When Did ADHD Start?

I was surprised to see an article in a major newspaper (The Toronto Star) reporting that ADHD didn’t exist until the 1950′s. They based this opinion on research by medical historian, Matthew Smith. While I support ongoing research and review of the history, I’m concerned about the impact of an article like this on the many families who are working hard to overcome stigma to get the help they need for ADD and ADHD.

The history of ADHD, as I see it, includes the fact that ADD and ADHD started out as a ‘moral diagnosis’. In other words – people started out by viewing people with ADD and ADHD as ‘bad people’. They were viewed as ‘lazy’, needing to ‘try harder’, etc.

Medical, neurological and genetic research has clearly established the reality of ADD and ADHD, and now we have moved more toward a ‘medical diagnosis’ of ADHD.

This researcher is suggesting that ADHD is a consequence of our modern and structured society. He suggests that the early medical accounts of ADHD – i.e. Dr. Hoffman’s poem in the mid 1800′s, or Dr. Still’s account of ADHD in 1902 were not accurate. He is suggesting that ADHD is a social construct, and not a real disorder, and it only became an issue in ‘modern society’.

ADHD is NOT a social construct – it is a real disorder.

In my work with bestselling author Dr. Hallowell, we discussed how the history of ADHD needs to evolve from the moral diagnosis, to the medical diagnosis, to the strength based diagnosis. The ‘strength based’ diagnosis is the evolution of the disorder – and suggests working toward how ADHD can actually be an asset for people who are diagnosed with it. You can read more about this in a special report we wrote here.

When the diagnosis of ADHD goes from being a disorder to ‘traits’, people can maximize their natural abilities and passions to do very well.

In the Toronto Star article, Matthew Smith is quoted as saying that the symptoms of ADHD which may interfere with school may be a ‘boon on the soccer pitch’. As a doctor who works with ADD and ADHD kids and teens on a daily basis, I regularly hear of kids with ADHD who struggle in sports like soccer – where their inattention has then watching the clouds rather than the soccer ball.

However, while Mr. Smith and I may disagree on the history of ADHD, we are not too far apart when it comes to the suggestion that people with ADHD can use their ‘traits’ as an asset. My main concern with his position is that the approach that he is taking discredits ADHD and promotes ignorance about the disorder. Even if his opinion is based on good research – by the time it gets to a ‘media soundbyte’, it ultimately takes away from the kids and teens who are dealing with an uphill battle. And it further stigmatizes ADD and ADHD. This is something that I am not interested in doing.

Please share your thoughts and comments in the discussion below.

Best,

Dr. Kenny

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Comments

  1. Thanks Dr. Kenny for clearing up this bit of misinformation.

    I missed that article, which apparently was published about the time I was attending and speaking at the CADDAC conference in Toronto.

    Seems the hundreds of adults who showed up to learn more about ADHD, after suffering for years due to rampant ignorance from physicians and therapists alike, might have taken umbrage at the piece.

    Indeed, as you point out, ADHD doesn’t always offer any advantages on the sports field (or sometimes any place else); in fact, it can dampen any natural sports ability due to distractability, impulsivity, poor planning ability (such as preparing for a game), etc. Several major-league baseball players have come forth in the media to explain how their ADHD often interfered with their ball-playing and how treatment has allowed their abilities to shine.

    Increasingly, we have historical evidence that ADHD has been described in the medical literature for more than 100 years — even dating to 1798, according to recently re-discovered medical textbooks from a Scottish physician. I write about it at my blog: http://tinyurl.com/la3w9r

    Unfortunately, some in the liberal arts academia crowd who apparently never took a shine to science classes are seeking to make a name for themselves by writing diatribes about brain disorders being “social constructs.” They conveniently leave out the fact that at no time in our history have we humans been at the mercy of so many distractions; it takes an extremely strong prefrontal cortex to resist derailment, in my opinion.

    I find their efforts shameful, as these authors are willfully pandering to a science-phobic public for their own self-aggrandizement. No, I can’t be charitable to these authors one iota, because their message denies the very real suffering encountered by people with these “social constructs.” Moreover, I would question how many suffer from their own undiagnosed conditions, such as oppositional defiance.

    As you rightly point out, they create more stigma than illumination. We need to be moving forward, not backward to the 1950s or farther.

    Gina Pera, author
    Is It You, Me, or Adult A.D.D.?
    Stopping the Roller Coaster When Someone You Love Has Attention Deficit Disorder
    http://www.ADHDRollerCoaster.org

  2. even if ADD and ADHD are real disorders, so what? Are we just going to tell our kids, it ok to not do well in school because you have ADD? You can just live on the government for the rest of your life? Making such a big fuss about this issue is just letting kids who are not interested in school make excuses. Hellen Keller was blind and deaf. Her teacher taught her that just because she is disabled in some sense does not exempt her from learning, and look at how far she went. People like you guys who tell kids poor you, you have to suffer from ADD and attend class, is not helping them. I’m not saying they don’t deserve extra time and extra help from both parents and teachers, but don’t let them think they can get away from learning because they have ADD. I’ve seen friends make that same ADD excuse from junior high all the way through high school, and they failed because of it, even though they are perfectly intelligent people capable of passing. Many students even joke about testing for ADD so they can skimp out on assignments. Even if I had ADD i would not want to know because I would not want to be tempted to use it as a crutch.

  3. Exactly, you can say whatever you want about this “disorder” but you are still not showing real proof. What happen with the kid that got addicted to Adderall and can’t get off? Is that in your statistics Dr.?

    Deep inside You know that this ADD and ADHD is not real and that these kids are just not adapting to the School system. BUT you won’t ever admit this because you are a Dr and you already published a book on this and you probably supported kids are prescribed these drugs and you have a reputation etc. and it would make you feel so wrong and bad if you say the real truth.

    I’m with Matthew Smith who had integrity and said the truth.

    • Obviously, you do not have a child with ADHD!!! I was in denial for one year, telling psychologist, that my boy is smart, intelligent, and so on…till I read about ADHD, and…it was my boy, exactly, 100%. I have 4 kids, so, have experience, can compare…we are doing homework with him taking turns, because not a person have that patience to take it every day… 3 hours, and it’s 2nd grade!!! 3hours every day, including weekends, we refused meds, but we suffer a lot, he’s 7 and half, and all his life I have to remind him to buckle many times per day!!! I’m not even talking about dressing in the morning, putting on socks…if you had a child like that, you would know!!! I even can diagnose ADHD myself at public places now…parents do not know, or are in denial as was I…by the way, school refused IEP because of our hard work, he has all 3s, and is not behind at any subject yet…My only hope, that he will outgrow it at age 13( God help, please!!!)

  4. I am a high school senior, diagnosed with ADHD the summer after my 8th grade graduation, and I find your downplay of ADHD to be extremely ignorant and offensive. There are a couple of good points you have brought up, which are the possibility of ADHD being used as a crutch, and the possibility of addiction to the stimulant-based medications used to treat ADHD. First of all, there is much suspicion (well-backed suspicion, i might say) about an extreme over-diagnosis of ADD and ADHD, which I will agree with, but that does not mean that those rightly diagnosed will use it as a crutch. In fact, knowing that I have ADHD has helped me to know what I have to do to fix my grades. Second, these medications (adderall, ritalin, concerta, focalin, and dexedrine) may be addicitive, BUT only when misused, abused, or erroneously prescribed will they result in a full-on addiction. I also have experience with this, as when I miss several consecutive days of medication, I start to feel some mild affects of dependence on it, but the dosage and release of the medication are such that the medication has to be deliberately taken as a “happy drug” in order to develop a full-blown addiction.

    I will tell you right now that ADHD IS REAL. I frequently find myself drawn away from tasks that are mundane, such as homework, because of the setting in which homework is done, as well as the different wiring of an ADHD brain. Think of it this way. A thought process is like a climber scaling a wall with a rope. The non-ADHD climber has a secure and strong rope, and moves at a moderate pace up the wall, perhaps missing a step here and there, but being held up by the strong rope, and making it up the wall in a timely manner. The ADHD climber, however, moves faster, though with more precision., but is held up by a frayed rope. This climber makes one mistake, and falls, having to re-tie the rope and try again, and as a result, the thought does not always make it onto the paper before the mind has moved on to something else.

    Tests, on the other hand, are timed and structured, as well as often being bubble-in. While the normal mind might be frantically trying to find the answer, moving slowly and methodically from one part of the memory to the next, the ADHD mind has the advantage due to a greater thought volume, resulting in quicker recollection, though sometimes cursory mistakes are made.

    One factor in tests and homework that I mentioned, but have not yet addressed, is the environment. During a test, students are closely watched and little is allowed that may distract the students. It is an environment built to aid focus. Homework, on the other hand, is often done at home, where many distractions are available, possibly even unintended ones. I personally have trouble with homework when working nearly anywhere in the house. I am convinced that my father is going deaf, because no matter where in the house I am, or how many closed doors are between me and the living room, I can always clearly hear the tv, and it draws my attention away from my homework, resulting in much more time taken than would normally be needed.

    Now I do not claim professional knowledge of ADHD, but this is what I have found through research and my own experience. I love taking tests, but hate doing homework. I excel in classes graded more on knowledge and mastery of material than “effort” (in my opinion, if you put forth the effort, then good for you, but you won’t get the credits (which say that you know the subject!) unless you actually do know the subject). I scored a 5 on the AP Chemistry test last year, and expect to do the same this year on AP Calculus and AP Physics. I am not addicted to my medication, nor am I a lazy oaf. I have ADHD

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