History & Discovery of ADHD

ADHD, short for attention deficit-hyperactivity disorder, is a behavioral condition that is characterized by hyperactive, inattentive and impulsive behavior. Although ADHD is often viewed as a condition of modern times, reports of behavioral disorders with ADHD-like symptoms have been recorded since the 1700s. Since that time, ADHD has been known as mental restlessness, a defect in moral control, minimal brain damage, a hyperkinetic reaction of childhood and ADD.

Mental Restlessness

• In 1798, Sir Alexander Crichton (1763-1856), a Scottish doctor and author, wrote about a "mental restlessness" that seems very similar to the inattentive subtype of ADHD. Crichton described the characteristics of this disorder, which included inattentiveness and restlessness in children, which he called "the fidgets." He noted that the afflicted children were unable to pay attention in school and suggested these kids receive special education interventions. Crichton also mentioned that the symptoms of this mysterious condition typically disappeared as patients grew older.

Defect in Moral Control

• In 1902, Dir George Still, M.D., a British pediatrician, gave a series of lectures at the Royal College of Physicians. These lectures described a condition that triggered impulsive, overactive, defiant and inattentive behavior in numerous patients. Since these patients had normal intellectual levels, Dr. Still believed the unacceptable behaviors were caused by a "defect in moral control." He proposed that this defect was a genetic tendency toward moral deviation or the result of an injury at birth.

Post-Encephalitic Behavior Disorder

• After the 1917 and 1918 encephalitis epidemics, many pediatricians noticed an increase in the number of patients who were exhibiting symptoms of hyperactivity, lack of focus and impulsiveness. The doctors decided these behaviors were the result of brain damage from the encephalitis, an illness that causes inflammation of the brain. As the affected children grew older, however, the doctors discovered that most of them were actually very intelligent. They renamed the condition "minimal brain damage."

Hyperkinetic Reaction of Childhood

• A disorder with ADHD-like symptoms first appeared in the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) back in 1968. Called "hyperkinetic reaction of childhood," the primary symptom was hyperactivity. Minor symptoms included the inability to focus and a sense of restlessness. Ritalin, a stimulant medication, had been introduced in the mid-1950s, and now became widely used to treat hyperactive patients. Mental health care professionals believed hyperactivity was a childhood condition that patients would eventually outgrow.

ADD

• During the 1970s, academic and medical research began focusing on the inattentive symptoms of ADHD-like behavior. Virginia Douglas, Ph.D., and Susan Campbell, Ph.D., determined that inattentiveness, daydreaming and lack of focus were all associated with verbal, physical and cognitive impulsiveness. Their research inspired the medical term "attention deficit disorder" (ADD). The 1980 version of the DSM included sets of diagnostic criteria for ADD both with and without hyperactivity. Mental health professionals started noticing that many parents of ADD children appeared to have some of the symptoms themselves, and adult ADD came into focus.

ADHD

• By the late-1980s, researchers had shifted their focus away from inattentiveness and introduced the theory that ADD was caused by the brain incorrectly receiving or translating the incoming information. The APA renamed the disorder "attention deficit-hyperactivity disorder" (ADHD), and defined three primary subtypes: predominantly inattentive subtype, predominantly hyperactive-impulsive subtype and a combination subtype. Although the American Medical Association (AMA) has stated that ADHD is the most widely researched behavioral disorder, the exact cause of ADHD remains unknown.