ADHD A Short History

     Various impairments that are seen with Attention deficit hyperactivity disorder, ADHD, have been noted for most of the twenty first century and perhaps even earlier. According to Dr. Russell Barkley (2006), the first scientists to have given “serious clinical attention” to the behavior associated with ADHD are George Still and Alfred Tredgold.  In 1902 Still wrote a series of papers regarding 43 patients that he had that displayed serious problems with “sustained attention.” (Barkley 2006 Page 4).  In these papers he described behavior and theorized that the behavior demonstrated a “defect in moral control.” (Barkley, 2006 ).  Tredgold used the terms early, mild and undetected to label a set of behavioral and learning deficiencies.  Both believed that there was perhaps a genetic link but more likely a post-natal injury causing this lack of morality.
Later the behavioral issues that are components of ADHD were associated with an outbreak of encephalitis.  This epidemic was most pronounced in 1917 and 1918 (Barkley, 2006).   This is a brain disease and the survivors showed behavior consistent with ADHD.  That is that the children were “impaired in their attention, regulation of activity and impulsivity as well as other cognitive abilities including memory.  They were often noted to be socially disruptive as well.” (Barkley, 2006)  Throughout the decades there were numerous studies done on children displaying the behavioral tendencies noted above.  Many of the studies were born from doctors who were involved with children that had diseases or evidence of brain damage.  However, there were some cases where these behaviors existed where there were no signs of brain damage.  A couple of doctors made the statement that “psychological disturbances alone were de facto evidence of brain injury.” (Strauss and Lehtinen, 1947).  Thus the idea of the brain injured child was born.  So was a new acronym.  Minimal Brain Dysfunction, MBD (Barkley 2006).  During this period prevailing theories existed on causes of MBD that mostly had to do with brain injury.  These injuries occur either pre or post natal or could be linked to some type of disease like encephalitis.  .
A study was done in 1876 with monkeys that had frontal lobe lesions.  These lesions were known to result in excessive restlessness, poor ability to sustain interest in activities, excessive appetite among other behavioral changes. (Barkley 2006).  Over ninety years later continued frontal lobe studies continued to show a path towards a reason for behavioral differences and some meaningful treatment for ADHD.  Early studies were conducted on children that had autism and retardation.  Some theorized that the absence of brain injury must lead to the conclusion that these behaviors were due to “spoiled child syndrome” (Barkley 2007).  It was much later in time that children that had no brain injury but displayed the triad of behavior were segmented out and studied on their own entirely.  Throughout the 1950s and 1960s research continued.  By the end of the decade of the seventies over 2000 studies on the subject were published. (Baker 2006).
Until the seventies almost all research of ADHD was concentrated on children.  In the 1970s Hans Hussey and Paul Wender observed that while some children seemed to grow out of ADHD it was not always the case. (Hallowell and Ratey, 2006).  Their observations led to many studies that concluded that anywhere between sixty to seventy percent of children with ADHD continue to have ADHD in to adulthood.
As far back as 1937 stimulants have been used to treat patients that exhibited these behaviors.  A very frustrated doctor was attempting to save some boys from being beaten in reform school.  He had read a study showing stimulant medication having the affect of altering the mood of some adults.  In desperation he thought this might help the boys.  He prescribed the stimulants to the boys and noticed a marked difference in their behavior. (Halowell and Ratey 2006)
     According to Ballard, Burton et al. The neuro-transmitters known as dopamine and serotonin are involved with attentional systems.  These chemicals are catecholamine which are used throughout the neuroanatomical structure (Ballard, Burton et al. 1997).  The neuro-transmitters relay messages across pathways that control behavior associated with ADHD.  These pathways control attentiveness, motor activity, restlessness and responsivity. (Ballard, Burton et al. 1997) ADHD medication, which is primarily stimulant, is used in order to stimulate the release of catecholamine in the brain in order to maintain control over these behaviors (Ballard, Burton et al. 1997).
Ballard, S., Bolan, M., Burton, M., Snyder, S., Pasterczyk-Seabolt, C., & Martin, D. (1997). The neurological basis of attention deficit
      hyperactivity disorder. Adolescence, 32(128),855. Retrieved from Academic Search Premier database.
Barkley, Russell Dr. (2006). Attention-Deficit Hyperactivity Disorder, Guilford publicationsHallowell, Edward Dr. and Ratey, John Dr.  (2006) Delivered from Distraction, Ballantine Boston MA

Strauss, A. and Lehtinen, L. (1947)  Psychopathology and education of the brain-injured child,  Grune and Sratton

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