ADHD: What We Used to Call It, What We Know Now, and What Actually Helps

ADHD is not new. Our understanding of it is.

For over 100 years, children (and adults) who struggled with attention, impulsivity, emotional regulation, and restlessness have existed in classrooms-often misunderstood, mislabeled, or disciplined instead of supported.

What has changed isn’t the children.

It’s the language.

What ADHD Was Called Over the Last 100 Years

ADHD has worn many names-and each one reflects how society viewed behaviour at the time.

• Early 1900s: “Defect of moral control” (Sir George Still, 1902)

• 1930s–1950s: “Brain-injured child syndrome”

• 1960s: “Minimal Brain Dysfunction”

• 1980 (DSM-III): “ADD” (Attention Deficit Disorder)

• 1987 onward: ADHD (Attention-Deficit/Hyperactivity Disorder)

  
  

Today, under the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ADHD is recognised as a neurodevelopmental disorder.

Not a moral issue. Not poor parenting. Not laziness.

A neurodevelopmental difference with strong biological underpinnings.

Research consistently shows ADHD is highly heritable-with heritability estimates around 70–80% (Faraone et al., 2005; Thapar et al., 2013). Brain imaging studies show differences in executive functioning networks, dopamine regulation, and cortical maturation timelines.

This is brain-based.

How Common Is ADHD?

ADHD is one of the most common neurodevelopmental conditions worldwide.

• Global prevalence in children: ~5–7% (Polanczyk et al., 2007; Thomas et al., 2015)

• Australian prevalence in children aged 4–17: approximately 8–10% (Australian Institute of Health and Welfare, 2023 estimates)

• Boys are diagnosed at roughly 2–3 times the rate of girls

But here’s the part that matters:

Many experts now believe girls are underdiagnosed-not unaffected.

The Three Types of ADHD Diagnosis

Under the DSM-5, ADHD is diagnosed as one of three presentations:

1. Predominantly Inattentive Presentation

More common in girls.

• Difficulty sustaining attention

• Appears forgetful

• Disorganised

• Struggles with task completion

• Often labelled “daydreamy”

Because this presentation is less disruptive, it is often missed in classroom settings.

2. Predominantly Hyperactive-Impulsive Presentation

• Fidgeting

• Constant movement

• Interrupting

• Blurting

• Risk-taking behaviour

This is the stereotypical image most people think of.

3. Combined Presentation

A mix of inattentive and hyperactive-impulsive traits.

Boys and Girls Do NOT Present the Same

For decades, ADHD research was conducted primarily on boys.

Large-scale diagnostic criteria were normed on hyperactive male presentations. Girls, who often internalise symptoms, were overlooked.

Research over the last 10–15 years has shown that girls with ADHD are more likely to:

• Present with inattentive symptoms

• Mask or compensate socially

• Develop anxiety or depression

• Experience significant self-esteem issues

  
  

Studies suggest that girls are referred later and diagnosed later-often in adolescence or adulthood (Quinn & Madhoo, 2014; Hinshaw et al., 2021).

Until recently, there was very limited literature on how ADHD presents in females.

That delay has had consequences.

Adult women are now being diagnosed in record numbers-not because ADHD is new, but because recognition is finally catching up.

My Own Story: Coca-Cola and Survival

Years before I was ever diagnosed-before ADHD was even considered-I used Coca-Cola to manage my focus.

Caffeine is a stimulant.

Stimulant medications such as methylphenidate (e.g., Ritalin) and amphetamine-based treatments work by increasing dopamine and norepinephrine availability in the brain-improving executive functioning and attention regulation.

Without understanding the neuroscience, I instinctively gravitated toward something that slowed my brain enough to think clearly-don't get me wrong drinking 2 litrs of coke in a day while doing my HSC not exactly healthy but it did help me with my study and focus.

I wasn’t defiant. I wasn’t lazy. I was self-regulating the only way I knew how.

That doesn’t make it ideal. But it makes it understandable.

Medication: Effective, But Not the Only Strategy

Stimulant medication is considered first-line treatment and is effective for approximately 70–80% of children with ADHD (Cortese et al., 2018).

But medication alone is not a full support plan.

Best practice includes:

• Psychoeducation

• Behavioural supports

• Environmental adjustments

• Parent training

• School accommodations

Practical Strategies for Parents (Evidence-Based)

Research supports behavioural parent training programs as effective in improving outcomes (Daley et al., 2018).

1. Structure & Predictability

Children with ADHD thrive on routine.Visual schedules reduce cognitive load.

2. External Executive Function

ADHD affects working memory.Use:

• Checklists

• Timers

• Written reminders

• Visual cues

Make the invisible visible.

3. Positive Reinforcement

Immediate, specific praise increases compliance more effectively than punishment.

4. Movement Breaks

Physical activity has been shown to improve attention and reduce hyperactivity symptoms in the short term.

5. Emotional Regulation Coaching

Children with ADHD often have delayed emotional regulation development (Barkley, 2015).Teaching emotional literacy is protective.

Classroom Strategies (Research-Informed)

Teacher-delivered classroom interventions significantly improve behaviour and academic engagement (DuPaul et al., 2012).

1. Clear, Chunked Instructions

One direction at a time.Check understanding.

2. Flexible Seating & Movement Access

Standing desks.Errand roles.Sensory tools. (Can we please end this concept that a student must be seated to complete work! My best work is completed laying on my stomach on the floor-and yes that was done at a wor place-because they realised that’s how I work best)

3. Reduced Public Correction

Private redirection maintains dignity and reduces oppositional escalation.

4. Adjust Workload Structure

Shorter work bursts.Frequent feedback.Alternative demonstration of learning.

5. Focus on Functional Impact

Ask:“How is this impacting access to learning?”

Not:“Why won’t they behave?”

That shift protects children from shame-based systems.

The Cost of Getting It Wrong

Untreated or unsupported ADHD is associated with:

• Increased school disengagement

• Higher rates of suspension and exclusion

• Increased risk of anxiety and depression

• Increased likelihood of substance misuse

• Higher rates of contact with the justice system

But early support dramatically improves outcomes.

This is not about labelling children.

It is about removing barriers.

ADHD Is a Difference -Not a Deficit

Many individuals with ADHD demonstrate strengths in:

• Creativity

• Rapid problem-solving

• High energy

• Entrepreneurial thinking

• Empathy

• Big-picture innovation

When supported properly, these traits become assets.

When shamed, they become wounds.

References

• American Psychiatric Association (2013). DSM-5.

• Australian Institute of Health and Welfare (2023). ADHD prevalence estimates.

• Barkley, R. (2015). Emotional dysregulation in ADHD.

• Cortese, S. et al. (2018). Comparative efficacy of ADHD medications. The Lancet Psychiatry.

• Daley, D. et al. (2018). Behavioural interventions for ADHD.

• DuPaul, G. et al. (2012). School-based interventions.

• Faraone, S. et al. (2005). Genetic influences on ADHD.

• Hinshaw, S. et al. (2021). Girls with ADHD longitudinal outcomes.

• Polanczyk, G. et al. (2007). Worldwide prevalence meta-analysis.

• Quinn, P., & Madhoo, M. (2014). ADHD in women and girls.

• Thomas, R. et al. (2015). Global prevalence meta-analysis.