ADHD - An Illustrated historical overview

A lfred Tredgold (1870–1952), a highly respected member of the English Royal Commission on Mental Deficiency and author of Mental Deficiency ( Amentia ; first published 1908), extended Still´s theory and observations and suggested that some forms of brain damage could present as behaviour or learning prob- lems in early school years. He was also the first to propose the existence of what would later be termed "minimal brain damage". Tredgold and Still were well aware of the legal and social importance of their findings. While the initial clinical description of ADHD is usually attributed to Still, Tredgold’s writings had a lasting impact on the social and political debate at the beginning of the 19 th century on how to deal with the feeble minded, as well as upon the classification of mental disorders through the landmark Mental Deficiency Act of 1913. As attendance at public elementary and other schools had been compulsory in England since 1876, Tredgold and other researchers had access to a vast set of data and reports, but it was some time before effective management of these children was developed. Mental deficiency and inattention "Attention – In the lethargic, inert type of feeble-mindedness there is a defect of spontaneous attention; but this is never so marked in this degree as in the more serious grades of amentia. The general stir and excitement aroused by a visitor is much more pronounced in the special school than in the imbecile ward. On the other hand, active or voluntary attention is commonly in defect, both with regard to its intensity and its duration. The most trifling thing serves to distract these children from their occupation, so that even where the attention is readily gained, it is with difficulty held. Many of them become capable of pursuing a congenial task with a certain amount of patience, but the majority have neither power of concentration nor will sufficient to be capable of sustained mental effort against inclination or interposed obstacles. They must go with, for they cannot fight against, the stream; and this lack of willpower and driving force is one of the most distinguishing characteristics of aments at all ages." Alfred Tredgold, Mental Deficiency, 4 th edition, 1922.