Attention Deficit Hyperactivity Disorder (ADHD) (cont.)

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What is the history of ADHD? How is it related to ADD?

ADHD has assumed many aliases over time from hyperkinesis (the Latin derivative for superactive) to hyperactivity in the early 1970s. In the 1980s, DSM-III dubbed the syndrome attention deficit disorder (or ADD), which could be diagnosed with or without hyperactivity. This definition was created to underline the importance of the inattentiveness or attention deficit that is often but not always accompanied by hyperactivity. The revised edition of DSM-III, the DSM-III-R, published in 1987, returned the emphasis back to the inclusion of hyperactivity within the diagnosis, with the official name of ADHD. With the publication of DSM-IV, the name ADHD still stands, but there are varying types within this classification to include symptoms of both inattention and hyperactivity-impulsivity, signifying that there are some individuals in whom one or another pattern is predominant (for at least the past six months). In the International Classification of Diseases (used predominantly in other Western countries), the term hyperkinetic disorder is used, but the criteria are the same as for ADHD/combined type.

What are the future research directions for ADHD?

  1. The current criteria for the diagnosis of ADHD are taken from the Diagnostic and Statistical Manual of Mental Health Disorders, 4th ed. (DSM-IV) published in 1994. Much has been revealed about ADHD since then. The next edition (DSM-V expected May 2012) will need to reflect our broader understanding of ADHD. In addition, there is currently just one set of diagnostic criteria used for the diagnosis of ADHD for all age groups. Clearly, we must establish different diagnostic criteria for childhood, adolescent, and adult ADHD.
  2. We need more data regarding the long-term effects of the methods of treatment (medication, behavioral therapy, etc.) that have now been used for several decades, as well as the long-term outcome of children with ADHD who have not been treated.
  3. The development of psychotropic medications in non-ADHD areas has expanded dramatically in the past few years. We must continue to look for even safer and more effective medications for ADHD alone and (perhaps even more importantly) for the patients with combined ADHD/comorbid conditions.
  4. The societal impact of ADHD needs to be investigated. Studies in this regard include: strategies for implementing effective medication management or combination therapies in different schools and pediatric health-care systems; the nature and severity of the impact on adults with ADHD as well as their families; and determination of the use of mental health services related to diagnosis and care of both children and adults with ADHD.
  5. Additional studies are needed to improve communication across educational and health care settings to ensure more systematized treatment strategies.
  6. Studies should be done in the areas of prevention/early intervention strategies that target known risk factors that may lead to later ADHD.
  7. Further evaluation is necessary for the rapidly evolving technology of brain-imaging techniques as a possible tool in the diagnosis and subsequent management of ADHD.

For more information regarding attention deficit disorder, contact the local school-district office or one of the following:

Bureau of Education for the Handicapped
U.S. Office of Education
Washington, DC 20202

The Association for Children With Learning Disabilities, Inc.
3739 S. Delaware Place
Tulsa, OK 74105

Council for Exceptional Children
PO Box 9382 Mid-City Station
Washington, DC 20005

U.S. Office of Civil Rights
Washington, DC 20402

For more information about ADHD, please visit C.H.A.D.D. (Children and Adults With Attention-Deficit/Hyperactivity Disorder (http://www.chadd.org).

REFERENCE:

"ADHD Clinical Practice Guideline for the Diagnosis, Evaluation and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents." Subcommittee of the American Academy of Pediatrics on ADHD; Steering Committee on Quality Improvement and Management. Pediatrics 128 (2011): 1007.


Last Editorial Review: 7/2/2012


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