Attention-Deficit/Hyperactivity Disorder (ADHD) in Children
- LAST REVIEWED: 09 May 2017
- LAST MODIFIED: 29 May 2014
- DOI: 10.1093/obo/9780199828340-0152
- LAST REVIEWED: 09 May 2017
- LAST MODIFIED: 29 May 2014
- DOI: 10.1093/obo/9780199828340-0152
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood, with a prevalence rate of about 5 percent of the childhood population (Polanczyck, et al. 2007 cited under Prevalence). The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (Washington, DC: American Psychiatric Association, 2013) defines the primary symptoms of ADHD as developmentally inappropriate levels of inattention, hyperactivity/ impulsivity, or both. These symptoms must be present in two or more settings with evidence that they were present before age twelve. Further, there must be clear evidence that the symptoms interfere with or reduce the quality of educational, occupational, or social functioning. Numerous potential causes of ADHD have been proposed, ranging from dietary factors to maladaptive educational systems, but the vast majority of these explain little variance in the development of ADHD. It is now generally accepted that no single factor is entirely responsible for the disorder and that ADHD is likely the result of a complex interaction between several biological/genetic and environmental factors. ADHD is associated with serious impairment in developmentally important areas, including family, academic, and social functioning, and is frequently comorbid with mood disorders, disruptive behavior disorders, and learning disabilities. Several studies demonstrate that youth with ADHD continue to experience difficulties as they grow up, resulting in poor long-term outcomes such as lower socioeconomic status/employment status, decreased academic achievement, substance use disorders, and difficulties with the law. Empirically based assessment of ADHD incorporates psychometrically sound rating scales to measure symptoms of ADHD and functional assessment interviews with teachers, parents, and other adults to determine factors that influence symptoms. Empirically supported treatments for ADHD include behavior therapy, stimulant medication, and the combination of the two. Parents and teachers play a critical role in the successful delivery and maintenance of each of these forms of treatment.
Although 25 percent of the general population believes that ADHD is not a “real” disorder and ADHD is sometimes attributed to 21st-century culture, there is, in fact, considerable evidence that for at least a few hundred years some children have had problems with inattention, hyperactivity, and impulsivity. Palmer and Finger 2001 uncovered a 1789 publication by Dr. Alexander Crichton that describes “mental restlessness” in a manner that is remarkably consistent with current conceptualizations of the disorder. Crichton’s original article was reprinted in a November 2008 issue of the Journal of Attention Disorders, along with an interesting commentary about it by Dr. Russell Barkley (Barkley 2008). Similarly, an early 1900s publication in which Dr. George Still provided a description of children who exhibited problems consistent with ADHD, including poor inhibition, a lack of self-control, excessive activity, high distractibility, and difficulty sustaining attention over long periods of time was reprinted in a 2006 issue for the Journal of Attention Disorders, along with a commentary by Dr. Barkley (Barkley 2006). However, another study suggests that the history of ADHD can be traced back even further, to a 1775 medical textbook by the German physician Melchior Adam Weikard in which he describes attention disorders (Barkley and Peters 2012). This article provides a clear summary of efforts to trace the historical origins of ADHD. The more recent history of ADHD arguably begins with seminal research by Virginia Douglas that is summarized in her Presidential Address to the Canadian Psychological Association (Douglas 1972). Largely because of Douglas’s work, attention deficit disorder (ADD) was introduced in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; American Psychiatric Association 1980). The disorder was renamed as attention deficit hyperactivity disorder (ADHD) in the revised third edition of the DSM (DSM-III-R; American Psychiatric Association 1980), with this name retained in the current edition of the DSM (DSM 5; American Psychiatric Association 2013).1.
American Psychiatric Association. 1980. Diagnostic and statistical manual of mental disorders. 3d ed. Washington, DC: American Psychiatric Association.
Describes the first formal definition of ADHD. Useful for understanding how ADHD has evolved over time.
American Psychiatric Association. 2013. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association.
Describes the current diagnostic criteria for ADHD including: a brief summary of information necessary for diagnosing the disorder, followed by more detailed information about the diagnostic features, associated features, prevalence, development and course, risk and prognostic factors, culture and gender issues, outcomes of ADHD, and common co-occurring conditions.
Barkley, R. A. 2006. The relevance of the Still lectures to attention-deficit/hyperactivity disorder: A commentary. Journal of Attention Disorders 10.2: 137–140.
Provides interesting commentary about Still’s early description of individuals with ADHD-like “mental restlessness” problems.
Barkley, R. A. 2008. Commentary on excerpt of Crichton’s chapter, on attention and its diseases. Journal of Attention Disorders 12.3: 205–206.
Provides interesting commentary about Crichton’s early description of individuals with ADHD-like “mental restlessness” problems.
Barkley, R. A., and H. Peters. 2012. The earliest reference to ADHD in the medical literature? Melchior Adam Weikard’s description in 1775 of “attention deficit” (Mangel Der Aufmerksamkeit, Attentio Volubis). Journal of Attention Disorders 16.8: 623–630.
Describes recent uncovering of an early description of attention deficits as a medical condition. Also reviews earlier efforts to uncover the history of ADHD, and provides commentary that places recent scholarship in historical context.
Douglas, V. I. 1972. Stop, look and listen: The problem of sustained attention and impulse control in hyperactive and normal children. Canadian Journal of Behavioral Science 4.4: 259–282.
A classic paper that describes Douglas’s early work on understanding the central deficits of what would later come to be called ADHD.
Palmer, E. D., and S. Finger. 2001. An early description of ADHD (inattentive subtype): Dr. Alexander Crichton and “mental restlessness” (1789). Child Psychology and Psychiatry Review 6.2: 66–73.
Presents Crichton’s early description of ADHD and places it in historical context.
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