What is ADHD and where is it from? Tristram Jones, Ph.D. Kaplan University Exceptional Children Unit V

Dr. Henrich Hoffman may have given the first list of ADHD symptoms in 1845 –he wrote children's books. A portion of Fidgety Philip, from the German: A portion of Fidgety Philip, from the German: See the naughty, restless child Growing still more rude and wild, Till his chair falls over quite. Philip screams with all his might, Catches at the cloth, but then That makes matters worse again. Down upon the ground they fall, Glasses, plates, knives, forks, and all. How Mamma did fret and frown, When she saw them tumbling down! And Papa made such a face! Philip is in sad disgrace. See the naughty, restless child Growing still more rude and wild, Till his chair falls over quite. Philip screams with all his might, Catches at the cloth, but then That makes matters worse again. Down upon the ground they fall, Glasses, plates, knives, forks, and all. How Mamma did fret and frown, When she saw them tumbling down! And Papa made such a face! Philip is in sad disgrace.

Did somebody discover ADHD? YES! As a matter of fact somebody did! Credit usually goes to Dr. George Still, an Englishman who considered it a medical disorder beyond the control of the patient. He called it “DEFECT OF MORAL CHARACTER” in 1902 which probably wasn’t the best possible label!

Post-Encephalitic Behavior Disorder? Symptoms identical to those we ascribe to ADHD were listed in 1922 in the United States, but were ascribed to Encephalitis and deemed the ramifications of that disease.

How About Stimulants? In 1937 Dr. Charles Bradley introduced the use of stimulants (benzedrine) to treat children exhibiting ADHD symptoms of hyperactivity. “It appears odd that a drug known to be a stimulant should produce subdued behavior.” Bradley thought a center in the brain was responsible for inhibiting activity. Many still believe that amphetamines in low doses calm hyperactive children. This effect, they believe, is distinct from the stimulating properties that amphetamines have on healthy children or adults.

But is that true? Bradley’s theory of reverse effect was challenged in 1980 by Judy Rapoport NIMH. Under well- controlled conditions, they surveyed the cognitive and behavioral effects of stimulants on both hyperactive and non-hyperactive children. Both groups performed better when taking stimulants. Bradley’s theory of reverse effect was challenged in 1980 by Judy Rapoport NIMH. Under well- controlled conditions, they surveyed the cognitive and behavioral effects of stimulants on both hyperactive and non-hyperactive children. Both groups performed better when taking stimulants. SOME OF US KNEW IT ALL ALONG!

By the 1960s it had become: “Hyperkinetic Disorder of Childhood” During the sixties the diagnosis for these symptoms changed twice to "Minimal Brain Dysfunction” and then to "Hyperkinetic Reaction of Childhood.” (Note the During the sixties the diagnosis for these symptoms changed twice to "Minimal Brain Dysfunction” and then to "Hyperkinetic Reaction of Childhood.” (Note the Psychoanalytic influence from 1968) The symptoms were certainly familiar: restless, fidgety and overactive restless, fidgety and overactive continuously chatter and interrupt people continuously chatter and interrupt people easily distracted and do not finish things easily distracted and do not finish things cannot concentrate on tasks cannot concentrate on tasks impulsive, suddenly doing things without thinking first impulsive, suddenly doing things without thinking first difficulty waiting their turn in games, in conversation or in a queue. difficulty waiting their turn in games, in conversation or in a queue.

In 1980 we were given ADD and lack of focus, inattention, and verbal/cognitive/motor impulsiveness as symptoms. Attention Deficit became widely reviewed in the 1960s and 1970s. The focus then was primarily on hyperactivity. This changed in the 1970s when researchers began making the connection between the inward daydreaming and lack of focus and the outward impulsivity. By the 1990s, Attention Deficit became widely studied, discussed, debated and diagnosed.

Today we have ADHD in three varieties! Today we have ADHD in three varieties! mainly inattentive mainly inattentive mainly hyperactive-impulsive mainly hyperactive-impulsive and both in combination. and both in combination.

Dr. Fred A. Baughman, Jr. “Twenty five years of research, not deserving of the term 'research.,' has failed to validate ADD/ADHD as a disease.” “Twenty five years of research, not deserving of the term 'research.,' has failed to validate ADD/ADHD as a disease.”

Doris J. Rapp, MD Eliminate foods with large quantities of dyes. Reduce or eliminate sugar and sugary sodas. Plan a consistent routine in the home. Snack on whole foods as found in nature instead of packaged snacks. Look for allergens in the home and see if eliminating them helps.

Psychoanalysis sees it differently: ADHD is centered in infantile development, attachment, object relations (regulation of drives and affects, ego functions) of the role of infantile trauma (object loss) and psychic conflict. ADHD symptoms may manifest as intrapsychic conflict on the level of self-representation ADHD is centered in infantile development, attachment, object relations (regulation of drives and affects, ego functions) of the role of infantile trauma (object loss) and psychic conflict. ADHD symptoms may manifest as intrapsychic conflict on the level of self-representation

Environment or Genetics? There is little compelling evidence that ADHD can arise purely from social factors or child-rearing methods but cigarettes and alcohol DURING PREGNANCY ARE SUSPECTED C ontributors. There is little compelling evidence that ADHD can arise purely from social factors or child-rearing methods but cigarettes and alcohol DURING PREGNANCY ARE SUSPECTED C ontributors. Most of the possible causes of ADHD are currently hypothesized to be related to neurobiology and genetics. Most of the possible causes of ADHD are currently hypothesized to be related to neurobiology and genetics.

What treats it? cognitive-behavioral interventions cognitive-behavioral interventions clinical behavior therapy clinical behavior therapy direct contingency management direct contingency management intensive, packaged behavioral treatments intensive, packaged behavioral treatments DRUGS DRUGS

Is it medical, mental, or mythical? Effective treatment protocols and etiological theories for ADHD have yet to be created…because ADHD, often renamed, has yet to be defined! What’s your belief? Effective treatment protocols and etiological theories for ADHD have yet to be created…because ADHD, often renamed, has yet to be defined! What’s your belief?