elevated cortisol levels, behavioural challenges and hyperactivity, particularly where care quality is poor. Other large-scale studies have found little evidence that time spent in childcare alone determines long-term mental health outcomes, with family stability, childcare quality and individual circumstances playing important roles.
Australia has experienced a steady increase in ADHD diagnoses over the past decade, reflecting greater awareness, expanded assessment pathways and changing approaches to diagnosis. Researchers continue to debate the relative contribution of genetics, environment, education systems and social factors to that trend.
Komisar’s remarks have added another perspective to that discussion, raising questions about infant care, parental leave policies and the role of early childhood environments in shaping long-term mental health outcomes.
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