The History of ADHD

Behavior Management Help

Nearly everyone is familiar with the acronym – ADHD. If you are not familiar with ADHD you have probably heard of ADD. Otherwise known as Attention Deficit Hyperactivity Disorder or simply Attention Deficit Disorder these DSM diagnoses describe children who have difficulty…

• Staying focused
• Sitting still (fidgets)
• Playing quietly
• Waiting their turn
• Staying seated
• Getting organized
• Completing or turning in school work

With ADHD on the rise and millions of American children being medicated with a variety of psychiatric drugs to allegedly help them control the above types of behaviors Christian parents and caregivers need discernment. This is especially important because according to the Harvard review, most diagnoses will arise from the child’s teacher not from within the home. In other words the first indication you may get that your child has a “behavioral problem” is a suggestion from their teacher that you should have your child evaluated for “possible ADD or ADHD.”

The next step suggested will be to complete a Conner’s scale or other such subjective behavioral inventory. And then you may be urged to take your child to your family physician or psychiatrist to be evaluated further for this disorder. If this happens it is very likely that you will leave your doctor’s office with a prescription for a psychiatric drug for your child.

All this can happen without knowing much at all about the history of ADHD or exactly how psychotropic medications work and whether they are the best option for your child.

Tracing the History of ADHD

Before we go any further let’s take a brief look at the history of ADHD. You might be interested in knowing that this label and specific diagnosis did not arise until 1980.

Before there was ADHD/ADD there was a disorder called “Minimal Brain Dysfunction”. This disorder (btw, a disorder is simply a cluster of symptoms; no more, no less) was used to label children who were aggressive or defiant when there was no other known organic cause such as epilepsy, brain tumors or meningitis all which can cause aggression and defiance.

In his book “The Anatomy of an Epidemic” Robert Whitaker writes,

Although attention-deficit disorder did not show up in psychiatry’s Diagnostic and Statistical Manual until 1980, the field likes to point out that it didn’t just appear out of thin air. This is a disorder that traces its medical roots back to 1902. That year, Sir George Frederick Still, a British pediatrician, published a series of lectures on twenty children who were of normal intelligence but “exhibited violent outbursts, wanton mischievousness, destructiveness, and a lack of responsiveness to punishment.” Moreover he reasoned that bad behavior arose from a biological problem (as opposed to bad parenting). (Emphasis added)

Bad Science at the Root of America’s Favored Childhood Diagnosis

Please observe three things about Sir Frederick’s hypothesis:

• First, it was a hypothesis, it was and has never been proven by science.
• Second, Frederick observed just 20 children and came to this conclusion.
• Third, Frederick used his own human subjective reasoning to conclude that the behavioral problems were biological and not environmental or otherwise.

Also note that:

• Psychiatrists with the APA have continued to use this same subjective, human reasoning to come up with over 300 mental diagnoses.
• The behavioral descriptors used by Sir Frederick bear no resemblance to those used descriptors used to define ADHD/ADD today.

Over the next 50 years the “hypothesis” that hyperactivity was caused by brain injury got a foot hold in American psychiatry. This theory was reinforced over the years by others:

• From 1917-1928 it was documented that children who recovered from a viral epidemic called encephalitis lethargica often had antisocial behaviors and severe mood swings. (Anatomy of an epidemic page 219)
• “Alfred Strauss, along with his colleagues Laura Lehtinen and Newell Kephart, created the diagnostic category of minimal brain damage in children. He presumed that children with learning difficulties, who were not mentally retarded, hearing impaired, or emotionally disturbed, had minimal brain damage. (From the website of Judith Felson Duchan, an emeritus professor at University of Buffalo.)
• At times this cluster of symptoms was also referred to as “Organic Brain Syndrome.”
• In 1937 Dr. Charles Bradley treated children for severe headaches using the amphetamine benzedrine. It was not effective for headaches but did seem to help children focus better on their school work. (This later led psychiatrists to hypothesize that there may be a “chemical imbalance in the brain.”)
• 1956 Cyba-Geigy the pharmaceutical company brought the drug Ritalin (aka methylphenidate) to market and soon it was identified as safe for use with children who had “Organic Brain Syndrome.”
• 1980 the DSM III identifies Attention Deficit disorder for the first time.
• 1987 the APA revises the diagnosis to Attention Deficit/Hyperactivity disorder expanding the diagnosis to now encompass a much larger percentage of the under age 18 population.
• 1987 Ciba-Geigy Pharmaceutical company helps to fund CHADD (children and Adults with Attention Deficit Hyperactivity disorder) a patient support group. CHADD lobbied congress to make ADHD a disability under the Individuals with Disability Education Acts. They were successful and as a result children diagnosed with ADHD are eligible for special services in the public school system.

According to science daily and the History of ADHD over the past 10 years children diagnosed with ADHD has risen by 66%:

According to the study, in 2010, 10.4 million children and teens under age 18 were diagnosed with ADHD at physician outpatient visits, versus 6.2 million in 2000.

With ADHD on the rise and an alarming millions of children taking stimulants and other psychotropic drugs, advocates for children should be concerned to say the least. For truth and justice to prevail in a land requires people to stand up and challenge the status quo especially when the life and health of children are involved.

Parents, caregivers and clinicians please consider:

• Given the history, is ADHD a valid diagnosis?
• What constitutes a valid diagnosis?
• What is the difference between a disease and a disorder?
• Is the medication actually helping? What is the long term evidence?
• Are there short or long term consequences of these medications?

Although the conventional psychiatric and medical wisdom continues to promote the idea that ADHD is a real disease the truth is although it is called by most a “neurobiological” disorder of childhood, there is no diagnostic test for ADHD neither is there a definitive cause. What is called ADHD is simply a cluster of behaviors.

According to the CDC (Center for Disease Control):

• The cause(s) and risk factors for ADHD are unknown…
• Mental Disorders are Determined by Popular Opinion not Science

Understand, that when dealing with so called disorders of the mind the diagnostic criteria are completely subjective. The APA (American Association of Psychiatrists) began the DSM in 1952 by asking for comments from some of their members on proposed categories. There never was and never has been a scientific study made to accurately identify and diagnosis most mental disorders as a disease. They almost all are based on subjective behavioral observations.

This does not mean that there may not be an underlying biological cause that could be contributing to a child’s behavioral repertoire. However, what it does mean is that until a definitive cause is identified the prescribing of psychotropic medications is turning millions of children into human guinea pigs and there is a devastating price they and society are paying.

Who Gets to Decide What is “Normal”?

The Harvard review reported in 2009 that most ADHD diagnoses arise from teachers complaints because “only a minority of children with the disorder exhibit symptoms during a physicians office visit.” What may be in the best interest of the child may not be what is in the best interest of the parent or teacher who may be frustrated with being able to maintain order in the home or classroom. However to label a child as pathological because they do not fit in to the “norm” is unethical.

There is no question that, at least for the short term, stimulant medications may reduce what teachers and parents see as “disruptive” behaviors. This does not mean the long term outcomes are beneficial to the child or have a lasting effect. On the contrary the long term, as well as some short term outcomes can be devastating to many children on these medications.

Mental health care professionals know that all so called mental health is on a continuum. Personality traits, cognitions, intellect, energy level, moral intellect, self control, moods and the like are all on a continuum. No two people who are exactly alike in their psychological makeup. There is not a magic line drawn in the sand that when a person crosses it, poof! They suddenly become “mentally ill.” In light of this the Christian parent or clinician might ask themselves several questions…

• Who gets to determine what is normal or not?
• Who should be allowed to label your child as disordered?
• What are the best options to help my child?
• Have I done my own thorough research on recommended medications?
• Do you know how ritalin works or other medications your child may be on?

When we embrace a label for a child created by an authoritative group like the APA we are sending several strong messages that may be internalized as…

• You are not OK
• You are not responsible for your choices
• The answer to your problem lies in a pill
• There is no cure
• You can never change
• Your hope is in a medication

According to Whitaker’s book between 1990 and 2007 children diagnosed with ADHD rose from 1 million to over 5 million. Furthermore 87% of children with the diagnoses are on brain altering medications. That’s over 4 million children and according to the Science Daily report for 2010 the numbers may be much higher, more like 8 million.

Conclusion on the History of ADHD

As explained earlier ADD was first introduced through the DSM in 1980. By 1990 1 million children had received the ADD/ADHD label. The numbers have risen to over 10 million as of 2010 with perhaps 87% of those children on psychiatric medications. Additionally, according to Robert Whitaker,

“The prescribing of psychiatric drugs to children and adolescents is a recent phenomenon, as relatively few youth were medicated prior to 1980.”

Any mental health professional who has been in the field long enough also knows this to be true.

Mental health professionals and parents should be seriously alarmed at this epidemic of so called mentally disordered children. The numbers alone are beyond absurd and are an unprecedented attack on children in America and elsewhere.

For more information on the toll this trend is taking on America’s children check out Robert Whitaker’s book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America.