Education Matters: ADHD going back centuries

Marsha Sutton
Marsha Sutton

By Marsha Sutton

How many parents have watched their children, more often boys, bouncing off the walls and running wild, unable to sit still or focus on a task for more than a few seconds?

We’ve all seen these kids – they are easily distracted, can’t wait their turn, and move around like mini-tornadoes. Is this just “being a boy” disease, or is it a medical condition that needs treatment?

David Feifel, M.D., professor in the department of psychiatry at the University of California San Diego, is an expert on Attention Deficit Hyperactivity Disorder, particularly in adults, and offered insights into the phenomenon of ADHD at a recent adult lecture at UCSD titled “ADHD Across the Lifespan.”

Because ADHD has gained more attention in the past few decades doesn’t mean it’s a new disease. ADHD is an old condition, observed and documented since the late 1700s, he said, and has generally been defined as the inability to inhibit impulsive behavior.

Girls also suffer from ADHD, although they can lack the hyperactivity aspect and so are easily overlooked, he said. Teachers often don’t identify the students who are not disruptive, those who sit quietly and daydream. But girls, Feifel said, can be internally pre-occupied and have ADHD with non-activated hyperactivity.

About 8 percent of school-age children and about 4.5 percent of adults have ADHD, he said, with statistics similar across cultures and countries. So this is not just an American phenomenon.

Four times as many males are diagnosed with ADHD as females, and in 60 percent of cases the condition persists into adulthood. This means, on the positive side, that about 40 percent of children and adolescents grow out of the condition as their brains mature or they learn to cope and function appropriately.

The 8 percent adolescent figure may seem low to those living in more affluent communities, but Feifel said 8 percent is the “true rate.” He distinguished between the “true rate” and the “diagnosed rate,” which depends upon several factors.

Those who live in low-income areas may see doctors less frequently, are less knowledgeable about identifying symptoms, or are less exposed to outside sources that can alert families to the condition.

“If I went to one school and gave a free public talk to teachers and parents on ADHD, the diagnosis rate at that school may change and end up differently than the school in the next neighborhood, even though the prevalence of ADHD among the students is identical,” Feifel said in an email.

The “true rate” is the prevalence of a disease or condition in the general population. “That’s a rigorous way to determine how many people have a condition whether they know it or not, whether they see a doctor or not,” he said.

Findings consistently show that, in studies of randomly selected subjects, about 8 out of every 100 kids have ADHD. That number, he said, has stayed fairly constant over the last few decades, despite pockets of increased diagnoses in higher socio-economic communities with more awareness and access to medical attention.

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