History of ADHD (attention deficit hyperactivity disorder)

The earliest literature referring to the inattentive subtype of ADHD dates back to the writings of the physician, Alexender Crichton in 1798. In his clinical practice, Crichton observed many cases of insanity and became increasingly interested in mental illness. In his paper ‘Mental Restlessness’, Dr Crichton described all the essential features of the inattentive subtype of attention deficit hyperactivity disorder.

In the mid-19th century, the characteristics of the ADHD were described by Heinrich Hoffman, a German physician, and represented by 2 of his characters—Fidgety Phil and Harry Who Looks in the Air—who appear in his children’s book.

In the story of Fidgety Phil, Hoffmann illustrates a family conflict at dinner caused by the fidgety behavior of the son and culminating in his falling over together with the food on the table. This can be interpreted as an early case of ADHD.

In 1902, at a meeting of the Royal College of Physicians, George Still, a paediatrician and first professor of childhood diseases at King’s College Hospital described a disease he characterized as resulting from a defect in moral character.

George Still described 20 cases of children with a “defect of moral control as a morbid manifestation, without general impairment of intellect and without physical disease”. The children he described experienced extreme restlessness and an ‘abnormal capacity for sustained attention’, impacting on academic performance and social relationships, despite normal intellectual functioning. Their behaviour was described as violent, destructive, oppositional and non-responsive to punishment.

He suggested that the children had likely experienced brain damage but that the behavior could also arise from hereditary and environmental factors.

In 1937 Charles Bradley, working at the Emma Pendleton Bradley Home in Providence, Rhode Island, USA, demonstrated the effi cacy of Benzedrine, a central nervous system stimulant, in the treatment of ADHD. He administered Benzedrine to children suffering with headache and noted a marked improvement in their behaviour and school performance.

As the association with brain damage became less certain, the name was changed to be more behaviorally descriptive. The change is reflected in the psychiatric classification system, where in the Diagnostic and Statistical Manual of Mental Disorders, Second Edition (DSM-II), it was called hyperkinetic reaction of childhood disorder.

ADHD is viewed by clinical professionals as consisting of three primary characteristics: inattention, impulsivity, and hyperactivity. The symptoms often arise early in childhood, typically by age 3 - 4 years, and are relatively persistent in most, though not all, children.
History of ADHD (attention deficit hyperactivity disorder)