Written in September 2025
One of the most pervasive myths about ADHD is that it’s a new thing. I’ve heard “we didn’t have all this ADHD stuff when I was at school” over and over again; if I had £1 for each time I’d be on rather a nice holiday right now.
ADHD is not new. None of this neurodiversity stuff is, even though that word is only 30ish years old.
First mentions of ADHD
The first mentions of what we now describe as ADHD in medical literature were published in 1775 by Melchior Adam Weikard’s in his book Der Philosophische Arzt (The Philosophical Doctor). Although this first edition and a subsequent second edition were published anonymously, it was strongly believed at the time (and still is now) that Weikard was the author. It wasn’t a well received book, so perhaps his decision to keep his name off it was sensible.
In Der Philosophische Arzt, Weikard described a condition affecting children (more so than adults) which he defined as a “lack of attention disorder”. It’s not a great leap from that to the name we use today.
Weikard described a set of traits (or symptoms) which we’d recognise in today’s diagnostic checklists and screening tools. He described people
- who were so distractible they could be distracted by their own imagination,
- who needed to put more effort in to complete tasks,
- who were seen as flighty,
- who seemed careless,
- who made frequent errors in their work,
- who were generally disorganised,
- who could be impulsive.
He recommended some “cures” for this, including isolation, cold baths, quinine, steel powders, mineral water, gymnastics, removing distractions and horseback riding. Many of these things would be dismissed as quackery now, however without actually knowing the underlying cause of ADHD he did land on a couple of useful strategies.
Removing distractions can help (such putting your phone in another room to create a barrier to scrolling), as can cold baths or plunging your face in cold water (this resets the nervous system) and exercise (movement can be really helpful for managing focus and emotions).
Weikard’s theory was that this condition was due to improper upbringing. A real “blame the parents” moment for science.
The Goulstonian Lectures of 1902
In 1902 the physician George Frederick Still delivered three lectures on the topic of children with “defects of moral control”, as he put it. The language is very Victorian, and the first two lectures use a lot of words we (thankfully) know better than to use today.
What Still was trying to achieve was to define a condition that caused this so-called “lack of moral control” or “inhibitory volition” in children where the cause could not be ascribed to another physical or mental condition. The first two lectures cover his observations in great detail and are not fun reading.
The third lecture explains how this apparent moral failing can present without an obvious cause, within the context of the thinking of the time. The cases he described could be considered to also refer to ODD (Oppositional Defiant Disorder) and CD (Conduct Disorder) which are often diagnosed alongside ADHD by behaviouralist-leaning clinicians.
Still noted that the majority of the cases in the third lecture were in children of normal intellect – that there was no “abnormality” in intellectual capacity. He did note, however, that some of these children struggled with school despite having normal or above average intelligence. Still mentioned too that there were episodes of “insanity”, which we would couch today in much more understanding terms of “emotional dysregulation”.
He also noted that the loss of moral control appears to be temporary, not continual. This was cause for concern about the origins of the condition he was studying, and today we would understand that when the environment is right and the child’s needs are met, ADHD traits can be less obvious, easier for the child to manage, or not a problem at all.
What can we take from this?
Weikard and Still are by no means the only people to have observed and written about ADHD cases through recent history, though they are notable for their influence.
In both cases, a neurodevelopmental angle was not taken and this is likely due to the context of medical knowledge at the time. In the 1700s the idea of psychology was a somewhat niche idea that wouldn’t become a formal area of study until nearly 75 years after the publication of Weikard’s book. The concept of neurobiology just did not exist.
Weikard attributed the cause to poor upbringing and while Still didn’t directly pin the blame on parents, he did use language that heavily implied that a lack of proper instruction was a cause. Still noted a family link in the presentation of this “defect of moral control”, and used language like “inhibitory volition” to imply that the behaviours he was observing were a conscious and deliberate choice on the part of his case studies.
The mention of normal intellect further cements this idea, pointing to the idea that if people can understand what they “should” do, then there should be no problem in enacting the correct choice. As we know now, the more problematic aspects of ADHD that lie in motivation and task inertia are not a choice; we cannot “think” ourselves into the right state to start or complete a task.
The influence of these works on modern thinking on ADHD cannot be dismissed. Many of the myths and misconceptions that exist today about ADHD are rooted in them.
I am, at this point, reminded of the Maya Angelou quote that I overuse –
“Do the best you can until you know better. Then when you know better, do better”