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ADHD Module

Historical Perspective

While there was an explosion of interest in AD/HD in the 1980s and 1990s, historical references confirm that individuals with symptoms that are now diagnosed as AD/HD have existed for centuries (Barkley, 1998; Conners, 2000). Throughout the early 19th century, children manifesting AD/HD-like symptoms were diagnosed as emotionally disturbed or having minimal brain dysfunction (MBD). The first published account of the disorder in the medical or scientific literature occurred in 1902 when a British physician, George Still, described children who were restless and had difficulties maintaining attention suggesting that these problems were the result of brain injury or dysfunction (Heward, 2006). In 1937, Charles Bradley, a pediatrician, published findings from an experiment in which children diagnosed with “behavior problems” were first successfully treated with a stimulant (Singh, 2008). Twenty years later, Maurice Lauffer coined the term “hyperkinetic disorder of children” to describe those who experienced symptoms synonymous with AD/HD. Lauffer and his colleague, Eric Denhoff, writing in the Journal of Pediatrics, “emphasized the organic components of the disorder and recommended the use of amphetamines for its treatment” (Singh, 2008, p. 351). Although not originally developed for hyperkinetic disorder, Ritalin was prescribed for children with these symptoms as early as 1955. By the 1970s, “Ritalin was being actively marketed to clinicians as a niche drug for [hyperkinetic disorder]” (Singh). From its origins as a neurobiological disorder, the diagnosis of AD/HD symptoms and treatment with stimulants has gone hand-in-hand.

Understandings of this disorder as a behavioral disorder crystallized in the 1960s and 1970s (Taylor, 2009). The syndrome first appeared in the 1968 edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-II) as hyperkinetic disorder with the focus on the hyperactive behaviors of children. The DSM is the publication of the American Psychiatric Association that is used by mental health professionals in making psychiatric diagnoses. It was not until the 1980 edition that the label Attention Deficit Disorder (ADD) appeared. Subsequent editions of the DSM presented revised diagnostic criteria with the most recent guidelines discussed in the section on Diagnostic Features and Subtypes of AD/HD.

 

References

American Psychiatric Association. (1968). DSM-II: Diagnostic and statistical manual of mental disorders. Retrieved from http://www.psychiatryonline.com/DSMPDF/dsm-ii.pdf

Barkley, R. A. (1998). Attention-deficit/hyperactivity disorder: A handbook for diagnosis and treatment (2nd ed.). New York: Guilford.

Conners, C. K. (2000). Attention-deficit/hyperactivity disorder: Historical development and overview. Journal of Attention Disorders, 3, 173-191.

Heward, W. L. (2006). Exceptional children: An introduction to special education (8th ed.). Upper Saddle River, NJ: Pearson.

Singh, I. (2008). ADHD, culture and education. Early Child Development and Care, 178(4), 347-361.

Taylor, E. (2009). Developing ADHD. Journal of Child Psychology & Psychiatry, 50(1/2), 126-132. doi:10.1111/j.1469-7610.2008.01999.x