ADHD: An 18th-Century Condition in the 21st-Century World

How old is ADHD? Newly uncovered medical texts from 1753 have updated the earliest documented mention of what would be considered modern “attention deficits.”¹ Independent of one another, Dutch physician Cornelius Albert Kloekhof and French physician Etienne Le Camus arrived at similar observations (both influenced by German physician Hieronymus David Gaubius), though Kloekhof’s work had more influential ripple effects on subsequent treatments of what is now known as ADHD.

Kloekhof’s work had been cited by German physician Melchior Adam Weikard, who had previously held the spot of the earliest mention of ADHD, devoting a chapter of his 1775 book to the topic of “Lack of Attention, Attentio Volubilis.” (Volubilis derives from the Latin volvere [“to roll”] and translates into the middle English voluble, all of which refer to “rotating around an axis” or “having a tendency to change,” per the online Oxford English dictionaries.) As observed in Weikard’s opening sentence to his chapter, “Those, who have a lack of attention, are generally characterised as unwary, careless, flighty and bacchanal.”²

A chapter published just shy of the turn of the 19^th century by physician Alexander Crichton³ also observed an attention deficit syndrome. Crichton described attention as “the parent of all our knowledge.”

ADHD in the 20th Century

Pediatrician George Still⁴ had long been credited with the distinction of the first account of ADHD in medical literature. Still reported on a group of 20 children who had no history of organic brain disorders or injuries who nevertheless had significant symptoms of impulsivity and poor self-control. Their difficulties (poor “inhibitory volition”) were viewed by Still as dispositional and thus likely rooted in hereditary, rather than environmental, causes (i.e., poor parenting).

It was later in the 20^th century that an ADHD-related diagnosis was officially introduced in DSM-II⁵ via a 22-word description of “Hyperkinetic reaction of childhood (or adolescence).” After a brief stint as attention deficit disorder (either with or without various subtypes), the current designation is attention-deficit/hyperactivity disorder (with predominantly inattentive, predominantly hyperactive/impulsive, or combined presentations).

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Critics often cite ADHD as a product of our modern world and lifestyle, particularly in the United States. Although the 18^th century is certainly not prehistoric, the discovery and translation of the Kloekhof text places ADHD before the establishment of the U.S. The authors reporting the new beginnings of ADHD take pains to point out that the issue of attention was already a domain of interest and research in the late 17^th century. Attention was viewed as a central feature of human nature, which, by logical extension, could result in difficulties from deficits of attention.¹

Validation for Those With ADHD in the 21st Century

In addition to the historical relevance of the discovery of the Kloekhof text, the long history of attention problems provides a point of validation for individuals who struggle with ADHD in the 21^st century, especially as it encompasses so much more than attention problems. Along with increased awareness and the development of various international guidelines for managing ADHD, including the forthcoming American guidelines and professional tool kits for the assessment and treatment of adult ADHD, there are more treatments and supports for helping individuals of all ages to better manage and transcend the difficulties associated with ADHD.