ADHD: Fact, Fiction and Beyond
A Comprehensive Study of Attention Deficit Hyperactivity Disorder
by Dr. Victoria Martin, M.D.
The first clinical description of ADHD was reported in the British journal, Lancet, by Dr. George Still in 1902. Dr. Still was a British physician treating children who noticed some of his patients were uninhibited and impulsive. In the 1930’s in the United States, Dr. Charles Bradley made further observations on the effect of stimulant medication on children. Since that time, the descriptive terms that have been used to identify ADHD people have reflected the current scientific understanding of the day as to what this condition represented biologically.
In the 1960’s the emphasis was primarily on hyperactivity and at that time a caricature of an ADHD child would have been “Dennis the Menace” – that is, a child with tremendous energy who could be seen perhaps, as intrusive. In spite of this impulsiveness, Dennis was always seen as a good child.
An important development occurred in the early 1970’s when Canadian researcher Dr. Virginia Douglas began to focus on cognitive impulsivity, or the daydreaming and lack of focus in addition to the outward manifestations of motor impulsivity, such as being fidgety. The diagnostic description became more of attention deficit hyperactivity disorder, which includes cognitive impulsivity in addition to motor impulsivity and verbal impulsivity. This currently reflects our understanding of this condition.
There was a time when a rational person could have had honest misgivings about whether ADHD actually existed at all. Because ADHD was first diagnosed in children who could not articulate their experiences, virtually all of our early formulations were based on second hand information from parents and teachers who filled out scales for researchers they oftentimes never met. The diagnosis was further complicated by the inconsistent nature of the impairments that could rise and fall over time and with the level of interest and challenge experienced by the individual.
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