History of hyperactivity off-base, says researcher

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Matthew Smith says not only is that notion wrong, it misleads patients, their parents and their physicians. Smith, who is from Edmonton, is finishing up his PhD at the Centre for Medical History at the University of Exeter.

Hyperactivity disorder, or ADHD, is currently the most commonly diagnosed childhood psychiatric disorder, says Smith, and millions of children are prescribed drugs such as Ritalin to treat it. Yet prior to the 1950s, it was clinically and culturally insignificant.

He argues in a paper presented at the Congress for the Humanities and Social Sciences taking place at Ottawa's Carleton University this week, that hyperactivity disorder as we understand it today is a modern construct that was first described as a disorder in 1957.

Before that, Smith says hyperactive behaviour existed - but it wasn't always thought of as a disorder or pathology worth treating.

However, Smith says many today assert that hyperactivity is a universal phenomenon, and say evidence of hyperactivity can be seen in historical figures such as Mozart or Einstein. Smith argues that hyperactivity as we understand it is rooted in social, cultural, political and economic changes of the last half century.

"When history is extended back beyond 1957, it overlooks all the social factors that contributed to the idea that children were hyperactive - and that that was a problem," he says.

"We need to refocus the history of hyperactivity on the period starting from the late 1950s and 60s. "By doing so, we start to understand why people started to think there was a problem with children, why they thought that problem needed to be fixed, and why it became acceptable to fix that problem with drugs."

Smith says that whether you consider hyperactivity a disease worth treating often depends on context - and the context changed in the late 1950s when the U.S. refocused its education system in response to the space race.

"If a child's playing soccer, there's a chance hyperactivity isn't going to be a problem. But if they are stuck in a classroom, it is a problem.

"We have to look at the social and historical factors that created the idea that children were distractible and that these were pathologies that needed to be treated.

"For patients and their parents, what this means is that the process by which their children are diagnosed is not rooted in a long history. If they understand that, they can develop the tools to question the diagnosis."

Canadian Federation for the Humanities and Social Sciences