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Attention Deficit Hyperactivity Disorder

Written by Joel Alcantara, DC   
Tuesday, 07 October 2008 11:01
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ADHD - attention deficit hyperactivity disorder. Of late, the disorder has been addressed a great deal in both the popular media and the scientific literature; particularly with the great number of children being diagnosed with the disorder and even more alarmingly by the type and amount of medication given to treat the condition.

The amount of information on the topic of ADHD is enormous, both in the scientific literature and the popular media such as newspapers and the Internet. For the pediatric chiropractor, attitudes towards the diagnosis and treatment of children with a diagnosis of ADHD runs counter to accepted medical practice to say the least. It is from this perspective that I address the topic.


History of ADHD

The original clinical description of ADHD is usually attributed to George Still, who in 1902 described 43 children with characteristics of aggression, defiance, emotionality, disinhibition, limited sustained inattention, and deficient rule governing behavior. Still hypothesized that the central feature of this disorder was a "defect in moral control". Still also noted that this disorder could occur in individuals with or without cognitive deficiency and with or without known neurologic disorders. He considered it a deficiency of sustained attention.

In the first half of the 20th century, the disorder was examined based on its relationship to insults to the brain, including infections, toxins and head trauma. It was noted that the characteristics were similar to animal and human findings with characteristics resulting from damage to the frontal lobes of the brain. Hence, the term "minimal brain damaged" was coined and later to "minimal brain dysfunction" to reflect the finding that no known damage could be found.

Hyperactivity became a central focus of etiology and diagnosis in the 1950’s with the term "hyperkinetic reaction of childhood" was coined. Interestingly enough, its been known since the 1930’s that stimulant medication improved symptoms but its widespread use did not gain popularity until the 1960’s.

In the 1970’s, the central role was placed on the deficit of sustained attention and the term "attention deficit disorder" was coined. In the 1980’s, the focus on "inattention" came into question and that the deficit may be the processing between the incoming information to the brain and the response that is generated, whether appropriate or inappropriate (1,2).