In the current issue of the Archives, we see additional evidence, in a retrospective design, that early developmental events are related to subsequent attention-deficit/hyperactivity disorder (ADHD) in children.1 Attention-deficit/hyperactivity disorder is a costly health condition rivaling traditional medical diseases in its effect on social, financial, and quality-of-life issues. Clinicians held a conviction in the early and mid-20th century that children with ADHD had minimal brain damage or minimal brain dysfunction.2 However, a vague phenotype characterization, the failure to identify the nature of the brain dysfunction in the mid-20th century, and demonstrations of substantial heritability for hyperactivity, inattention, and ADHD in the late-20th century rendered the terminology obsolete and also seemed to discourage investigations of environmental inputs to the condition. Did we discard the concept of brain damage too soon?
Nigg J. Environment, Developmental Origins, and Attention-Deficit/Hyperactivity Disorder. Arch Pediatr Adolesc Med. 2012;166(4):387–388. doi:10.1001/archpediatrics.2011.905