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Fifteen years ago, no one had ever heard of attention deficit hyperactivity disorder. Today it is the most common behavioral disorder in American children, the subject of thousands of studies and symposiums and no small degree of controversy. Experts on ADHD say it afflicts as many as 3 1/2 million American youngsters, or up to 5% of those under 18. It is two to three times as likely to be diagnosed in boys as in girls. The disorder has replaced what used to be popularly called "hyperactivity," and it includes a broader collection of symptoms. ADHD has three main hallmarks: extreme distractibility, an almost reckless impulsiveness and, in some but not all cases, a knee-jiggling, toe-tapping hyperactivity that makes sitting still all but impossible. (Without hyperactivity, the disorder is called attention deficit disorder, or ADD.)
For children with ADHD, a ticking clock or sounds and sights caught through a window can drown out a teacher's voice, although an intriguing project can absorb them for hours. Such children act before thinking; they blurt out answers in class. They enrage peers with an inability to wait their turn or play by the rules. These are the kids no one wants at a birthday party.
Ten years ago, doctors believed that the symptoms of ADHD faded with maturity. Now it is one of the fastest-growing diagnostic categories for adults. One-third to two-thirds of ADHD kids continue to have symptoms as adults, says psychiatrist Paul Wender, director of the adult ADHD clinic at the University of Utah School of Medicine. Many adults respond to the diagnosis with relief -- a sense that "at last my problem has a name and it's not my fault." As more people are diagnosed, the use of Ritalin (or its generic equivalent, methylphenidate), the drug of choice for ADHD, has surged: prescriptions are up more than 390% in just four years.
As the numbers have grown, ADHD awareness has become an industry, a passion, an almost messianic movement. An advocacy and support group called CHADD (Children and Adults with Attention Deficit Disorders) has exploded from its founding in 1987 to 28,000 members in 48 states. Information bulletin boards and support groups for adults have sprung up on CompuServe, Prodigy and America Online. Numerous popular books have been published on the subject. There are summer camps designed to help ADHD kids, videos and children's books with titles like Jumpin' Johnny Get Back to Work! and, of course, therapists, tutors and workshops offering their services to the increasingly self-aware ADHD community.