ADHD often gets a bad rap because it seems like a “new” thing. The problem here is that it is an old problem that has been called many names, but just like a rose, whatever you call it, it still amounts to the same problem for many.

ADHD was described in a book of German Fairy Tales as “Fidgetey Phil” in the late 1800’s, and was first described in the medical literature by a Dr Alexander Crichton as “Mental Restlessness” in 1798, which most folks agree closely matches the DSM diagnosis for ADHD. In 1922, the group of symptoms we would now recognize as ADHD were described as Post Encephalitic Behavior Disorder. By 1937, it was discovered that benzedrine would help this group of symptoms in a group of children at the Bradley Home in Providence, Rhode Island- the first mental health/psychiatric hospital for children in the Country.

In the early 1960’s, this same cluster of symptoms was called Minimal Brain Dysfunction, and later, Hyperkinesia, or hyperkinetic disorder of childhood. In 1980, the Diagnostic and Statistics manual put out by the American Psychological Association (DSM-III) referred to ADD- Attention deficit disorder, with or without hyperactivity, taking into account the inattentive issues association with ADHD. ADD and ADHD were considered separate disorders. By 1987, The APA renamed the disorder Attention Deficit Hyperactivity Disorder and noted it was a medical diagnosis that could cause behavioral problems. They noted these behavioral problems to be different than those caused by emotional turmoil, such as divorce or moving to a new area.

In 1990, Dr. Alan Zametkin published research showing that the metabolism in the brains of adults who had been hyperactive since childhood was much different than those who were not classified hyperactive, when doing cognitive tasks, using PET scan technology. More recent studies using functional MRI and more advanced brain imaging technology continue to show differences in the brains of people with and without ADHD. It must be said that there is not yet any reliable brain scan test to determine whether someone has ADHD, although there are some centers who allege the ability to do so.

So ADHD has been called many things, but remains the same. It is unequivocally a neurological difference, and long-term studies from the NIH have shown the most effective treatment regiment appears to be a combination of medication with behavioral and cognitive therapy. This means while the medicine may increase a brain’s overall functioning to that of “normal”, it does not help instill the behavior and social skill deficits people with ADHD need to work on.

ADHD is often found along side other learning disabilities, and can make things like dyslexia more difficult for kids. Without effective treatment, many kids have a much higher risk of dropping out of school and getting into more serious trouble. A study out of the lab of Dr. Tim Wilens at Harvard suggests that kids treated with medication have a 6 fold less chance of developing a substance abuse disorder through adolescence; there are estimates that the juvenile justice system is composed of 75% of kids with undiagnosed learning disabilities, including ADHD.

ADHD seems to run in families. 80% of adults with ADHD have at least one child with ADHD, 52% have two or more children with the disorder. There are ongoing studies to look at the genetic aspects of ADHD, to try to find common genetic factors. Interestingly, recent research also shows ADHD affecting the limbic areas of the brain, involved with saliency determination and motivation, perhaps explaining in part why getting kids with ADHD going is much harder, and why they have a harder time picking out the most important issues in their environment.

New studies like the longitudinal National Children’s Study, looking at the developmental course of over 100,00 children from the pre-natal care stage through age 21, will answer some of the questions about what factors in the environment and during development may help trigger many diseases, including ADHD.

The development of new technologies is drastically changing the rate at which we are finding out about how the brain works, and what we know about learning issues like ADHD. Understanding this is a very real, neurological disorder hopefully will go a long way to destigmatizing kids and adults with this issue.

ADHD does cause problems for people with the disorder. Early diagnosis and treatment can head off many of the long term negative consequences, but early treatment will be a battle until we stop looking at ADHD as merely ineffective parenting, poor self-discipline, or other moral defects. That said, ADHD shouldn’t be an excuse, either, and doesn’t rule out ineffective parenting as an exacerbating factor. Kids and adults with ADHD have to take responsibility for their issues, and work with their strengths to compensate for their weaknesses- if anything, it should imply a greater, rather than less responsibility for their actions.

I used to get frustrated by the mexican jumping beans I called my kids, unable to sit at the dinner table for more than 30 seconds at a shot. It aggravated me, and led to a lot of yelling. Once I understood that this was part of the ADHD, I could be more patient and understanding. The activity bothered me less, and I could then help them learn ways to self-settle and clam themselves when need be.

We still have school issues from time to time, like forgotten homework, or distraction while trying to get homework done, but I at least expect and understand these issues now, rather than assume my children are lazy and only trying to drive me crazy. The truth is they are doing their best to execute as asked, but their brains don’t always cooperate. They will learn, over time, how to manage their own neurological quirks, and develop skills to work around the problem areas.

So I have learned to lighten up and laugh a little more, to be open with everyone about the ADHD in our house, and I can say, without a doubt, we are all happier and better adjusted because of it.

I hope this post has helped explain ADHD a little more for you. If you have any questions, or would like the references to the applicable scientific and medical journals, please email me at ldpodcast@gmail.com and I’ll be happy to send them your way.

by Whitney Hoffman

[tags]kids, children, parents, parenting, ADHD, ADD, Hyperkinesia, behavior, DSM-III, Attention deficit disorder, hyperactivity, MRI, PET scans, scanning, medicine, medication, stigma[/tags]