What is Attention Deficit Hyperactivity Disorder?
ADHD is a neurodevelopmental disorder — along with ASD (Autism Spectrum Disorder) and Dyslexia. That means certain networks in the brain develop slower than normal.
ADHD is characterised by frequent, difficulties with regulating attention, distractability, and forgetfulness and/or difficulties with emotional regulation, impulsivity, and hyperactivity impacting all aspects of life.
Importantly, ADHD is a chronic disorder — extending into adulthood — and is associated with significant personal, familial, and societal costs when left untreated.
ADHD has been around for a long time
ADHD is not a “modern invention”. The hallmarks of ADHD were first documented in medical texts 270 years ago. Dutch physician Cornelius Albert Kloekhof and French physician Etienne Le Camus arrived at similar observations independently in 1753. In 1775, German physician, Melchior Adam Weikard, devoted a chapter of his medical textbook, to the topic of “Lack of Attention.” Heinrich Hoffmann described ADHD in his children’s book, “Fidgety Phil” (“Zappelphilipp”) In 1845 — my favourite. Numerous other references occur over the years.
ADHD is a highly heritable disorder
ADHD is a highly heritable disorder. The first hint that ADHD has a genetic origin by Spanish neurologist and psychiatrist, Gonzalo Rodriguez-Lafora in 1917.
The estimated heritability of ADHD is 80%, so if you have ADHD, there’s an 80% chance one of your parents has or had ADHD. This means that if your child has ADHD, it’s a good idea to check if you have ADHD too.
ADD or ADHD?
“A rose by any other name would smell as sweet” — William Shakespeare.
ADHD, as it is formally known now, was described in 1932 by Franz Kramer and Hans Pollnow described as “Hyperkinetic disease of infancy.” In the 1940s, ADHD was called “minimal brain dysfunction”. In 1968, the DSM II included “Hyperkinetic reaction of childhood”.
It was only in 1980 that the — the still common term — ADD replaced “Hyperkinetic reaction of childhood” in the DSM II (with or without hyperactivity). In 1987, the DSM III-Revised changed ADD to ADHD and removed the 2 subtypes. In 1994, three subtypes we added (Inattention, Hyperactive, and Combined).
The most significant change came in 2013 with the DSM 5. Subtypes were replaced with presentations (meaning that someone can present with inattention, hyperactivity or both), and importantly — that presentations can change over time.
ADHD in adults
Spanish neurologist and psychiatrist, Gonzalo Rodriguez-Lafora, describes ADHD and suggests genetic origins in 1917.
In the mid-1950s, follow-up studies hinted that minimal brain dysfunction (what ADHD was called until 1968) persists into adulthood. Acknowledging that ADHD extends into adulthood, in 1994 the DSM IV includes examples of adult workplace difficulties, and in 2013 the DSM 5 reduces the threshold for adult ADHD.
Two years before the DSM extends ADHD to include adults, Edward Hallowell and John Ratey published, “Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood to Adulthood.” In the same book, they are the first to introduce the concept of ADHD coaching.
