ADHD: History-A defect of moral control pt2

What has ADHD looked like over the years?  Here is a breakdown on how it has been researched and viewed.  

I want you to be mindful of the language being used here.  What do you think?

1798: Sir Alexander Crichton - He wrote a book called ‘On Attention and its Diseases’

In his book he noted children having ‘difficulty sustaining attention in tasks or play activities.’  Crichton also reports that the disorder can be “born with a person” and ‘when born with a person it becomes evident at a very early period of life.’  

First of all, I think it is important to note that he made his observations in a school setting.  You can imagine what a school was like in the late 1700-1800s.  Crichton also said that this disease diminishes with age, which later studies disprove and suggest that ADHD symptoms are retained into adulthood.  

Other studies have said that Critchen seems to only look at distractibility rather than hyperactivity….but it's a start.  

1844: Fidgety Phil

A story was written that illustrated a family dinner with a boy fidgeting.  From the reaction of the father this was not the first time.  The boy wasn't listening to his father when he gave instructions.  Dad became angry.  

This is the first story written that illustrates some symptoms of adhd.  The illustrator Heinrich Hoffman was a Doctor who realised that not all mental illnesses are criminal or obsessive, which was the common thinking at that time. 

1902: Defect of moral control

The first medical research known on ADHD from Sir George Frederic who was known as the father of British Pediatrics.  

Fredreic suggested that this symptom was ‘abnormal defect of moral control in children.’ To which, he defined a defect of moral as ‘the control of action in conformity with the idea of the good of all.’ 

He said the lack of moral control can be seen in many ways:

(1) passionateness; (2) spitefulness – cruelty; (3) jealousy; (4) lawlessness; (5) dishonesty; (6) wanton mischievousness – destructiveness; (7) shamelessness – immodesty; (8) sexual immorality; and (9) viciousness. 

And the overall feature was an instant self gratification regardless of the consequences.  

From his observations:

The case of a boy with a moral defect who would repeat the process of saying ‘Good-night’ several times before he was aware that he had done so; the same boy would often put his boot on the wrong foot apparently without noticing it. Another boy, aged six years, with marked moral defect was unable to keep his attention even to a game for more than a very short time, and, as might be expected, the failure of attention was very noticeable at school, with the result that in some cases the child was backward in school attainments, although in manner and ordinary conversation he appeared as bright and intelligent as any child could be.

1908: Postencephalitic behaviour disorder

This refers to a serious illness that leads to swelling of the brain that leads to hyperactivity.  

1932: Hyperkinetic Disease of Infancy

 Kramer and Pollnow said that some children who have this disease show ‘remarkable motor activity, which appears to be very urgent’ and ‘they cannot stay still for a second, run up and down the room.’.....sound familiar?

According to these authors, hyperkinetic children show no perseverance in their activities, e.g. they play no game for more than a few minutes. However, Kramer and Pollnow also noticed that the children were able to persevere at some activities of their interest for hours.

1937: The first treatment

Charles Bradley who was a medical doctor from Rhode Island gave a test group of 30 children Benzedrine and found it worked.  

Please watch this video about Benzedrine 

1944: (&1955) Methylphenidate (Ritalin)

The compound was first synthesised in 1944 by Leandro Panizzon and marketed as “Ritalin” by Ciba-Geigy Pharmaceutical Company in 1954.

1968: Hyperkinetic Reaction of Childhood

“The disorder is characterised by overactivity, restlessness, distractibility, and short attention span, especially in young children; the behaviour usually diminishes by adolescence.

Hyperactivity was recognized to be “a behavioural syndrome that could arise from organic pathology, but could also occur in its absence. Even so, it would continue to be viewed as the result of some biological difficulty, rather than due solely to environmental causes

1987:  ADD and ADHD

The hyperactivity was still not recognised at this stage.  

The symptoms of inattention, impulsivity, and hyperactivity were combined into a single list of symptoms with a single cutoff score.

1990s:

It was finally recognized in the 1990s that ADHD was not exclusively a childhood disorder, which disappeared with age as was previously thought but rather a chronic, persistent disorder remaining into adulthood in many cases.  

Three subtypes of ADHD were identified on the basis of structured diagnostic interviews of multiple informants and of validation diagnoses.

So there we have it.  A brief history of ADHD.

What do you think of the language being used here?  

My thoughts

It seems that this ‘condition’ is something that you don’t want.  Something that needs to be treated.  Some excuse given for the reasons why someone behaves in a certain way.  A label.  

From the start ADHD has been viewed as something that needs to be controlled or get rid of, rather than embracing it.  The use of drugs to subdue a patient has been seen to be celebrated.  In the next post, I want to look into more detail about the drugs given to people with ADHD and possible alternative ideas.  

Reference

A big thankyou to the National Library of medicine where I found most of this research.  Have a look here for more information.  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000907/#Sec2title