Definitions, Terminology and the Devlopment of ADHD

114 Pages·2003·0.6 MB·English

by  Rene Helmerichs

Historical Definitions and Nomenclatures of the Label ‘ADHD’:
An Investigating into Attention-deficit and Hyperactive Behavior through Time

By
René Helmerichs

A Research Paper
Submitted in Partial Fulfillment of the
Requirements for the
Master of Science Degree
With a Major in

Education
Approved: 2 Semester Credits

______________________________
Investigation Advisor

The Graduate School
University of Wisconsin-Stout
December, 2002
i
The Graduate School
University of Wisconsin-Stout
Menomonie, WI 54751

ABSTRACT

Helmerichs René __
(Last Name) (First) (Initial)

Historical definitions and nomenclatures of the label ADHD: An investigating into

attention-deficit and hyperactive behavior through time.
(Title)

Education Dr. Alan Block December / 2002 114
(Graduate Major) (Research Advisor) (Month / Year) (No. Pages)

American Psychological Association (APA) Publication Manual
(Name of Style Manual Used in this Study)

The purpose of this study was to examine whether attention-deficit or hyperactive
behavior has always been present but overlooked by society in general. Of particular
interest were the differing labels used throughout history describing symptoms akin to
those now attributed to the mental disorder ‘ADHD’ (APA, 1994). These labels have
been isolated and their relation to ADHD identified. Awareness of select social
influences promoting the use of such labels has also been discussed and for which reason
(in lack of) supports earlier non-specific recognition of non-threatening misbehavior.
ii
Acknowledgements

To everyone I have known, conversed with, read about, observed, and imagined.
And,
to You, the reader.

My sincere gratitude to the people of the University of Wisconsin-Stout Student
Research Fund (Provost Office) for their consideration and financial assistance,
Himalayan Missionaries for drawing me toward this degree, the staff and resources of the
school library, and to existence. Recognition is bestowed upon Alan Block for his
endearing patience, Amy Gillett who unfortunately works too hard, Bonni Falkner for all
her assistance, Dan for his spare room, and Mandy & Brian for sharing your living
quarters. Thank you.
iii
Dedication

to everyone with ADHD
to anyone curious about ‘ADHD’
to Logan McAbee
to Brigitta
To the present.
iv
TABLE OF CONTENTS

CHAPTER ONE: Introduction.............................................................................................1
Statement of the Problem............................................................................................3
Research Objectives....................................................................................................3
Definition of Terms.....................................................................................................4
Assumption.................................................................................................................6
Limitations..................................................................................................................6
CHAPTER TWO: Review of Literature...............................................................................8
Introduction.................................................................................................................8
A Concern for Moral Behaviorism.............................................................................9
Emerging Thoughts on Attention Characteristics.....................................................18
A Neurological Condition.........................................................................................32
Reemergence of Behavioristic Deficits....................................................................45
Attention Deficit Disorder and its ‘Official’ Definitions.........................................53
Present Considerations on Terminology...................................................................71
CHAPTER THREE: Discussion, Conclusions, and Recommendations............................77
Introduction...............................................................................................................77
Discussion.................................................................................................................77
Conclusions...............................................................................................................88
REFERENCES...................................................................................................................91
APPENDIX A: List of Acronyms Used Throughout this Study......................................101
APPENDIX B: An Account of Feeblemindedness in the English Educational System..103
v
APPENDIX C: Factors Attributed to Attention-Deficit or Hyperactive Behavior..........105
AUTHOR’S NOTE..........................................................................................................106
vi
LIST OF TABLES

TABLE 1: Resemblance of ADHD in the standard classified nomenclature of disease..36
TABLE 2: Differences between U.S. and U.K. hyperactive child syndrome definitions 48
TABLE 3: DSM-III diagnostic criteria for attention deficit disorder with hyperactivity.54
TABLE 4: DSM-III diagnostic criteria for attention deficit disorder, residual type........56
TABLE 6: DSM-III-R diagnostic criteria for attention-deficit hyperactivity disorder....61
TABLE 7: DSM-IV diagnostic criteria for attention-deficit/hyperactivity disorder........67
vii
LIST OF FIGURES

FIGURE 1: U.S. death rates for influenza and pneumonia from 1910 to 1950................33
1
CHAPTER ONE
Introduction

Attention-Deficit/Hyperactivity Disorder (‘ADHD’1) is a term used to describe a
very broad spectrum of behaviors (Edelbrock, 1997). Clinicians, school psychologists,
parents and teachers are often divided whether a particular child exhibiting periodically
questionable behavior should be branded with such a pernicious label. As will be
detailed, the subjectivity involved in the diagnosis of this disorder has become a problem
of great significance in the latter part of the 20th century. It is my contention, however,
that this is nothing new, that both the disorder and subjectivity of its measure of
inadequacy have existed in children long before its inclusion in the American Psychiatric
Association’s Diagnostic and Statistics Manual III (DSM-III; 1980) as Attention Deficit
Disorder (ADD).
It has become common knowledge that incidences of ‘ADHD’ diagnoses have
increased dramatically over the past decade, 1990-2000 (Minde, 1998; Zito, et al., 2000).
There has also been much debate over the use of methylphenidate2 as the first and often
only line of attack used to combat this disorder. It is interesting to see domestic sales of
methylphenidate increase nearly 500% from 1991 to 1999 (Woodworth, 2000), prior to

1 ‘ADHD’ is also recorded in literature as Attention-deficit/Hyperactivity Disorder and Attention Deficit
Hyperactivity Disorder. ‘ADHD’ without quotations (i.e. ADHD) represent its characteristic behaviors.
2 Methylphenidate is the generic name of one of many medications falling into the amphetamine family of
drugs and used almost exclusively to treat ADHD. The Physicians’ Desk Reference (PDR; Thomas
Healthcare, 2002) list 12 variants of Methylphenidate under the heading Methylphenidate Hydrochloride,
among them: Concerta®, Metadate®, Methylin®, and Ritalin®.
2
which they remained relatively stable, and to have Zito and colleagues (2000) discover a
1.8 to 3.1-fold increase in the use of stimulant drugs (methylphenidate) among children
aged 2 to 4 years. All while drug companies themselves cite methylphenidate “should
not be used in children under six years, since safety and efficacy in this age group have
not been established” (Thomson Healthcare, 2002, p. 1999). Coupled with an abundance
of unspecified criteria in research studies and a great deal of ambiguity in previous
literature (Barkley, 1998), each indictment of ‘ADHD’ must be administered with a grain
of salt.
Just as language itself is evolving and continually undergoing change, so, too, is
the essence of what the ‘ADHD’ label purportedly represents and describes. How long
has it been since English was spelled Englyshe, ‘read’ (i.e. you read this text) spelled
‘rede,’ and ‘you’ abbreviated simply ‘ye’? The notion of language as a living entity has
been addressed by many, including Samela Harris (2002) in an article titled Mangling the
language: Abused apostrophes, the death of group nouns… who affirms: “language is a
living entity. It changes with society and the times.” If this is true, then the essence of
language, created to portray the sonority of our thoughts, vibrant emotions and lively
ideas, and represented by a series of structured, organized characters, must also change
now and again. A striking example is presented by the term ‘comorbid,’ not listed in the
1981 edition of Webster’s third new international dictionary: Of the English language
unabridged (Gove & Merriam-Webster) and coincidentally of which there is no mention
prior to adoption of the term ‘Attention-deficit Disorder,’ ADD, in literature.