![]() Still’s politically incorrect implication that ADHD children are “immoral.” Children now start school earlier and are expected to sit still and remain largely inactive in a highly structured environment for six to seven hours a day (depending on the state in which you live), about 180 days per year. Why? Is this some kind of epidemic? Is this just a function of widespread misdiagnosis? Has something changed with our children? Are aliens commandeering the minds of our kids? I would have say “yes” to all of the above (except maybe the last one).Ĭertainly, things have changed with our children since Dr. Population surveys have found that about 5% of all children (and 2.5% of all adults) qualify for this diagnosis. Unless you’ve been living under a rock or are under the age of 20, you may have noticed the steep increase in this diagnosis over the last several decades, mostly since the ‘80s and ‘90s. ![]() At long last, we have all the diagnostic bases covered…at least for the next year or two. And so it was to remain for the rest of all eternity…or at least until 2000, when the DSM was revised for the fourth (but certainly not yet final) time.įrom that year until this, we have labored under the most modern terms for this disorder: ADHD, predominantly inattentive type (which refers to children who are inattentive but not particularly hyper or impulsive) ADHD, predominately hyperactive-impulsive type (for children who can’t seem to sit still and sometimes endanger themselves by being so impulsive), and ADHD, combined type (which is the most common). Oh, and I almost forgot…there’s also Unspecified ADHD, which can be used when a child (or adult, for that matter) exhibits some of the characteristics of ADHD but doesn’t seem to fit the entire clinical picture. On that go-around, the two subtypes were re-united into a new stand-alone term: Attention Deficit Hyperactivity Disorder (ADHD). Never ones to be happy with the status quo (and always looking for ways to shake things up), psychiatrists and psychologists decided to remove this distinction when the DSM was revised (yet again) in 1987. Therefore, the diagnosis was split in two: ADD with hyperactivity, and ADD without hyperactivity. However, by that time, there was already some debate about whether or not all kids with ADD were hyperactive: some had problems with attention and concentration, but they were not usually climbing the walls or shaving the pet cat. The term Attention Deficit Disorder (ADD) made its first appearance in 1980, when the DSM went through its third revision. ![]() This term was further refined in 1968, when the Diagnostic and Statistical Manual of Mental Disorders (aka the DSM, which is the catalog of all known psychiatric diagnoses) first recognized a disorder called “hyperkinetic impulse disorder.” The three key symptoms of this disorder were overactivity, inattention, and impulsiveness. Hence the term “Minimal Brain Dysfunction,” which was actually a junkyard term that included several disorders that were assumed to be due to abnormal neurological development, such as learning disabilities and “hyperkinesis” (hyperactivity). In fact, many of this children were quite pleasant to be around…if you could only get them to sit still!Īs is usually the case with newly emerging medical mysteries, researchers and doctors in the modern age tried to come up with a term that sounded impressive and implied that we knew exactly what we were talking about. Back in 1902, British pediatrician Sir George Still described this syndrome as an “abnormal defect of moral control in children” but this didn’t really seem to fit, because quite often, these children were not mean-spirited or intentionally disobedient. Quite often, there was nothing to explain why these children were having these problems: they were usually quite intelligent, and they came from good families that enforced discipline and tried to properly balance rewards and punishments. However, there was growing concern about a population of children who were clearly overactive and had trouble paying attention, especially in school. In my 36 years as a psychologist who specializes in treating children, there has been no more controversial and confusing issue than the diagnosis and treatment of…um…of…now what were we talking about again?īut seriously, back in the Dark Ages when I started my training (and men still wore bearskins), the term Attention Deficit Disorder was not yet the buzzword it is today.
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