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It is a question that runs through the mind of every parent upon hearing an ADHD diagnosis: what caused this? Unfortunately, parents searching for a definite answer to that question will not find one. The medical community has thus far been unable to find a “smoking gun" as to a cause for attention disorders. Instead, ADHD theories run the gamut from genetic causes to the assertion that the syndrome is not actually a disorder but rather a creation of a conformist society.
Below is a sample of some of the current ADHD theories that have gained popularity over the years. While some are supported by scientific research and others are based on anecdotal evidence. Remember that for many children, the cause of ADHD is likely a complex combination of factors.
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ADHD Theories Related to Diet
For parents of ADHD children, food related ADHD theories offer the most hope. Unlike genetics, diet and nutrition can be strictly regulated if needed. Within the discussion of whether foods cause ADHD, concern seems to center on food allergies and food additives.
Elimination diets, such as the Feingold Program, have long been a popular way for parents to determine whether a child is reacting negatively to a food in their diet. Gluten, dairy and artificial food dyes are often targeted as the culprits.
Research studies seem to support the assertion that food, if not the cause of ADHD, can certainly play a role in making its symptoms worse. While food dyes have garnered the most attention lately, studies have also been done on other dietary staples. For example, a small study initiated in Norway in 1996 seems to demonstrate that eliminating milk proteins from the diet of ADHD children results in a clear improvement in behavior and hyperactivity.
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ADHD Theories Related to Genetics and Neurodiversity
There is little doubt that genetics play a role in ADHD. Research indicates that up to 76 percent of the factors that contribute to an individual’s ADHD can be attributed to family history. How genetics causes the symptoms is less clear. It may be related to brain structure, chemical make-up of the brain or differences in how the brain functions to control impulses and activity.
Alongside the idea that genetics cause ADHD is an emerging theory of neurodiversity. The concept first gained traction in the late 1990s with autism activists. Neurodiversity argues that humans are complex beings who encompass a broad spectrum of experiences and behaviors. While mainstream culture categorizes those with autism, ADHD and related disorders as having something “wrong" with them, the theory of neurodiversity holds that they are instead “different."
In addition, this idea of different shouldn’t be equated with “bad." Under the theory of neurodiversity, those with ADHD have behavior that represents an alternate type of brain function. Just as society expects us to value differences in gender and ethnicity so too should attention disorders be embraced as part of our human diversity. Neurodiversity asks that the differences exhibited by those with autism and ADHD be celebrated, not stifled.
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ADHD Theories Related to Environmental Factors
As mentioned previously, the causes of ADHD are believed to be complex with no one factor causing ADHD in its entirety. However, two environmental factors have been shown to increase inattention and hyperactivity in children.
The first environmental cause of ADHD is maternal smoking. Women who smoke while pregnant are more likely to have children with hyperactivity and attention disorders. In a 1996 study conducted by researchers at the Massachusetts General Hospital, 22 percent of children with ADHD had mothers who smoked during pregnancy compared to 8 percent of children without attention disorders. A 2003 population-based study confirmed the results and found that maternal smoking was associated with a significant increase in ADHD symptoms among children.
Another environmental factor related to ADHD is exposure to lead. Researcher Joel Nigg has led recent efforts to connect lead to attention disorders and hyperactivity. In one study, children diagnosed with ADHD had slightly higher levels of lead in their blood compared to that of children in a control group. This study linked only the hyperactivity and impulsivity symptoms of the disorder with elevated lead levels. However, a second study concludes that teachers and parents report higher levels of both hyperactivity and inattention in children with higher lead levels.
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ADHD Theories Related to Social Construct
A final ADHD theory worth discussing is the idea that ADHD is not, in fact, a disorder at all. Instead, it is a social construction created by a culture that expects too much from children too soon. Proponents of the social construct theory argue that children are naturally immature and distraction and hyperactivity are to be expected.
In addition, a whole host of societal factors—from parental pressure to succeed to pharmaceutical companies’ quest for profits—can be used to explain the rise in ADHD diagnoses in recent years. Those who believe ADHD is a social construct point to the lack of medical testing for the disorder, the hazy criteria sometimes used to establish a diagnosis and the lack of a clear method of treatment.
Under the theory of social construct, children are boxed into cultural expectations. Instead of families being encouraged to problem-solve on their own, categorizing children with attention disorders promotes the use of medications that can have significant side effects. Overall, the idea of social construct asserts that ADHD was created as a convenient scapegoat when a child cannot be easily controlled or corrected.
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“Milk, ADHD, and Dr. Reichelt's Theories." The ADHD Information Library (http://newideas.net/adhd/milk-adhd-dr-reichelts-theories)
Association for Psychological Science. "Lead May Be the Culprit in ADHD." ScienceDaily 29 January 2010. 22 September 2010 (http://www.sciencedaily.com /releases/2010/01/100128130227.htm)
Smalley, Susan. “Reframing ADHD in the Genomic Era." Psychiatric Times 1 June 2008
“Attention Deficient Hyperactivity Disorder (ADHD) – Cause." WebMD (http://www.webmd.com/add-adhd/tc/attention-deficit-hyperactivity-disorder-adhd-cause)
Armstrong, Thomas. “Special Education and the Concept of Neurodiversity." New Horizons for Learning (http://www.newhorizons.org/spneeds/inclusion/information/armstrong.htm)
Solomon, Andrew. “The Autism Rights Movement." New York Magazine 25 May 2008
National Institute for Mental Health. “What Causes ADHD." (http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/what-causes-adhd.shtml)
Thapar, Anita et al. “Maternal Smoking During Pregnancy and Attention Deficit Hyperactivity Disorder Symptoms in Offspring." American Journal of Psychiatry 2003
Milberger, S et al. “Is maternal smoking during pregnancy a risk factor for attention deficit hyperactivity disorder in children?" American Journal of Psychiatry 1996
Timimi, Sami and Taylor, Eric. “ADHD is best understood as a cultural construct." The British Journal of Psychiatry 2004