You may know an adult who is frequently late, scattered, and who procrastinates. They may overpromise and under deliver, starting projects that they never seem to quite finish.
But what if there’s another reason for the child’s or adult’s behavior? One that is as closely linked to their biology as their height or hair color? Between 5 and 11 percent of American children have been diagnosed with attention deficit hyperactivity disorder (ADHD) as well as 1 in 25 adults. This neurological condition is often clouded by stigma and misunderstanding. Some people question whether it’s a legitimate diagnosis or just an excuse for people who don’t quite fit into modern society.
There is overwhelming scientific proof that ADHD is a real disorder, and that it’s been around for several hundred years. There’s also strong evidence that treatment works, and that it can help people with ADHD enjoy both personal and professional success.
ADHD Brains Are Different
People diagnosed with ADHD share a common set of traits, including inattention, excessive activity, and impulsivity. It turns out that they have similar brains, too. Using MRIs and other brain imaging techniques, scientists have found that the brains of people with ADHD are distinctly different from those without it.
Russell Barkley, a professor of psychiatry and neurology at the University of Massachusetts Medical Center, has been studying children with ADHD since 1973. During an interview for the PBS show Frontline, Barkley said there’s an extensive amount of research showing that certain parts of the brain, particularly in the right frontal area, are smaller and less developed than they should be.
As it turns out, Barkley said, “these regions are absolutely crucial for inhibitions and for thinking before you act—for self-control.”
However, this does not mean that individuals with ADHD are not intelligent. ADHD is not an intelligence deficit, but rather a performance deficit.
ADHD Has a History
Although the term “ADHD” is only 30 years old, you’ll find descriptions of people with similar symptoms that date back to the 1700s.
Some claim the story of “Fidgety Phil” is one of the earliest examples of ADHD in literature. In 1844, the German physician Heinrich Hoffmann started creating illustrated children’s stories. The second edition of his book, printed in 1846, includes the story of Fidgety Phil. In it, Hoffmann illustrates a family conflict at dinner caused by the behavior of the son, who can’t seem to heed his father’s warnings to keep all four chair legs on the floor. The story ends with Phil falling over, along with the food on the table.
Many authors claim that the scientific observance of ADHD started in 1902, when a British pediatrician noticed that some children could not control their behavior the way a typical child would, although they were intelligent. The pediatrician, Sir George Frederic Still, described ADHD as “an abnormal defect of moral control in children.”
Still, no one knew what caused ADHD symptoms throughout much of the 20th century.
It wasn’t until 1968 that the American Psychiatric Association (APA) formally recognized ADHD as a mental disorder and gave it a name: hyperkinetic impulse disorder. Over time, scientists realized that hyperactivity wasn’t always a symptom of the disorder. In 1980, it became attention deficit disorder (ADD) with two subtypes: one with hyperactivity and one without.
In 1987, it was renamed ADHD, a term still used today.
The disorder is recognized by all major medical associations, including the American Psychiatric Association, the American Medical Association, the American Academy of Pediatrics, and the National Institutes of Health. Plus, the Americans with Disabilities Act and other disability laws protect the rights of people who have been diagnosed with ADHD.
ADHD Treatment works!
As the number of people with ADHD has increased, so has the need for treatment. Stimulant medications, like Ritalin or Adderall, have been effective at improving the performance of people with ADHD. They are the most common form of treatment today. Even with medication, people with ADHD still struggle to cope with the daily challenges of life. That’s where behavioral modification approaches come in, such as coaching or cognitive behavioral therapy. Studies have shown good results from multimodal treatment.
So, while there may be debate in some circles about whether ADHD is real, there is no controversy among practicing scientists who have devoted their careers to this disorder, according to Barkley. “The science speaks for itself,” Barkley tells Frontline. “And the science is overwhelming that the answer to these questions is in the affirmative: it's a real disorder; it's valid; and it can be managed, in many cases, by using stimulant medication in combination with other treatments.”
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