The History of ADHD

Discover tips, treatment options, and support strategies from the Finding Focus Care Team

Last Update: January 15, 2025 | 6 min read

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) is now recognized as a complex neurodevelopmental condition. However, this understanding is relatively recent. The historical trajectory of ADHD, from scattered early references to its formal diagnostic inclusion, reflects an evolving appreciation for neurodiversity, cognitive differences, and the need for structured clinical support (Palmer & Finger, 2001; Hinshaw & Ellison, 2016).

Early Observations

1700s: First Descriptions

One of the earliest known descriptions of behaviour resembling ADHD came from Scottish physician Sir Alexander Crichton. In 1798, he described individuals with “mental restlessness” who struggled to maintain attention, even in the absence of obvious external distractions, an observation that aligns closely with today’s inattentive subtype of ADHD (Palmer & Finger, 2001).

1800s: Fidgety Phil

In 1845, German psychiatrist Heinrich Hoffmann published Struwwelpeter, a children’s book that included the character “Fidgety Phil.” Although fictional, the character’s persistent movement and inability to stay seated mirrored behaviours we now associate with hyperactivity. This cultural artifact suggests societal recognition of such behaviours long before medical terminology existed.

1902: A Medical Condition?

British pediatrician Sir George Still presented lectures to the Royal College of Physicians describing a group of children who were unusually impulsive, inattentive, and unable to regulate their behaviour. Importantly, Still emphasized that these traits were not due to poor parenting, but to a constitutional abnormality, thereby framing the behaviour within a medical model (Lange et al., 2010).

The Emergence of a Medical Condition

1930s: The Role of Medication

A major turning point came when American physician Charles Bradley observed that children treated with Benzedrine, an amphetamine, not only showed behavioural improvements but also enhanced academic performance. This discovery marked the beginning of stimulant use in ADHD management (Lange et al., 2010).

1940s-1950s: Early Medical Terms

By the mid-20th century, clinicians used terms like “Minimal Brain Dysfunction” (MBD) to describe hyperactivity and behavioural dysregulation. Although the term lacked diagnostic precision, it signified growing medical interest in children's behavioural problems and their neurological underpinnings (Hinshaw & Ellison, 2016).

ADHD Enters the Diagnostic Manuals

1968: The DSM-II

In the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II), the condition was classified as “Hyperkinetic Reaction of Childhood.” However, this terminology emphasized only hyperactivity, omitting inattention and impulsivity (American Psychiatric Association, 2013).

1980: The DSM-III

With DSM-III, the diagnosis evolved into “Attention Deficit Disorder” (ADD), finally acknowledging that inattention could exist independently of hyperactivity. This edition allowed clinicians to identify different behavioural profiles under the same umbrella diagnosis (Barkley et al., 2008).

1987: The DSM-III-R

The revised DSM-III reintroduced the term “Attention Deficit Hyperactivity Disorder” (ADHD) and defined it through three main symptom clusters: inattention, impulsivity, and hyperactivity. This represented a more holistic view of the condition’s complexity (Hinshaw & Ellison, 2016).

1994: The DSM-IV

The DSM-IV introduced three formal subtypes of ADHD:

• Predominantly Inattentive Type
  
  
• Predominantly Hyperactive-Impulsive Type
  
  
• Combined Type

This allowed for more personalized diagnoses and treatment plans, reflecting the heterogeneity of ADHD presentations (Barkley et al., 2008).

2013: The DSM-5

The DSM-5 emphasized that ADHD is not exclusive to children. It acknowledged that symptoms often persist into adulthood and can significantly impact occupational, academic, and social functioning (American Psychiatric Association, 2013).

Advances in Understanding ADHD

Genetics and the Brain

ADHD is now recognized as highly heritable, with genetic contributions estimated at 70-80% (Faraone et al., 2005). Brain imaging studies have consistently shown structural and functional differences in individuals with ADHD, particularly in the prefrontal cortex, which is critical for executive functioning and impulse control.

Environmental Factors

Environmental influences such as prenatal exposure to nicotine or lead, low birth weight, and early childhood trauma can increase the risk of developing ADHD. These factors may interact with genetic predispositions to exacerbate symptoms (Faraone et al., 2005).

ADHD Today

A Lifelong Condition

ADHD is now firmly established as a lifelong condition for many. Adult manifestations include challenges with organization, time management, and emotional regulation. These symptoms often require support beyond childhood interventions (Barkley et al., 2008).

Strengths of ADHD

Despite its challenges, ADHD is also associated with unique strengths. Individuals with ADHD often excel in creativity, divergent thinking, and high-intensity focus when engaged in areas of personal interest (Hinshaw & Ellison, 2016).

Treatment and Support

Medications

Stimulants such as methylphenidate (Ritalin) and amphetamines (Adderall) remain first-line pharmacological treatments, with decades of research supporting their efficacy. Non-stimulant options like atomoxetine (Strattera) also offer alternatives for individuals at risk of stimulant misuse or with comorbid conditions.

Therapy

Cognitive Behavioural Therapy (CBT) is widely used for both children and adults with ADHD. It supports the development of coping skills, behavioural modification, and emotional regulation strategies.

Lifestyle Changes

Interventions such as regular exercise, structured routines, sleep hygiene, and mindfulness practices have been shown to improve focus and reduce symptoms. Psychoeducation and coaching are also key tools in long-term management.

Looking Ahead

Future Research

Emerging treatments include neurofeedback, digital therapeutics, and genetic profiling for medication response. The integration of technology into treatment represents an exciting frontier in personalized ADHD care.

Neurodiversity Advocacy

The growing neurodiversity movement is helping to reduce stigma and foster inclusive environments at school, work, and home. A strengths-based approach can empower individuals with ADHD to thrive on their own terms (Hinshaw & Ellison, 2016).

Conclusion

The story of ADHD illustrates how science, culture, and clinical practice evolve together. From vague early observations to the nuanced neurodevelopmental diagnosis it is today, ADHD’s history reflects progress in recognizing, understanding, and supporting cognitive diversity. Continued research and compassionate care will further enhance outcomes for those living with ADHD.

Finding Focus Care Team

We are a group of nurse practitioners, continuous care specialists, creators, and writers, all committed to excellence in patient care and expertise in ADHD. We share content that illuminates aspects of ADHD and broader health care topics. Each article is medically verified and approved by the Finding Focus Care Team. You can contact us at Finding Focus Support if you have any questions!

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. Link

Barkley, R. A., Murphy, K. R., & Fischer, M. (2008). ADHD in adults: What the science says. Guilford Press. Link  

Faraone, S. V., Perlis, R. H., Doyle, A. E., Smoller, J. W., Goralnick, J. J., Holmgren, M. A., & Sklar, P. (2005). Molecular genetics of attention-deficit/hyperactivity disorder. Biological Psychiatry, 57(11), 1313–1323. Link  

Hinshaw, S. P., & Ellison, K. S. (2016). ADHD: What everyone needs to know. Oxford University Press. Link  

Palmer, E. D., & Finger, S. (2001). An early description of ADHD (Inattentive Type): Dr. Alexander Crichton and “mental restlessness” (1798). Child Psychology and Psychiatry Review, 6(2), 66–73. Link  

Lange, K. W., Reichl, S., Lange, K. M., Tucha, L., & Tucha, O. (2010). The history of attention deficit hyperactivity disorder. Attention Deficit and Hyperactivity Disorders, 2(4), 241–255. Link