Understanding the Evolution of Attention-Deficit Hyperactivity Disorder (ADHD)

Over the years, attention-deficit hyperactivity disorder (ADHD) has become one of the most common neurodevelopmental disorders in childhood. Originally referred to as attention-deficit disorder (ADD), the condition has undergone significant changes in its diagnosis and classification. The first clinical description of children with symptoms of inattention, hyperactivity, and impulsivity dates back to 1902. British paediatrician Professor George Still observed 43 children who displayed defiant, aggressive, and emotional behaviors. These characteristics were later included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which clinicians use to diagnose various mental health conditions.

In the early 1980s, the DSM introduced attention deficit disorder with two sub-types: with hyperactivity (ADDH) and without hyperactivity. However, in 1987, the DSM-III-R replaced ADD with ADHD and introduced three sub-types: predominantly inattentive, predominantly hyperactive-impulsive, and combined. This change was driven by controversies surrounding the presence of hyperactivity in ADD and the similarities/differences between the sub-types. The new focus on inattention also played a role in shifting the terminology from ADD to ADHD.

Today, ADHD is classified into three sub-types: predominantly inattentive, predominantly hyperactive-impulsive, and combined. Individuals with the inattentive sub-type struggle with sustaining concentration, while those with the hyperactive-impulsive sub-type find it hard to be still and have impulse control issues. The combined sub-type encompasses characteristics from both inattentive and hyperactive-impulsive sub-types. Despite the name change and shift in terminology, ADHD diagnoses continue to rise among both children and adults.

While ADHD diagnoses were more common in boys in the past, there has been an increase in girls and women seeking diagnoses in recent years. However, there are international experts who challenge the expanded definition of ADHD, suggesting that cultural, political, and local factors play a role in how the condition is perceived and diagnosed. Regardless of these challenges, ADHD continues to impact individuals’ educational, social, and personal lives.

The evolution of ADHD from ADD to its current classification has been driven by a better understanding of the condition and its sub-types. The controversies and debates surrounding ADHD highlight the complexities of diagnosing and treating this neurodevelopmental disorder. As we continue to learn more about ADHD, it is essential to consider the individual differences and factors that contribute to the manifestation of symptoms. Ultimately, increased awareness and research can help improve the lives of individuals affected by ADHD.