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November 30, 2000
Causes of Attention-Deficit Hyperactivity Disorder
Five percent of all school-age children have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).  Most of these children are males (O'Connel, 1996).  ADHD is characterized by inattention, hyperactivity, and/or impulsivity that are developmentally inappropriate and are not the result of other conditions.

    Despite the fact that ADHD has been studied and researched extensively, no single cause of ADHD has been discovered (Conners, 1998).  Many causes, however, have been hypothesized and researched.  In the seventies, sugar and food additives were thought to be causes of ADHD (The Ritalin Rx, 1996). Yet diets that would have corrected this problem have not been proven effective by research (Attention Deficit, 1994; The Ritalin Rx, 1996).  A bad home life has also been thought of as a cause of ADHD.  This theory has also been rejected.  No clear relationship between home life and Attention-Deficit Hyperactivity Disorder has been determined (Attention Deficit, 1994).  ADHD has also been related to minimal brain dysfunction (Savage, 1996; O'Connel, 1996; The Ritalin Rx, 1996).  Most of the evidence from current research points to biological causes (Swanson & Castellinos, 1998; Attention Deficit, 1994).  Research has shown that people with ADHD have abnormalities in two brain regions (Swanson & Castellinos, 1998).  Also, many family, twin, and adoption studies have documented a strong genetic basis for ADHD (Swanson & Castellinos, 1998).  Damage to neurodevelopment, especially during fetal development, is strongly related to ADHD.  Research has shown that abnormalities in neural networks that affect input-output processing and attention are affected by stimulant drugs.  These drugs are the same drugs that doctors prescribe to children with ADHD (Swanson & Castellinos, 1998).  Teratogens such as maternal alcohol, tobacco use, lead, smoking, and lack of nutrients may also be related to ADHD (Conners, 1998).

    Diagnosing a child with ADHD is a difficult process.  This may be due to the unknown cause of ADHD.  Diagnosis is also difficult because symptoms of ADHD are common and the interpretation of these symptoms is subjective (The Ritalin Rx, 1996).  Many parents go to their family physician and demand a diagnosis for ADHD so that the child can be medicated and the child's behavior problems will be corrected.  Many pediatricians succumb to the pressure and often make an inaccurate diagnosis after a 15-minute evaluation.  But a proper evaluation of the child is important to have accurate results.  This evaluation is time consuming because it requires "a comprehensive assessment of the child's environment, biological factors, school, home, [and] review of medical records" (The Ritalin Rx, 1996).  Due to the fact that many children are being diagnosed improperly, many children are being overdiagnosed.

    Because ADHD is so common, all educators need to keep reading current research.  Educators need to be aware of causes, treatments, and indications of ADHD so that they can provide parents with information.  Many parents still believe that sugar, emotional problems, and home life problems cause ADHD.  These causes are unproven.  Educators should show parents what the research says.  However, educators should also keep in mind that nothing is absolute.  Biological causes may seem the cause of ADHD now, but this perception could change in a few years.

    Future parents should also be aware of the research surrounding ADHD, since some teratogens may cause ADHD.  Unfortunately, many of the same teratogens that are linked to ADHD are also linked to other development problems.  This may be why some children with ADHD may also have learning disabilities.

    If parents believe their child may have ADHD, they should make sure their child is evaluated properly.  Though it may be tempting to get a quick diagnosis so that their child can receive medicine and can be treated quickly, parents should know that medicine is not a quick fix.  Many professionals are now suggesting that children diagnosed with ADHD be treated with medicine, behavioral management, and counseling.  Also, children diagnosed with ADHD may have that label the rest of their lives.  A misdiagnosis could harm the child in educational performance, in social situations, and emotionally.  Parents need to pick their doctors carefully and not pressure a doctor to make a diagnosis.  Physicians also are responsible for making an accurate diagnosis.  Collaboration between parents, teachers, and physicians can make a big difference in whether a child is diagnosed correctly.

    Attention-Deficit Hyperactivity Disorder has been known by many names in the past century.  Controversy has arisen over its causes and treatments.  Teachers, parents, and future parents need to stay current on ADHD research.  Physicians should properly evaluate children before diagnosing them with ADHD.  Most of all, the child should be kept in top priority.  ADHD may affect parents and teachers for a short period, but it will affect the child for a lifetime.


   Attention Deficit Hyperactivity Disorder.  (1994).  National Institute of Mental Health [Publication No. 96-3572].  Retrieved November 18, 2000 from the World Wide Web:

   Conners, C. K.  (1998).  Overview of attention deficit hyperactivity disorder.  In NIH consensus development conference on diagnosis and treatment of Attention Deficit Hyperactivity Disorder (pp. 21-24).  Maryland:  National Institutes of Health.

   Savage, T.  (1996, May-June).  Ethical issues surrounding attention deficit hyperactivity disorder.  Pediatric Nursing, 22(3), 239-243.

   Swanson, J., & Castellanos F. X.  (1998).  Biological Bases of ADHD:  Neuroanatomy, genetics, & pathophysiology. In NIH consensus development conference on diagnosis and treatment of attention deficit hyperactivity disorder (pp. 37-41).  Maryland:  National Institutes of Health.

   O'Connell, K.  Attention Deficit Hyperactivity Disorder.  (1996, January).  Pediatric Nursing 22(1), 30.

   The Ritalin Rx:  Controversy, Abuse.  (1996, June 10).  Newsday, pp. A5.