ADHD is a real problem for many kids and parent! So why the controvery?
I have watched the evolution of our conception of this “mental disorder” from the time was called Minimum Brain Dysfunction to the current DSM-5 definition of ADHD (attention-deficit/hyperactivity disorder) with 3 sub-types ie combined presentation; predominantly inattentive presentation and predominantly hyperactive/impulsive presentaton prior to age 12.
Our understanding of the neurobiology has progress with functional MRI and diffusion MRI studies. Some studies suggest that the inattentive form is different from the hyperactive form by being a primary deficit in working memory. There is evidence to suggest that there are abnormalities of white matter pathways identifying a specific sensory processing disorder (SPD) not recognized in the DSM-5.
There is co-morbidity of SPD with attention deficit hyperactivity disorder (ADHD) and autism and there are ofter many other co-morbidities with ADHD including anxiety, learning disorders, and mood disorders. It is obvious then the these diagnoses reflect complex heterogenous abnormalities of neurobiology in the child dynamic developing brain/mind.
Until we can unravel the complex neurobiology we will be like the blind men and the elephant. And we must approach each child as unique and therefore tailor treatment accordingly always remembering: “Even the term ‘mental disorder’ implies a mind-body dichotomy that is outmoded and not embraced by most present day basic neuroscientists and developmental neurobiologists.” Peter Jensen et al.