ArticlePDF Available

Bad Boys, Good Mothers, and the “Miracle” of Ritalin



Contemporary debates around Attention Deficit/Hyperactivity Disorder (ADHD) and the most common form of drug treatment, Ritalin, are rarely placed in the context of the social-scientific history of diagnosis and drug treatment. This is possibly due to the fact that brain talk and brain imagery have replaced earlier theories about children's psychopathology that had mainly focused on the toxic effects of the mother. These theories and their psychoanalytic roots are considered somewhat embarrassing and certainly unscientific in a contemporary light, and modern biological psychiatry has worked hard to demonstrate that physiological and genetic factors underpin this contested disorder. Such theories have tended to make the history of ADHD and Ritalin seem irrelevant to scientific progress and understanding of disorder, as well as to public understanding and acceptance of disorder and drug treatment. Examining this history, however, clarifies the relation between social, cultural, and scientific values in constructing a need for medical intervention within the domestic realm. When, Ritalin came on the United States market in 1955, neither psychiatric diagnosis of children's behaviors, nor drug treatments for children's behavior were commonplace. Mothers especially were located in the center of active political, moral, and scientific debates over boys' normative behaviors. These debates helped codify an intimate association between a problem boy and his problematic mother in relation to ADHD diagnosis and Ritalin treatment. The story I tell here suggests that this association may have supported mothers' acceptance of medical intervention and drug treatment for their boys' troublesome, but arguably not pathological, behaviors. In the concluding sections I argue that the lack of attention to these social-scientific roots means that we miss seeing their potential relevance to the contemporary predicament of rising ADHD diagnoses and Ritalin use.
Bad Boys, Good Mothers, and the “Miracle” of Ritalin
Ilina Singh
Centre for Family Research, Faculty of Social and Political Sciences, University of Cambridge
Contemporary debates around Attention Deficit/Hyperactivity Disorder (ADHD) and the
most common form of drug treatment, Ritalin, are rarely placed in the context of the social-
scientific history of diagnosis and drug treatment. This is possibly due to the fact that brain talk
and brain imagery have replaced earlier theories about children’s psychopathology that had
mainly focused on the toxic effects of the mother. These theories and their psychoanalytic
roots are considered somewhat embarrassing and certainly unscientific in a contemporary
light, and modern biological psychiatry has worked hard to demonstrate that physiological
and genetic factors underpin this contested disorder. Such theories have tended to make the
history of ADHD and Ritalin seem irrelevant to scientific progress and understanding of
disorder, as well as to public understanding and acceptance of disorder and drug treatment.
Examining this history, however, clarifies the relation between social, cultural, and scientific
values in constructing a need for medical intervention within the domestic realm. When
Ritalin came on the United States market in 1955, neither psychiatric diagnosis of children’s
behaviors, nor drug treatments for children’s behavior were commonplace. Mothers especially
were located in the center of active political, moral, and scientific debates over boys’
normative behaviors. These debates helped codify an intimate association between a problem
boy and his problematic mother in relation to ADHD diagnosis and Ritalin treatment. The
story I tell here suggests that this association may have supported mothers’ acceptance of
medical intervention and drug treatment for their boys’ troublesome, but arguably not
pathological, behaviors. In the concluding sections I argue that the lack of attention to these
social-scientific roots means that we miss seeing their potential relevance to the contemporary
predicament of rising ADHD diagnoses and Ritalin use.
In 1996 Newsweek magazine called Attention Deficit/Hyperactivity Disorder
(ADHD) America’s “No. 1. childhood psychiatric disorder” (Hancock 1996, 51). In
1998 a National Institutes of Health Consensus Conference statement admitted in its
final remarks, “After years of clinical research and experience with ADHD, our
knowledge about the cause or causes of ADHD remains speculative” (National
Institutes of Health 1998). Despite the mysterious etiology and consequent
Science in Context 15(4), 577–603 (2002). Copyright © Cambridge University Press
DOI: 10.1017/S0269889702000650 Printed in the United Kingdom
controversy over ADHD, however, diagnoses continue to rise.
Based on 1994 U.S.
Census gures, 6 per cent of boys and 1.5 per cent of girls in the United States
population have been diagnosed with ADHD (Swanson et al. 1993). As alarming as
these numbers may seem, at least one prominent researcher of ADHD believes the
true proportion of ADHD in the U.S. childrens population to be nearer 10 per
Hand in glove with the ADHD controversy is controversy over Ritalin, the most
common form of treatment for the disorder. Ritalin is the market name for the
stimulant drug methylphenidate, originally manufactured by Ciba (now Novartis).
ADHD and Ritalin cannot truly be disaggregated in contemporary debates. U.S.
consumption of Ritalin has risen sharply, from 70 dened daily doses (DDD) in 1990
to approximately 425 DDD in 1999. To put these numbers in some perspective: In
1999 the U.S. accounted for 85 per cent of worldwide medical use of Ritalin (United
Nations Report 1999).
In contemporary debates ADHD and Ritalin enjoy almost iconic status; they are
a focal point of modern anxieties about children, parents, families, schools, cities,
civilization, and genetic futures. Popular media articles capitalize on the novelty of
the Ritalin riddle, a brain teaser for the 90s, questioning whether our culture has
gone so high-baud haywire that it is willing to tranquilize children into submission
(Hancock 1996, 51). Psychologists writing for a popular audience have called ADHD
a symptom of a rapid-re culture rather than brain-based disorder (DeGrandpre
1999), and have connected ADHD diagnosis with a cultural intolerance of boys,
whose high energy levels and aggressiveness can make them difcult for teachers and
parents to handle. By this argument Ritalin is used to medicate boyhood (Pollack
1998; Kindlon and Thompson 1999).
Environmental explanations for ADHD diagnosis and Ritalin use are positioned on
one side of a sharply polarized debate about the true causes of symptomatic behaviors
and the legitimacy of diagnosis and treatment. On the other pole, the biological
According to DSM-IV, ADHD is a childhood psychiatric disorder characterized by three core behavioral
problems: impulsiveness, inattention, and hyperactivity. The intensity and pervasiveness of these common
childhood behaviors are key components in the translation of behaviors into symptoms; symptoms must be
present in two or more locations and they must have been present to a disruptive degree for six months or
longer. There is no diagnostic test for ADHD, and evaluations for the disorder vary widely, from 15-minute
sessions with a pediatrician to multi-disciplinary neuropsychological evaluations.
Joseph Biederman is one of Americas foremost experts on ADHD, and he is the Chief of Harvard Medical
School Child Psychopharmacology Clinic (see Biederman 1996, 26).
I am using Ritalin representatively here, as there are other stimulants on the market for ADHD. While in the
past Dexedrine was another popular stimulant, the relatively new drug Adderall appears to be making gains
in the market. In 1998 Adderall was the second most commonly prescribed treatment for ADHD by U.S.
pediatricians. However the difference in number of prescriptions is still large: In the year ending August 1998
pediatricians wrote 4.6 million prescriptions, valued at $165 million, for generic methylphenidate (Ritalin);
and 742,000 prescriptions, worth $24 million, for Shire Richwoods Adderall (
It is difcult to discern whether these writers believe that such boy behaviors are innate or culturally
derived, or a combination of both. There is increasing discussion of biological and genetic bases to young
childrens gendered behaviors within American developmental psychology (see for example Maccoby 1998).
578 Ilina Singh
perspective on ADHD posits dopamine processing dysfunction as the key to
understanding the disorder and views stimulant drugs as the most effective treatment.
While the media continues to stoke the nature-nurture debate, the reality is that the
medical-scientic perspective on ADHD is now widely accepted in the U.S.
Theories of a genetic basis to ADHD are rapidly gaining currency: Recently Russell
Barkley, a psychiatrist and a prominent proponent of the genetic account, has
suggested that we view ADHD as a template for understanding that human inhibition
and self control are traits [which are] largely, though not solely, genetically
determined (Barkley 1997, 318).
Public and scientic agitation over ADHD and Ritalin has a distinctly
contemporary avor, caught up in the familiar language of neurotransmitters, genes,
stress, and competition. And so it may come as a surprise that as far back as 1971 the
U.S. Department of Health, Education and Welfare estimated that 3 per cent of
school age children suffered from an antecedent of ADHD called hyperkinesis
(HEW 1971). Indeed, diagnosis and treatment of ADHD have been inspiring medical
and public debate for almost a century. Ritalin too has a history, now almost half a
century old and riddled with controversy. Over 30 years ago the Washington Post
created a media sensation with a report that 510 per cent of children in Omaha
school districts were being prescribed Ritalin or other behavior modifying
medication (Maynard 1970). National outrage over the Omaha Incident prompted
a federal inquiry entitled, Federal Involvement in the Use of Behavior Modication
Drugs on Grammar School Children in the Right to Privacy Inquiry (U.S.
Congressional Report 1970).
Despite the rich scientic and social history of ADHD and Ritalin there are few
historically based accounts in the literature. Peter Conrads inuential accounts of
medicalization have queried the relationship between the creation of a hyperkinesis
diagnosis and the availability of a social control mechanism in the form of
psychotropic drug treatment (Conrad 1975; idem 1992). Shrag and Divoky (1975)
include chapters on the invention of the hyperactivity diagnosis and Ritalin, which
present important details about governmental and pharmaceutical company practices
during the 1960s and 70s. However this history is rather biased due to the authors
strong anti-psychiatry position. Other literature on ADHD in the anti-psychiatry
tradition has tended to pursue a contemporary critique without delving further into
the historical context of diagnosis and drug treatment (i.e., Grinspoon and Singer
1973). Recent popular books on ADHD sketch a history of ADHD in their
introductory chapters (i.e., Barkley 1997; Hallowell and Ratey 1994; Diller 1998). To
a great extent these authors tend to repeat a version of the history of ADHD without
sufcient critical inquiry or analysis, collapsing a complicated century of changing
In comments to me on a research proposal, a prominent pediatrician and author wrote that the ideology
of ADHD behavior as a brain disorder is so strongly entrenched in the U.S., that any study that might deny
or delay the use of medication in the above age 6 years age group might be seen as medically unethical.
Bad Boys, Good Mothers, and the “Miracle” of Ritalin 579
diagnostic labels, symptoms, and etiology into a coherent story of disorder.
problem with such accounts is that they veil the productive processes by which this
disorder and its drug treatment achieved meaning, status, and power. The story of
how ADHD and Ritalin came into being and how they became meaningful as
solutions to the problematics of childrens behavior is still unfolding.
In this paper I hope to further the process of re-contextualizing ADHD and Ritalin
by excavating some of the historical and cultural surroundings that have nurtured
both this diagnosis and its drug treatment in America. On a general level I want to
understand something of how the diagnosis and drug came into being, and into
parents consciousness. More specically I seek to understand and describe the social-
scientic context that supported parents turn to medication to improve their
childrens behavior. I hope to make the point that as long as we understand ADHD
to be a de-contextualized problem of an individual brain we miss seeing the social-
scientic commitments that have been borne along in the ADHD diagnosis and in
Ritalin treatment. One such commitment I focus on in this paper involves the
intimate association between a problem boy and his problematic mother. I suggest
that this association has encouraged scientic interventions in childrearing generally,
and more specically, it has supported, and may continue to support, mothers turn
to ADHD diagnosis and Ritalin treatment for their childrens behavior and
Science on the Domestic Front
Ritalin came on the U.S. market in 1955, a time when pediatric psychotropic
treatments were not commonplace. How did it come to pass that a little more than
a decade later rates of Ritalin use would inspire a congressional inquiry? However
many pieces there are to that puzzle, at its center sits a family, and a boy (usually)
whose behavior is seen as problematic. Parents perceptions of these behaviors as a
medical problem that requires a medical solution is not a given. Therefore, in order to
understand the appearance and success of a medical diagnosis and intervention into
childrens problem behaviors, we need to understand something of how the science
of abnormal child behavior entered into and persuaded the domestic realm of its
authority and efcacy.
One widely cited claim in this history of ADHD is that the British physician George Still (1902) was the
rst to describe ADHD-like behaviors in children. In a series of lectures published in the Lancet, Still described
children who lacked inhibitory volition and had decits in attention and concentration. A closer look at
Stills descriptions of this group of 23 children reveals that attentional issues are secondary to his concern with
moral control. Still lists these childrens major qualities as (1) passionateness; (2) spitefulness-cruelty; (3)
jealousy; (4) lawlessness; (5) dishonesty; (6) wanton mischievousness-destructiveness; (7) shamelessness-
immodesty; (8) sexual immorality; and (9) viciousness (1902a). Most of these qualities are not considered
primary symptoms of ADHD (for further argument along these lines, see Palmer and Finger 2001).
580 Ilina Singh
Important domestic sources for scientic information on childrearing and child
behavior from the 1940s through the 1960s included popular books and magazine
articles. It is difcult to discover how parents acted in response to received advice and
information about child development; however the substance and nature of the
material itself can illustrate the particular kinds of scientic knowledge and beliefs
that penetrated the domestic realm (Mechling 1975). In popular womens and
parenting magazines during this period hundreds of articles provided advice and
information to women on the broad topic of child behavior. Regular contributions
by prominent gures such as the pediatrician Dr. Spock
indicate that magazines were
seen as an important and valid forum for the dissemination of expert advice and
This paper is based in part on a systematic qualitative review of more than 200
articles on child rearing and child behavior found in two womens magazines and one
weekly newspaper advice column between 1945 and 1965.
These articles provide a
glimpse of macro-level social movements and ideological shifts that affected the
family, schools, and mental-health professions, as well as providing insight into advice
and concerns regarding micro-level details of childrens behavior. Articles on younger
childrens behavior are specically relevant to this paper, and cover topics including
obedience, discipline, parental authority, disturbances or decits, and treatments.
Magazines can be seen as part of the social machinery that drives the dissemination
of scientic products and ideas into families and homes. In the 1940s and 1950s, a
burgeoning industry of experts in mental health began descending on families,
penetrating the domestic sphere via popular publications, and communities via the
schools and community health clinics.
In all media resources I consulted, writers
clearly targeted mothers as the primary, or even sole, interested party in the area of
the childs upbringing. More surprisingly, almost all early childhood articles focused
on boys, and almost all articles were about boys behavioral development, and
particularly aggressive behaviors such as “fighting, talking-back, toughness, and
sports. In contrast, most articles about girls were aimed at teenage girls and often
assumed that the girl herself was the audience, having picked up her mothers
magazine. Articles emphasized etiquette, grooming, and dating. Boys in early
Dr. Benjamin Spock wrote the enormously popular book, Baby and Childcare, rst published in 1946, now
in its 7
edition and still a bestseller.
Much of this research was performed at Harvards Schlesinger Library, which houses complete sets of
numerous womens magazines in its archives. I reviewed two popular monthly magazines, Womans Day and
Parents, and the weekly parenting advice column in the New York Times Magazine, between 1945 and 1965.
I limited my review to three sources because articles in womens and parenting magazines tended to replicate
each other. These selections represent my attempt to achieve a balanced view on issues from three publications
with differing styles and, to some extent, differing readership. While I could not hope for a diverse readership
based on race or class, I do feel that my selections represent a balance of views and opinions.
I have occasionally included relevant articles from one or two other womens magazines and weekly journals
such as Time and Newsweek, but these magazines were not reviewed systematically.
There are a number of books that detail aspects of this deluge of experts and its impact on women, including
Ehrenreich and English 1978; Grant 1998; and Margolis 1984.
Bad Boys, Good Mothers, and the Miracle of Ritalin 581
childhood were viewed as still heavily dependent on their mothers, and articles on
boys development were addressed to mothers. In this sense, experts writing in these
magazines were clearly dening boys behaviors as the signicant topic of research
and discussion in the area of early childhood development. They were also reinforcing
a focus on an interrelated group of subjects: mothers, sons, and problem behaviors.
In the 1940s this relationship between mothers and sons was framed by a
philosophy known as permissive childrearing. The permissive era was itself a
reaction to the strict behaviorist approach propounded by developmentalists such as
John Watson (1928) whose book Psychological Care of Infant and Child urged the
scientic upbringing of the young and discouraged mothers as a potential threat
to this scientic endeavor. In 1946 Dr. Spocks seminal work Baby and Childcare
invited mothers back into their childrens lives, with the encouragement to trust
themselves. As the historian Michael Zuckerman (1975) points out, however, the
Watsonian image of mother was not replaced so much as subtly amended in the
permissive era. In both periods, mothers were seen as impediments, rst to men of
science (who interpret the laws of nature), and then to natural law itself. As the vision
of the child changed from a creature needing strict management to one needing very
little outside control at all, the child with the inborn wisdom to know his needs was
hampered by mothers comparatively poor childrearing instincts (Weiss 1985).
Mothers needed to rely on experts to avoid becoming impediments to their boys
development. A notion that boys operated according to certain natural laws of
being (Bevans 1946a) encouraged mothers to keep an appropriate distance from
their sons. From this distance, mothers, drawing upon expert knowledge, could
observe the boy and monitor his needs. Magazine columnists warned mothers that
discipline or control could tarnish a boys natural joy of living and his desire to do
good (Bevans 1946b). Zuckerman has suggested that Spocks manual is punctuated by
a concerted effort to detach the youngster from the moral authority of the
immediate family (Zuckerman 1975, 226). My reading of magazines in the same
period narrows the relevance of Zuckermans point: sons need to be detached from
Magazine columnists rarely acknowledged that advice given to mothers about
childrearing was written from the perspective of a particular paradigm. This gentle
gloss over complicated and contested territory was, and is, relatively usual fare for a
magazine column. In the late 1940s, however, it veiled the growing inuence of
psychoanalysis on ideas of mothering and the mother-son relationship. Psychoana-
lytic ideas shaped Spocks perspective on mothers and childrearing, and almost
certainly inuenced the focus on the mother-son relationship during early childhood
in magazine articles written during this period (Weiss 1985). It was probably near
impossible to soften psychoanalytic theories of mother into the agreeable tones of the
From here on I will refer specically to boys and mothers instead of children and parents to
underline the implicitly gendered nature of the discussion in the pages of these magazines.
582 Ilina Singh
standard magazine column without emasculating the message entirely. But the
complex interplay between mothers presence/absence and her sons well being,
hinted at in magazine columns, is fully elaborated in many psychoanalytic writings,
most famously, perhaps, in Frieda Fromm-Reichmanns articulation of the
schizophrenogenic mother. In 1948 Fromm-Reichman wrote: The schizophrenic
is painfully distrustful and resentful of other people due to the severe early warp and
rejection he encountered in important people in his infancy and childhood, as a rule
mainly the schizophrenogenic mother (Fromm-Reichman 1948). Two important
qualities characterized the schizophrenogenic mother: overprotection and rejection.
The result of these mothering qualities was boys who grew up to be dictatorial, weak,
or psychotic.
In the postwar period, these kinds of men were not viewed merely as an annoyance
or disappointment to their communities. They were a threat to democracy. Fromm-
Reichman claimed that Hitler and other fascist leaders were born of a fatherless
homeland following World War I (Neill 1990). In a widely read book called Their
Mothers Sons, psychiatrist and U.S. surgeon general Edward Strecker argued that
mental breakdown during war reected a soldiers immaturity. Mature men were
essential to ensuring the future of democratic nations: There is nothing of which
Psychiatry can speak with more condence and assurance than the danger to our
democratic civilizations and cultures from keeping children enwombed psycho-
logically and not permitting them to grow up emotionally and socially (Strecker
1946, 219). Unfortunately for democracy, psychiatrists and psychologists working in
World War II diagnosed 12 per cent of all recruits as predisposed to mental breakdown
during pre-screening tests. Over one million more soldiers suffered from some form
of neurosis during combat (Herman 1995).
Against this backdrop of World War II, the breezy voice of the 1940s magazine
columnist appears disingenuous, veiling a deep connection between concerns about
the normalcy of male behavior and the supremacy of the democratic world, as well
as a trenchant political and moral critique of mothers and their relationships with
their sons. Such connections among mother, son, nation, and neurosis were further
encouraged by a new generation of childrearing experts propelled into schools and
communities under the aegis of the National Committee on Mental Hygiene
(NCMH). The central mission of the inuential NCMH was prevention of mental
illness, which was regarded as a problem involving the personality rather than the
brain. Hygienists believed that a childs adjustment or pre-delinquent states
would be most effectively identied through the school, which they saw as an
institution to develop childrens personality. Combining psychoanalytic premises
with biomedical understanding of disease prevention, hygienists ideas for American
education effectively resulted in what Sol Cohen has called the medicalization of
American education (Cohen 1983a). Newly trained teachers, counselors, social
workers, and psychologists ooded the schools. The presence of these experts helped
to reinforce the idea that parents were the root cause of early psychological and
Bad Boys, Good Mothers, and the Miracle of Ritalin 583
behavioral damage to children; parents sowed the seeds of mental disorder in children
through harsh restraints, prohibitions, and punishments (Cohen 1983b).
The hygienists emphasis on preventive mental health care likely helped encourage
the scientic establishment of normative standards of childrens cognitive and
emotional behaviors. In magazine articles, the pervasiveness of the scientic attitude
is clear: mothers are invited to avail themselves of evaluation and assessment of the
child in the home (social worker); the school (school psychologist, school nurse and
guidance counselor); and the clinic (psychologist, psychiatrist). The scientic
attitude according to one columnist, pervades everything we see, think and know
including our functioning as parents and as people (Puner 1958, 40). As a result
parents are self-critical and self-examining while children are being watched,
studied, measured and tested as never before (Barclay 1957, 76).
The “Normal” Boy
By the end of the 1950s, magazine columnists had moved away from talk about
maternal instincts and permissive childrearing and had embraced a different agenda,
focusing on two interrelated topics: discipline and normalcy.
In 1959, Dorothy
Barclay, the New York Times Magazine childrearing advice columnist from 1949 to
1963, celebrated a decade of progress outlining not only the changes in childrearing
philosophy but also the extent to which experts had taken over from parents:
Research revealing that children as well as adults suffered in an atmosphere of total
license led to a renewed setting of reasonable standards of behavior and a return to favor
of discipline achieved through education, guidance, planning and, wonders of
wonders, a rm No! when necessary. . . . Counseling services have increased and
parents in growing numbers turn to them for help. (Barclay 1959, 24)
Barclays emphasis on discipline through education and guidance echoes the ideals of
national education put forth in the 1958 National Defense Education Act (NDEA).
Enacted partially in response to the Sputnik launch of 1957, one of the Acts
stipulations was to identify gifted young people through testing, and with the help of
the guidance counselor ensure their early and successful planning for a college
education. The Act helped ofcially establish the guidance counselor in schools, and
institutionalized testing and college counseling. The NDEA once again reminded the
public that the probing of boys mental and emotional depths was a matter of national
interest. As one columnist suggested, the NDEA was meant to strengthen community
Ehrenreich and English link this change in childrearing ideology to the failure of the Americans to beat the
Russians in the satellite launch race. After 1957, they argue, education became an issue of national defense.
While it seems unlikely that a widespread change in ideology would be linked so intimately to one event, it
is certainly true that the cold-war climate encouraged a variety of defense-based education initiatives, such as
the National Defense Education Act.
584 Ilina Singh
and citizenship by uncovering not only intellectual gifts, but also deviance and
trouble (Bemer 1964).
The new toughness in schools and the new discipline were also part of an
institutional attempt to undo the damage of parents who had been said to be too
permissive and who had seen a loss of authority with their children (Hechinger
and Puner 1959; Mead 1958). Therefore mothers were told to encourage their
children to use the schools resources: Children with worries know they can go to
the school social worker. He has been trained to listen (Bemer 1964, 78). Mothers
themselves could draw upon these external resources to discover their sons problems:
Go to the school psychologist, who will consult with your childs teacher (Carson
1959, 44).
Mothers trained in the wisdom of the permissive era were likely in need of some
education in face of these new ideals of childrearing. Good mothering was now
dependent on discipline, and discipline had an important relationship to normalcy.
Articles on discipline-related areas, such as obedience and aggression were heavy with
talk about normative levels of (boys) aggressiveness, impulsiveness, and conformity.
Such articles emphasized that mothers should be able to make a distinction between
normal and abnormal behaviors, but conrmation of this distinction and intervention
of most any kind was the job of the expert. However well mothers observed their
sons, boys behavior was not straightforward and therefore normalcy was difcult to
ascertain. Mothers might view behavior as a manifest sign of normalcy, but experts
knew that behavior was not necessarily a reliable sign of mental health. As one
columnist wrote, It is a common misconception that being good is a sign of mental
health in a child (Honor 1957, 57). Articles on sound adjustment, emotional
balance and temperament revealed the murky depths of psychopathology; and
mothers needed expert help to determine pre-school growing pains from real
trouble (Carson 1959, 44).
The specter of real trouble must have been
particularly frightening for mothers, especially when psychological problems were
compared with severe physiological illnesses. In a move that clearly medicalized
behavior, treatment for a psychiatric disorder was likened to treatment for a physical
illness, thereby underlining the need for preventive care and emphasizing need for
expert attention. Two well-known psychologists compared untreated emotional
problems in a child to an untreated cold [that] could be a symptom of pneumonia
(Ames and Ilg 1957).
There is some critical reaction to experts jurisdiction over children in the pages of
these magazines, aimed mostly at the homogenizing goals of expert evaluation. One
columnist told mothers not to worry about normalcy, for they, and their children,
were different, peculiar human beings with all the vagaries and foibles that go with
individual differences (Jenkins 1958, 71). Similarly, another columnist argued that
Talk about adjustment and balance was likely derived from the work of Adolf Meyer on mental illness
as maladaptation. Meyers version of psychoanalysis was enormously inuential in shaping American
psychoanalysis generally.
Bad Boys, Good Mothers, and the Miracle of Ritalin 585
normal was average, and great men arent normal (Whitman 1960, 46). Expert
advice was viewed as undermining parents, who had a gnawing sense of insecurity
about how their youngsters measure up (Tolchin 1961, 32). To avoid the experts,
mothers should rely more on their own knowledge and celebrate the simple
wonderfulness of their boys (Hunt 1957, 35).
Yet only a handful of articles indicate such resistance to the experts; the majority
of writers appeared to nd experts scrutiny and research both helpful and necessary
for proper childrearing. One reason for the lack of resistance may be that by 1960 an
increasing number of articles were written by experts themselves. Articles by non-
experts often just summarized expert research on a particular topic. A few articles
propounded the importance of a lay perspective; one such author urged mothers to
speak up about the boys [we] know as our own (Hunt 1957, 35).
Much more
often, however, mothers authority was undermined and expert advice pushed
forward. This loss of authority culminated in advice that sent mothers themselves to
the experts, not only to understand their children but also to seek advice and help for
their own behavior. Columnists recognized that mothers might feel overwhelmed
with all their tasks; they might feel guilty for promoting emotional difculties in
their children; they might inate disturbances. Most often the advice was to seek
professional help. The cycle renewed itself: expert opinion caused mothers confusion
and anxiety that was properly managed by consulting more experts. As Julia Grant has
pointed out in her study of mothers letters to advice columnists in this period:
Whatever negative behavior their children exhibited, mothers questioned what they
might have done, or failed to do, to cause the problem. The mothers who wrote to child-
care experts during the 1950s judged themselves harshly, often seeking in vain to nd the
source of their childrens troublesome behavior in their own conduct as mothers. To
some extent, they had incorporated enough of the philosophy of scientic utopianism
to believe that proper child management could alleviate their intrinsic difculties. (Grant
1998, 227)
The new emphasis on a boys mental health served to further remove mothers from
jurisdiction over their sons development and codied deep anxieties about
mothering behaviors and the mental stability and strength of young boys through
scientic discourse. Childhood psychiatric diagnoses had become a ground on which
local and national anxieties surrounding mothers and sons could be elaborated. In the
early 1950s, magazine columnists began to pay more and more attention to one such
diagnosis, an ancestral form of ADHD called emotional disturbance.
It seems important to note that mothers did speak up in their letters responding to expert columnists. These
letters document a more robust critique and resistance of experts than I found within the magazine articles
themselves (see Grant 1998, chap. 7).
586 Ilina Singh
Emotional Disturbance
Emotional disturbance was the most commonly noted mental health problem
affecting young boys in magazine articles spanning the 1950s to 1965. The symptoms
of emotional disturbance, culled from the pages of womens magazines and clinical
psychology textbooks of this period, suggest a close relationship to the contemporary
ADHD diagnosis. Symptoms affected boys almost exclusively, and included
hyperactivity, inattention, moodiness, delinquency, and impulsiveness.
In magazine
articles emotional disturbance has a number of variants including emotional trouble
and emotional illness. A clinical psychology textbook published in 1965 indicates
that contemporary researchers saw emotional disturbance as the eminently normal
result of abnormal (in the case of socially and morally deviant) behavior (Mowrer
1965, 243). Proposed causes for these deviant behaviors were split predictably along
the nature-nurture divide; but emotional disturbance itself was viewed for the most
part as a set of secondary symptoms of underlying disorder. When the underlying
disorder was left untreated abnormal behaviors would multiply, thereby exacerbating
the emotional sequelae of the disorder.
Emotional disturbance is increasingly referenced in articles at a moment when
mothers attention is excruciatingly xed on the mental and emotional normalcy of
their sons. Discipline, conduct, and aggressive behavior had been the mainstay of
mothers concerns about their sons, as represented in these magazines, and these
qualities are at the center of the symptom cluster that characterizes emotional
disturbance. However as a descriptive diagnosis emotional disturbance must be
viewed as an immature scientic category, extending an extremely wide net over a
range of behaviors that were, as yet, not categorized as distinctive disorders. Magazine
articles and clinical textbooks of the period suggest that the disorder was not well
differentiated from dyslexia and learning disabilities, disabilities resulting from head
injury, behavioral disorders of childhood such as oppositional deant disorder and
conduct disorder, and depression. Emotional disturbance was explicitly linked, and
occasionally interchangeable with Minimal Brain Dysfunction (MBD), which most
researchers consider an early diagnostic form of contemporary ADHD (Barkley 1997;
Diller 1998). MBD was the term most often used in a scientic context; its name
points to the hypothesized organic cause of disorder. Emotional disturbance had a
more ambiguous etiology and was a term more often found in popular venues.
This close association between emotional disturbance and MBD is somewhat
curious, given that emotional disturbance was often identied as a psychological
problem borne of anxiety and conicts, and MBD was almost always seen as an
organic problem. The frequent linking of the two actually reveals an interesting
Emotional disturbance is still referenced in social science and medical journals today, and it is still a
somewhat ambiguous category. In addition to symptoms such as depression, emotional disturbance can also
include ADHD or other disorders now categorized as neurobiological disorders. My overall impression,
however, is that todays emotional disturbance connotes something deeper and more severe than ADHD.
Bad Boys, Good Mothers, and the Miracle of Ritalin 587
interaction between traditionally psychoanalytic ideas and ideas more usually found
in biological psychiatry, as related to the production of a scientic diagnosis for boys
problem behaviors. Historians of psychiatry have tended to present great antipathy
between biological psychiatry and psychoanalysis during this period (Shorter 1997);
however, in the case of childrens behavior disorders pediatricians and child
psychologists brought these disorders and associated treatments into the limelight in
work that overtly pulled from competing positions within psychiatry. Their work
created an inter-disciplinary setting in which experimentation with drug treatments
for childrens behavior problems could occur alongside other psychoanalytically
oriented treatment approaches with relatively little fanfare.
Benzedrine Experimentation in a Cooperative Atmosphere
In 1937, Charles Bradley, a pediatrician, published the rst article documenting
experiments with the stimulant Benzedrine on children with a wide variety of
behavior problems in the American Journal of Psychiatry (Bradley 1937a). Bradley
performed his experiment on 30 children, ages 5 to 14, who manifested a variety of
behavior disorders ranging from specic educational disabilities to epilepsy. All the
children had normal intelligence. He pronounced the results most striking in the
effect of Benezedrine on school performance. Almost half the children responded in
spectacular fashion presenting with unusual motivation to work, and an enhanced
ability to read, comprehend, and do arithmetic. In their emotional response too,
Bradley reports that half the children became more placid and easy-going, a clinical
improvement in the opinion of the staff.
In a series of subsequent articles, Bradley
and his colleagues build on this body of work, publishing their results in the major
psychiatric and medical journals of the day.
Charles Bradley was the director of the Emma Pendleton Bradley Home in East
Providence, Rhode Island, which opened in 1931 as the nations rst psychiatric
hospital devoted to children. The Home was planned and equipped especially for the
care of children with neurologic and behavior disorders (Bradley 1936, 651). In
1936, there were 269 patients at the Home, 80 with behavior problems, 64 with
convulsive disorders, 40 with CNS (central nervous system) birth disorders, 37 with
mental deciency, and the remainder with a variety of disorders including reading
disability and post-encephalitic syndrome. Bradley does not specify the gender of
these patients; however patients included girls as well as boys. In his rst published
experiment with Benzedrine Bradley included approximately twice as many boys as
girls (21 boys, 9 girls); in subsequent research the proportion of boys is larger. Bradley
asserts that these numbers reect the incidence of behavior problems by gender in the
clinical population. By 1940 one of Bradleys samples includes 77 boys and only 23
girls. Much of the other research with Benzedrine on children during this period did
Bradley does not specify the gender of children in his analysis of results.
588 Ilina Singh
not include girls at all in part because behavior problems were so closely associated
with delinquency, and experiments were frequently performed in homes for
delinquent boys.
The design of the Home in Bradleys descriptions appears to have been grounded
in a combination of behaviorist, psychoanalytic, and mental hygienist principles,
emphasizing a natural, healthy, and encouraging environment as essential to a childs
mental well being. Bradley contrasted this environment with the environment of the
family home, which he felt was chaotic and troubling to his patients, often sending
them into relapse upon their release from the hospital. Bradley felt the Homes
environment was particularly therapeutic for children with behavior problems, who
beneted from multiple activities based in natural and cultural surroundings,
reinforced by nurses and teachers who have combined the rare endowment of an
attractive, unrufed and ingenious personality (ibid.). But while Bradley grounded
the plans for his patients daily life in these environmental principles, he also
emphasized more active biomedical interventions with patients. The Home was
envisioned specically as a hospital for treatment of childrens psychiatric disorders,
with the facilities and opportunity for therapeutic experimentation. A surgery
handled the more extreme therapeutic interventions, while experiments with drug
therapies were performed in a more naturalistic setting, but under closely controlled
conditions. To add to the therapeutic mix, Bradley also had children undergo
individual psychotherapy, believing that even the best environmental adjustment
does not preclude the advisability of personal psychotherapy, particularly in cases in
which a rather exhaustive analysis and reconstruction of the patients personality are
indicated (ibid., 652).
In his published work Bradley mixes psychoanalytic, behaviorist, biomedical, and
mental hygiene perspectives quite masterfully, nding ways to appease potential
critics from all sides. A central factor in this process is his repeated emphasis that drug
therapy is not a reason to ignore modication of the environment in the promotion
of childrens mental health. Indeed, the success of Bradleys Home, which housed
patients anywhere from 6 to 18 months, was predicated on the therapeutic efcacy
of separating children from the environment of their family homes. Writing in the
American Journal of Orthopsychiatry in 1940, Bradley and his colleague Margaret Bowen
As Conrad and Schneider have noted in their book, Deviance and Medicalization (1980), stimulants are part
of the medicalization of delinquent behavior. The authors do not make much of the gender dynamics at play
here, but clearly delinquency is a gendered phenomenon. Since the history of Ritalin is part of the history
of delinquency, and both are part of the history of ADHD, it is not so surprising that ADHD too is largely
a problem of boys. When ADHD is presented purely as a neurochemical problem, neurochemistry must
explain the gender skew.
Bad Boys, Good Mothers, and the Miracle of Ritalin 589
The use of pharmacological agents such as amphetamine sulfate, offers a supplementary
. . . approach to the treatment of childrens psychiatric problems. This approach in no
sense replaces that of modifying a childs surroundings and so removing the sources of
conict. Neither can it offer the same assurance of mental health as do forms of
psychotherapy which enable a child to work out his emotional problems. . . . However,
distressing surroundings cannot always be altered, and lack of facilities frequently make
effective psychotherapy impossible. In such situations the simple administration of a drug
that produces an improved social adjustment or accelerated school progress may offer
considerable assistance. (Bradley and Bowen 1940, 102)
Throughout the 1940s, children with disturbances thought to be of psychological and
biological origin were subjected to experiments with Benzedrine, usually by child
psychologists and pediatricians. This research continues the kind of cooperative, all-
inclusive tone initiated by Bradley. In 1948, a well-known psychologist explained
that, an illness [minimal brain damage] which interferes with normal maturation will
give rise to anxiety (Bender 1948, 412); and Benzedrine was a useful adjunct to the
treatment of the neurotic child (Bender and Cottingham 1942, 116). Such
explanations helped create the ground for a productive interconnection between
biomedical orientations and psychoanalytic perspectives around MBD and emotional
disturbance in the 1950s.
Throughout this period of experimentation with Benzedrine the possibility of
mothers toxicity and the necessity for separating mother and child went
unchallenged in published articles. Indeed, one important factor that these diverse
scientic positions agreed upon was the potentially harmful nature of a childs family
environment, with special focus on mothers. From the hygienist perspective, mother
was not expert enough to be given the responsibility of her childs upbringing; her
understanding of the child was pre-scientic (Cohen 1983b, 129). Behaviorists like
Watson (1928) felt that mother-love was a dangerous instrument while psycho-
analysts stressed the pathology-inducing nature of mother-love. Even Dr. Spock
(1946), under the inuence of psychoanalytic ideas, subtly expressed that the life of
a child can be harmed by improper mother love (quoted in Weiss 1985, 291).
Thus we see at the center of this early experimentation with Benzedrine therapy
for problem children certain ingredients for a scientic model for ADHD and Ritalin
treatment. First, and simply, there is the pairing of mother and son. This pairing will
be the normative object of investigation in most family based studies of ADHD in the
past several decades.
Second, there is the centrality of mother in the development
of problem behaviors in boys. Third, there is the centrality of separation from mother
in the construction of healthy male development.
In a review of ADHD literature using the psychology database PSYCHINFO I found only a handful of
articles involving fathers in hundreds of studies in the past 15 years. Of 25 studies I reviewed concerning
effects of medication on parent-child interactions, two involved fathers and two involved girls. In my
experience in public and clinical ADHD-related settings, fathers are largely absent from the clinic, support
groups, and public talks and conferences on ADHD.
590 Ilina Singh
A New Name and A New Drug Treatment
By the late 1950s, the spirit of cooperation between biologically oriented
pediatricians, psychiatrists, and psychoanalysts was in decline. Frustrated with the lack
of therapeutic results in psychoanalysis, some child psychiatrists decided to challenge
the psychoanalytic identity inherent in the term emotional disturbance by
emphasizing the organic etiology in the term MBD.
Their efforts were assisted by
two developments. First, a new term appeared to describe emotional disturbance/
MBD. The term was hyperkinetic disorder of childhood, coined in 1957 by
Maurice Lauffer, the new director of the Bradley Home. Reecting the cooperative
atmosphere at Bradley, Lauffer was trained as a pediatrician and a child psychiatrist.
But Lauffer and his co-author, Eric Denhoff, writing in the Journal of Pediatrics rather
than in a psychiatric journal, emphasized the organic components of the disorder
and recommended the use of amphetamine for its treatment. With this move,
Lauffer and Denhoff effectively narrowed MBD and emotional disturbance to one
symptom through nomenclature and drug specicity, and grounded the new disorder
in biological foundations.
Following Lauffer and Denhoff, psychiatrists urged the community to make up for
its neglect of biology and organicity. In psychiatric journals, writers encouraged the
consideration of organic factors when diagnosing childrens behavior because the
psychogenic factors have so often been exclusively emphasized (Knobel 1959, 319).
Others suggested that child psychiatrists look as carefully among the myriad of
possibilities of organic causation as we have in the past among the interpersonal,
deprivation and stress factors (Clements and Peters 1962, 17).
Among childhood psychiatric disorders, hyperkinetic syndrome held unique
promise for a revived biological psychiatry because it was already connected to a
specic drug treatment. Indeed, Lauffer and Denhoff claimed that a favorable
response to amphetamine is supportive evidence for a diagnosis of the hyperkinetic
syndrome (Lauffer and Denhoff 1957, 473). These revivalist psychiatrists had to tread
carefully, and well into the 1960s their articles still offered some integration of
psychoanalytic and biological perspectives.
The important conceptual shift,
however, was that biological psychiatrists now emphasized medication not as an
adjunct to psychoanalytic therapy, but as a therapy with its own specic role.
The second important development during this time was the appearance of a new
stimulant called Ritalin, marketed by Ciba Pharmaceuticals (now Novartis) in 1955.
Ritalin was not initially indicated for hyperkinetic syndrome; instead it was a
Leon Eisenberg, a child psychiatrist now at the Department of Social Medicine at Harvard, was one of the
rst psychiatrists to urge this change in nomenclature. He told me his reasons in a conversation we had in the
fall of 1996.
Even DSM-II, which appeared in 1968, hedged on the etiology of hyperkinetic reaction of childhood,
specifying that if this disorder is caused by organic brain damage it should be diagnosed under the appropriate
non-psychotic organic brain syndrome.
Bad Boys, Good Mothers, and the Miracle of Ritalin 591
treatment for mild depression and narcolepsy. Treatment for various behavior
problems in children was rst indicated in 1961.
Marketing Ritalin
Stimulants were one of three major types of drugs used for behavior modication in
children during this period; tranquilizers, such as Raudixin, were also used, as were
anti-depressants such as Tofranil and Aventyl (Ladd 1970, 68). Ritalin came to market
at a time of extraordinary growth and competition within the pharmaceutical
industry: According to one estimate, there were 150,000 pharmacological prepara-
tions available in 1961 (when Ritalin was rst licensed for use in children for behavior
problems), of which 90 per cent did not exist in 1951. In 1961, approximately 15,000
new drugs were being put on the market each year, while about 12,000 were dying
off each year (Time 1961).
It is likely that Ciba Pharmaceuticals were aware early on of Ritalins benets as a
patented drug with a strong research record, few side effects, and known benets for
childrens behavior. Pharmaceutical companies invested heavily in sponsoring
experimental research in clinical settings. Smith-Kline-French supported Charles
Bradleys Benzedrine experiments (Bradley acknowledges the donation of tablets in
his published work); and Diller claims that Ritalin research fueled many grants and
careers in the 1960s, although he provides no direct support for this statement (Diller
1998, 25). Ciba played an important role in the promotion of Ritalin within the
medical industry through paid clinical research, advertising in physicians journals,
and direct sales strategies.
This kind of promotion was standard practice for drug
companies in this period, and unethical advertising practices would prompt a series
of congressional hearings, notably the Kefauver (1957), Nelson (19671979) and
Kennedy (1979) hearings.
In the Kefauver hearings particular concern was voiced
over the industrys role in popularizing anti-depressant drugs for relatively common
unpleasant tension states (Kefauver Hearings 1960). Later critiques would focus on
the medicalizing of human problems of living through drug advertisements (Katz
1972; Hill 1977). It is more difcult to establish Cibas role in promoting acceptance
of Ritalin within the domestic realm. It can be argued, speculatively, that Ritalin
beneted from a shift in public understanding of mental illness, promoted in part by
the creation and marketing of drugs for a nation of worried well. In particular, the
success of anti-depressant drugs may have contributed to mothers acceptance of
Ritalin for relatively common behavior problems in boys. The pharmaceutical
industry and the medical profession probably targeted women for anti-depressant
Shrag and Divoky (1975) provide some useful information about Cibas marketing strategies for Ritalin in
the 1970s and they cite interviews with (anonymous) Ciba sales representatives and FDA ofcials during this
See Smith 1991 for a very useful, but generally uncritical compilation of material from these hearings
relevant to the regulation of drug advertising.
592 Ilina Singh
diagnoses and treatments (Cooperstock 1978), and women accustomed to drugs for
their own relatively common problems may have been more likely to accept Ritalin
for their sons problems. The history of Cibas marketing agenda for Ritalin is difcult
to access; therefore much of the above remains speculative.
In recent years, however,
Novartis has clearly demonstrated its interests in the domestic realm. For the past
decade it has funded the major American ADHD parents organization, CHADD
(Children and Adults with ADD). This organization provides such a powerful lobby
for Ritalin that in 1995 the United Nations International Narcotics Board issued a
warning about its role in rising rates of Ritalin consumption (United Nations INCB
Report 1995).
Novartis and other stimulant drug-makers have also actively employed the
relationship between mothers and sons in contemporary public advertisements for
Ritalin. Direct-to-consumer advertising of Ritalin, a controlled substance, was
prohibited in 1971 as a result of the Convention on Psychotropic Substances of 1971
(ibid.). Until approximately two years ago, the pharmaceutical industry respected this
prohibition and did not advertise Ritalin and other stimulants to the public. Today
advertisements for ADHD drug treatments can be found in many popular magazines
including womens and parenting magazines. The great majority of advertisements for
Ritalin and other stimulants for ADHD depict only two characters a boy and his
Popular Reactions
For mothers with problem boys, the news about drug treatment and the emphasis on
the organic nature of childrens behavior problems appears to have been very
welcome. Schooled to give their children up to expert treatment, weary of mother-
blame, and anxious to look good in the eyes of society, mothers represented in these
magazines appeared to herald drug treatment for their sons problem behavior as a
true miracle. Magazine articles on this topic were lled with positive testimonials
In the spring of 1998 I had several telephone conversations with a representative from Novartis Medical
Information Services. I was given Medical Information Services each time I called Novartis to ask about
archival and historical information about clinical testing and marketing. Unfortunately I was not given much
information in these conversations. I was sent a half-page time-line of Ritalin-related developments. I asked
whether Novartis could provide access to their records of the procedures that led to the approval of Ritalin
for child behavior problems. I was told that the approval was based on a large number of physician
testimonials made by private investigators during the 1950s, and given a list of ve references (Letter, March
2, 1998). Novartis must protect its own interests, of course, but the lack of access and information will do little
to encourage accurate reports on Ritalins history.
My own collection includes ads for Ritalin, Metadate, Adderall, and Concerta, since 2001. In September
2001, Time published an article entitled, New Ritalin ad blitz makes parents jumpy (Novak 2001). The
author claims that the U.S. never passed a law in line with the 1971 UN prohibition on public advertising of
controlled substances (although the U.S. did sign the UN document). According to the article, the FDA and
DEA do not have the authority to control public advertising for Ritalin and other stimulant treatments for
Bad Boys, Good Mothers, and the Miracle of Ritalin 593
from mothers; the titles of many articles themselves reinforce the sense that there is
a new future for troubled boys and mothers, highlighting new frontiers and the
opening [of] doors in child psychiatry. Popular womens magazine articles
uniformly assert both the overwhelming presence of mental illness in children and the
need for expert medical intervention, including drugs. One writer called childhood
mental health Americas Number One Neglected Health Problem and urged the
medical profession to further differentiate and categorize illnesses (Krieg 1960).
None of the magazines I surveyed contained an overtly negative article on the
issues surrounding children and psychostimulant medication. Although the child
psychiatrist Leon Eisenberg writes in 1964 of the heat generated in discussions of
the proper role of drugs in treating disturbed children, I found little evidence of
such debate in the pages of popular womens magazines (Eisenberg 1964, 167).
Ritalin and the various diagnostic terms for problem boys likely beneted from the
positive atmosphere surrounding drug treatments following the pharmaceutical
revolution, which also helped bring about a renewed emphasis on the organic
etiology of mental and emotional disorders (Lasagna 1969). The emphasis on
organicity found its way into media treatment of psychiatric disorders. Following a
U.S Public Health Service report on MBD in 1966, the editor of Time took on the
task of public education in face of a possible epidemic:
There are hundreds of thousands, possibly millions of such boys and girls in the United
States [with MBD] and little is being done about them. There are not enough pediatric
psychiatrists to treat them all, and most of them get no farther than the family doctors
ofce. (Time 1968, 92)
Such editorials should not be taken to mean that parents were not skeptical about
psychiatric labels and drug treatments for their childrens behaviors. It does appear
that these magazines did not give voice to dissent during this period largely because
they promoted expert advice and research so actively, and because of a tendency to
soothe parents anxieties by reducing problems and presenting absolute solutions. The
cocoon-like atmosphere of these magazines is further illustrated by the lack of
discussion about the active debate around pharmacology generally in the late 1950s
and 60s, which is documented in many articles in weeklies such as Time, Newsweek,
and U.S. News and World Report. Although most of the concern focused on regulation
of the pharmaceutical industry, a few editorials take on the larger philosophical
questions surrounding the use of pharmaceuticals to manage not only disease but also
behavior (e.g., Newsweek 1959).
Another reason for the lack of criticism of drug use may have been that a biological
tool suggested a biological problem. An increased emphasis on the organic
underpinnings of childhood behavior problems meant that mothers were more often
assured that mental illness was not their fault. Still, the dynamic of mothers presence/
absence in relation to a boys problems remained complicated. While an organic
account of mental illness potentially absolved a mother of blame it simultaneously
594 Ilina Singh
removed her from the sphere of authority over her sons behavior and well-being.
Thus even while articles in magazines do more to relieve the burden of guilt and
blame on the mother, there remains a pervasive undercurrent of judgment. This
judgment appears in a number of guises but continues to be organized around the
dynamic of mothers presence/absence. Articles that dealt with the stigma of mental
illness in children, for example, sometimes judged mothers harshly for neglecting
their childrens mental health in order to preserve the public appearance of family
harmony. One writer claimed that the well-to-do children are often the last to get
help. They suffer the most because their parents feel that emotional trouble will affect
the familys social position (Honor 1957, 57). While the aestheticized ideal of the
1950s American family held little room for mental illness or family upset, mothers
were likely conscious that not only their social position but also their quality of
mothering would be harmed by an admission of emotional problems in a boy. A
mother whose son was put on medication for emotional disturbance assured readers
of both her social position and her love for her son: We are the average one TV, two-
car family; we go places on weekends . . . and to church in the morning . . . friends
who drop by in the afternoon. . . . Our boy has a decent home; he loves his family
and is loved (Dunn 1962, 45).
However the close association between problem boys and problematic mothers
lingers even more insidiously in the suggestion that mothers of out-of-control boys
had themselves become out-of-control. A (male) writer recalls a mother whose
realization of her sons needs (medication) changed her life; she is calmer, more
poised, more attractive (Moak 1959, 35). Mothers self-control is linked directly
with her aesthetic qualities: Her newly learned self-control has made her a more
attractive person. Given that this aestheticism is, in the 1950s, so closely linked to
ideals of domesticity, I would suggest that to some extent this writer hints at a project
of domestic sanitization, through medication. Part of what is sanitized within the
family is mothers authority. As scientic practices displace mothers authority, mother
is able to more nearly achieve the ideals of 1950s domestic life.
Medication use also tended to raise the specter of mother-love albeit now in
sanitized fashion. Mothers inability to love her troubled son was amended through
expert treatment: Now I can love this child again, claimed one mother (Time 1968).
This admission of lack of mother-love for a problem boy echoes the association
between maternal neglect or rejection and child psychopathology. In another article
a (female) columnist quotes a pretty young mother as saying, [With expert
intervention] Mark has become the potentially loveable child he always was (Welton
1964). A mother who loves her son achieves an aesthetic ideal as long as her
mother-love is mediated, sifted and sanitized, through expert intervention.
Of course the lifestyle outlined by this mother is not so average at all; in fact it is privileged. This points
again to the nature of readership in these magazines and reminds us not to generalize from this commentary
to the experiences of women of other social classes and ethnicities.
Bad Boys, Good Mothers, and the Miracle of Ritalin 595
It is important to say that articles which heralded the discovery of drug treatment
and organic theories for emotionally disturbed children were also punctuated by the
real anxiety and distress mothers felt over their boys behaviors. While much of the
discussion above tends to incorporate a critique of scientic attitudes toward mothers
during this period, it is by no means meant to minimize the emotions of families
dealing with problems associated with emotional disturbance and other associated
disorders. Many women at a loss over their sons behaviors did probably see
remarkable improvements not only in their sons behaviors but also in their own
mental and emotional well-being through the magic of child psychiatry (Moak
1959, 35). The decision to treat children for emotional disturbance was clearly not
made lightly by mothers: The hardest part . . . was recognizing that our boy did have
a problem and needed more help than we, his parents, were able to give, and then
going out and getting it for him (Dunn 1962, 46). In face of writers urging that
emotional disturbance needs to be treated quickly (Tolchin 1959, 70) mothers who
made such decisions no doubt felt their sons behaviors were intolerable and that they
were doing the right thing in medicating them.
Given the historical stream of events that links mothers, sons, and childhood
psychopathology in the period preceding the development of Ritalin, magazine
writers apparent reluctance to protest drug treatment for boys behaviors is not so
surprising. A problem boy struck his mother at the heart of her insecurity about the
quality and the repercussions of her mother-love. No matter what the ultimate cause
of a boys behavior, mothers who questioned their ability to love their boys properly
were programmed to worry that their inadequacies could do further harm to their
sons. Consulting the experts and accepting medical intervention had the paradoxical
effect of absolving mothers of some blame and guilt, and displacing their authority
with social-scientic ideals.
Lingering Residue: Mothers, ADHD, and Ritalin Today
The philosopher of science Elizabeth Lloyd uses the phrase pre-theoretical
assumptions to describe the social assumptions and prior commitments of scientists
[that] play a major role in the practice of science itself (Lloyd 1993, 150). Multiple
social assumptions and prior commitments played leading roles in the creation of
ADHD categories and Ritalin: the construction of certain kinds of problem
behavior in boys as a medical problem; the belief that science had superior methods
for raising psychologically healthy boys; and an association between problems in boys
and problems in mothers. These social assumptions do not just shape the way science
is done. They also shape the way scientic knowledge is received and incorporated
back into society, thereby creating a complex interrelationship between social
assumptions and scientic knowledge. This dynamic can lay the groundwork for the
legitimizing of social and cultural prejudices through scientic theory and practices.
596 Ilina Singh
The social-scientic assumption that a boys ADHD-type behaviors are associated
with the neurotic behavior of his mother is disturbing enough that we may wish to
dismiss it as an idiosyncrasy of mid-century thinking. I believe we would be wrong
to do so. Mothering ideals continue to powerfully shape American womens
experiences of mothering.
In addition, rising rates of ADHD, depression, and
violence among young American boys have prompted psychologists to declare a
national crisis: Boys today are in serious trouble, including many who seem normal
and to be doing just ne (Pollack 1998, xix). A recent explosion of popular books,
television shows and conferences related to the psychological problems of young boys
helps fuel this crisis.
Many of these popular books on boys problem behaviors
contain direct prescriptives for better mothering of sons. In particular, ADHD
symptoms are now seen as evidence of boys psychological and emotional distress,
possibly over a rejecting mother. One prominent psychologist has argued that
ADHD-type behaviors in boys are a sign of boys distress at being forced by mother
and a cultural boy-code to separate emotionally and physically from mother at an
early age (ibid.). Other psychologists suggest that mothers emotional separation
from, or rejection of, sons is a result of mothers confusion over how to raise happy,
successful men (Kindlon and Thompson 1999). These publications and the
enormous public interest in them (several of these books spent many weeks on the
New York Times bestseller list) indicate the extent to which the linkages between
problem boys and problematic mothers linger today. Even as authors attempt to
persuade mothers that their sons problems are not medical, they enforce the idea that
mothers are part of boys problems and that professional intervention into the
mother-son relationship is required for boys future wellbeing. I would suggest that
under these conditions contemporary American mothers are likely to view medical
intervention into their sons problem behaviors as one of an array of available
professional services of which they will avail themselves in the process of trying to be
good mothers to their sons.
Modern American mothers are historically programmed to worry about their sons
behaviors and to blame themselves when those behaviors do not meet normative
standards of achievement and success.
Mothers perceptions of their sons behaviors
are likely to be ltered through their desire to be good mothers, the pressure to
produce good sons, the need to consult expert opinion, pervasive media coverage of
The good mother ideology is often mentioned in feminist treatments of mothering, and there is
substantial agreement as to the substance of the good mother aesthetic. See, for example, Thurer 1994;
OReilly 2001; and Glenn et al. 1994.
For a sampling of books, see Pollack 1998; Kindon Thompson 1999; Garbarino 2000; Newberger 1999;
and Gurian 1998.
Susan Bordo (1998) has argued that women are especially vulnerable to technologies that promise to
enhance womens appearance, behavior, and performance in line with cultural and social norms. Bordo has
written about the use of cosmetic surgery to bring womens bodies into line with cultural ideals; others (i.e.,
Kramer 1993) have suggested that Prozac can be used to improve womens behaviors in line with social ideals.
Part of Ritalins appeal is that it can improve mothers and sons.
Bad Boys, Good Mothers, and the Miracle of Ritalin 597
ADHD and Ritalin, and blatant advertising appeals to improve their relationships
with their sons through the use of stimulant medication. Mothers are not to blame
for rising diagnoses of ADHD; however it is possible that mothers tolerance for their
sons problem behaviors is reduced because of the factors outlined above, leaving
them vulnerable to medical intervention. It is important to incorporate an awareness
of mothers vulnerability to ADHD diagnosis and Ritalin treatment into public and
clinical spaces. While this vulnerability is still veiled, or unspoken for fear of blaming
mothers, mothers are less able to resist medical intervention for their sons
I hope this elucidation of the historical concerns with the behaviors of mothers and
sons in the particular context of ADHD and Ritalin brings an embodied perspective
to the predicament of mothers of boys with ADHD. When we embody the overly
generous spaces of this diagnostic category with historical actors we begin to glimpse
the scaffolding of a gendered social order that the diagnosis serves and upholds.
Mothers talk about the effects of their boys medication surfaces a deep identication
with the cultural script that connects behavior problems in boys to problematic
mothers. As a diagnostic category, ADHD serves and maintains this anxiety about
boys and their mothers.
A question remains related to historical memory: Why is the history of ADHD and
Ritalin largely unrecognized, indeed, forgotten, in the heat of contemporary debates?
My own thinking about this puzzle begins with Foucault (1965) and his ideas about
the processes by which social behavioral norms become codied in psychiatric
categories. Foucault argued that these categories appear to be divested of social
subjective meaning even while psychiatric practices continually reproduce
normative social standards and (re)inscribe them on the social body. Psychiatric
categories thereby reify social norms as objective truths by removing them from the
social body and from the historical space the body inhabits. Scientic understanding
of ADHD in this decade has actively promoted a disembodied reality to ADHD
through a brain-based discourse of neurotransmitters, receptor sites, and chemical
processes. The brain, divorced from the body, is divested of time and history in which
the body moves, and so ADHD, which resides in the brain, would also appear to have
no history.
Unfortunately this Foucauldian answer to the puzzle of memory ignores the fact
that a substantial portion of the social body strongly contests scientic explanations of
ADHD. These contestations would appear to re-embody ADHD, casting it as a social
phenomenon invested with a litany of social anxieties and elevated to cultural icon
status. However as cultural icon the ADHD phenomenon is sufciently inated to
have become a site crowded with noisy ideological debates that often lose sight of
grounded realities. As it becomes more and more difcult to look at on-the-ground
598 Ilina Singh
experiences with ADHD and Ritalin, it also, paradoxically, becomes more difcult to
understand ADHD and Ritalin as embodied phenomena.
And so I would venture the hypothesis that our historical memories fail us because
from both a sociological and a scientic perspective, we do not tend to treat ADHD
and Ritalin as phenomena grounded in time, space and peoples lives. We in a sense
reify the icon through research and analyses that produce a-historical medical
narratives and disembodied social critiques. Both types of narratives veil the medical
professions long (and potentially embarrassing) romance with ADHD diagnosis and
Ritalin as tools to manage a professional concern: the relationship between mothers
and sons.
A nal note: Throughout this discussion I have attempted to treat ADHD as
simultaneously a real and a constructed diagnosis. While the legitimacy of the
diagnosis is obviously at stake in an analysis of its social functions and historical roots,
I am not here attempting to say that ADHD as a neurological disorder does not exist.
Indeed, it is impossible to say denitively whether ADHD does or does not exist. It
is perhaps more useful to note that the diagnostic category has expanded signicantly
over the past century, incorporating ever milder and more ambiguous behaviors. The
state of the diagnosis today is such that many young American boys t diagnostic
criteria, and that if a diagnosis of ADHD is desired, it can very likely be obtained. The
important question, it seems to me, is not about the reality of ADHD; rather it has
to do with the desire for ADHD diagnosis.
Ritalin is an effective, quick and safe drug for improving focus and attention.
major NIMH study has recently found that Ritalin is the most effective treatment for
ADHD (MTA Group 1999). However successful Ritalin treatment provides no proof
that a diagnosis of ADHD is real. In fact, Ritalin has been found to improve
attention and focus in normal as well as ADHD boys (Rapoport et al. 1978).
Therefore Ritalin is a key factor in the desire for ADHD diagnosis, as long as ADHD
diagnosis is required for a Ritalin prescription.
As with many psychiatric disorders, the evaluation of childrens behavior as
symptomatic of pathology is subjective, and the strident and narrow attitude of some
biological accounts of ADHD reect the effort to lessen the subjective nature of this
ambiguous diagnosis. No matter what future evidence for the biology or genetics of
ADHD emerges, it seems important to remember that children do not ask for
Ritalin; adults do. Therefore adults and the adult-world are necessarily and
legitimately included in the scope of diagnosis and treatment. The childs developing
As an amphetamine, Ritalins effects are felt within 30 minutes, and last only about 34 hours. Children
must take several doses a day to experience lasting improvements in behaviors. Side effects to Ritalin are
usually mild and include loss of appetite, sleeplessness, and tics. These side effects can often be ameliorated by
adjusting the daily dosage schedule. At present, there is very little research support for media reports about
long-term side effects to Ritalin use.
Ritalins widespread effectiveness in improving attention and concentration is (anecdotally) conrmed by
reports of its use among American university students as a study-aid.
Bad Boys, Good Mothers, and the Miracle of Ritalin 599
brain is embedded in the collective mind in any case, in addition to having its own
inherent strengths and weaknesses. The real complexities surrounding the ADHD-
Ritalin phenomenon are surely most productively elaborated from this embedded
starting point.
I would like to thank Anne Harrington, Hans Pols, and two anonymous reviewers for
their comments on earlier versions of this paper.
Ames, L. and F. Ilg. 1957. When a Child Rebels. Wom ans Day (February): 58.
Barclay, D. 1957. Microscope on Children. New York Times Magazine (3 November): 76.
Barclay, D. 1959. Family Portrait: A Decade of Progress. New York Times Magazine (27 December):
Barkley, Russell. 1997. ADHD and the Nature of Self-Control. New Jersey: Guilford Press.
Bemer, P. 1964. Are School Psychologists Helping or Hurting Your Child? Redbook (April): 76.
Bender, Lauretta. 1948. The Psychological Problems of Children with Organic Brain Diseases.
American Journal of Orthopsychiatry 19:404415.
Bender, L. and F. Cottingham. 1942. The Use of Amphetamine Sulfate (Benzedrine) in Child
Psychiatry. American Journal of Psychiatry 99:116121.
Bevans, G. H. 1946a. Dont rule by fear. Womans Day (January): 18.
Bevans, G. H. 1946b. Try a dash of neglect. Wom an s Day (March): 10.
Bevans, G. H. 1946c. The in-between stage. Wo ma ns Day (June): 12.
Bevans, G. H. 1946d. Obedience. Wo mans Day (August): 14.
Bevans, G. H. 1946e. When is a problem not a problem? Wo mans Day (October): 10.
Biederman, Joseph. 1996. Are Stimulants Overprescribed for Children with Behavioral Problems?
Pediatric News (August): 26.
Bordo, Susan. 1998. Braveheart, Babe and the Contemporary Body. In Enhancing Human Traits: Ethical
and Social Implications, edited by E. Parens, 189221. Washington, D.C.: Georgetown University
Bradley, Charles. 1936. Childrens Hospital for Neurologic and Behavior Disorders. Journal of the
American Medical Association 107:650653.
Bradley, C. 1937a. The behavior of children receiving Benzedrine. American Journal of Psychiatry
Bradley, C. 1937b. The family physician and the feebleminded child. Rhode Island Medical Journal
Bradley, C. and M. Bowen. 1940. Amphetamine (Benzedrine) Therapy of Childrens Behavior
Disorders. American Journal of Orthopsychiatry 11:92103.
Campbell, S., C. March, E. Pierce, L. Ewing, and E. Szumowski. 1991. Hard to Manage Preschool
Boys: Family Context and the Stability of Externalizing Behavior. Journal of Abnormal Child
Psychology 19(3):301318.
Carson, R. 1959. Problems are part of growing. Womans Day (March): 44.
Clements, S. and J. Peters. 1962. Minimal Brain Dysfunctions in the School-Age Child. Archives of
General Psychiatry 6:1731.
Cohen, Sol. 1983a. The Mental Hygiene Movement, the Development of Personality and the School:
The Medicalization of American Education. History of Education Quarterly 23(2):123149.
600 Ilina Singh
Cohen, Sol. 1983b. The School and Personality Development: Intellectual History. In Historical
Inquiry in Education: A Research Agenda, edited by J. H. Best, 110137. Washington, D.C.: American
Educational Research Association.
Cohen, Sol. 1989. Every School a Clinic: A Historical Perspective on Modern American Education.
In From the Campus: Perspectives on the School Reform Movement, edited by S. Cohen and L. Solomon,
1834. New York: Praeger Press.
Conrad, Peter. 1975. The Discovery of Hyperkinesis: Notes on the Medicalization of Deviant
Behavior. Social Problems 23:1221.
Conrad, Peter. 1992. Medicalization and Social Control. Annual Review of Sociology 18:209232.
Conrad, P. and J. Schneider. [1980] 1992. Deviance and Medicalization. Philadelphia: Temple University
Cooperstock, Ruth. 1978. Sex Differences in Psychotropic Drug Use. Social Science and Medicine
Department of Health, Education and Welfare. 1971. Report on the Conference on the Use of
Stimulant Drugs in the Treatment of Behaviorally Disturbed Young Children. Ofce of Child
Development and the Ofce of the Assistant Secretary for Health and Scientic Affairs (January).
DeGrandpre, Richard. 1999. Ritalin Nation. New York: Norton Books.
Diller, Lawrence. 1998. Running on Ritalin. New York: Bantam Books.
Dunn, M. 1962. No Room for Pride. Wo ma ns Day (December): 44.
Ehrenreich B. and D. English. 1978. For Her Own Good. New York: Anchor Press.
Eisenberg, Leon. 1964. Role of Drugs in Treating Disturbed Children. Children II(5):167173.
Fromm-Reichman, F. 1948. Notes on the Development of Treatment of Schizophrenics by
Psychoanalytic Psychotherapy. Psychiatry 11:263273.
Foucault, Michel. 1965. Madness and Civilization. New York: Vintage Press.
Glenn, Evelyn Nakano, G. Chang, and L. R. Forcey, eds. 1994. Mothering: Ideology, Experience and
Agency. New York: Routledge.
Grant, Julia. 1998. Raising Baby by the Book. New Haven: Yale University Press.
Grinspoon, L. and S. Singer. 1973. Amphetamines in the Treatment of Hyperactive Children. Harvard
Educational Review 43:515555.
Hallowell, E. and J. Ratey. 1994. Driven to Distraction. New York: Simon and Schuster.
Hancock, L. 1996. Mothers Little Helper. Newsweek (18 March): 5156.
Hechinger, L. and H. Puner. 1959. The New Toughness in Our Schools. Parents (November).
Herman, Ellen. 1995. Nervous in the Service. In The Romance of American Psychology. Berkeley, CA:
University of California Press.
Hill, S. 1977. Drugs and the Medicalization of Human Problems. Social Science and Medicine
Honor, E. 1957. When Your Child Needs Special Attention. Cosmopolitan (November): 57.
Hunt, M. 1957. This Boy. Woma ns Day (December): 35.
Jenkins, J. 1958. The Hobgoblin. Wom ans Day (December): 71.
Katz, R. 1972. Drug Therapy Sedatives and Tranquilizers. New England Journal of Medicine
Kefauver Hearings. 1960. Administered Prices. Hearings before the (Senate) Subcommittee on
Antitrust and Monopoly of the Committee on the Judiciary, Part 16. Washington, D.C.
Kindlon, D. and M. Thompson. 1999. Raising Cain: Protecting the Emotional Lives of Boys. New York:
Ballantine Books.
Knobel, M. 1959. Hyperkinesis and Organicity in Children. American Medical Association Archives of
General Psychiatry 1:310321.
Krieg, P. 1960. Outlook for the Mentally Ill. Parents (October): 37.
Ladd, Edward. 1970. Pills for Classroom Peace? Saturday Review (21 November): 6683.
Lasagna, Louis. 1969. The Pharmaceutical Revolution: Its Impact on Science and Society. Science
Bad Boys, Good Mothers, and the Miracle of Ritalin 601
Lauffer, M. and E. Denhoff. 1957. Hyperkinetic Behavior Syndrome in Children. Journal of Pediatrics
Lloyd, Elizabeth. 1993. Pre-theoretical Assumptions in Evolutionary Explanations of Female
Sexuality. Philosophical Studies 69:139153.
Maccoby, Eleanor. 1998. The Two Sexes: Growing Up Apart, Coming Together. Cambridge, MA: Harvard/
Belknap Press.
Margolis, M. 1984. Mothers and Such. Los Angeles: University of California Press.
Maynard, Robert. 1970. Omaha Pupils Given Behavior Drugs. Washington Post (29 June): 1.
Mead, M. 1958. A New Kind of Discipline. Parents (September): 50.
Mechling, Jay. 1975. Advice to Historians on Advice to Mothers. Journal of Social History 9:4463.
Moak, H. 1959. Theres Help for Troubled Children. Parents (May): 35.
Mowrer, H. 1965. Learning Theory and Behavior Therapy. In Handbook of Clinical Psychology, edited
by B. Wolman, 242250. New York: McGraw-Hill.
MTA Cooperative Group. 1999. A 14-month Randomized Clinical Trial of Treatment Strategies for
Attention-Decit/Hyperactivity Disorder. Archives of General Psychiatry 56:10731086.
National Institutes of Health. 1998. Diagnosis and Treatment of Attention Decit Hyperactivity
Disorder. NIH Consens Statement 16(2) (1618 November): In press.
Neill, J. 1990. Whatever Became of the Schizophrenogenic Mother? American Journal of Psychotheraphy
Novak, Viveka. 2001. New Ritalin Ad Blitz Makes Parents Jumpy. Time (10 September): 6263.
OReilly, Andrea, ed. 2001. Mothers and Sons: Feminism, Masculinity and the Struggle to Raise our Sons.
New York: Routledge.
Palmer, E. and S. Finger. 2001. An Early Description of AD/HD: Dr. Alexander Crichton and Mental
Restlessness. Child Psychology and Psychiatry Review 6(2):6673.
Pollack, William. 1998. Real Boys: Rescuing Our Sons from the Myths of Boyhood. New York: Random
Puner, H. 1958. Wo r r y, Wor r y, Wo r r y. Parents (November): 40.
Rapoport, J., M. Buchsbaum, et al. 1978. Dextroamphetamine: Cognitive and Behavioral Effects in
Normal Prepubertal Boys. Science 199:560563.
Schilder, P. 1937. The Psychological Effects of Benzedrine Sulphate. Journal of Nervous and Mental
Disorders 87:2732.
Shorter, Edward. 1997. A History of Psychiatry. New York: John Wiley and Sons.
Shrag, P. and D. Divoky. 1975. The Myth of the Hyperactive Child. New York: Pantheon.
Smith, Mickey. 1991. A Social History of the Minor Tranquillizers. New York: Howarth Press.
Spock, Benjamin. 1946. Baby and Childcare. New York: Dutton/Pocket Books.
Still, George. 1902a. Some Abnormal Psychical Conditions in Children. (Lecture I). Lancet (12 April):
Still, George. 1902b. Some Abnormal Psychical Conditions in Children. (Lecture II). Lancet (19
April): 10771082.
Still, George. 1902c. Some Abnormal Psychical Conditions in Children. (Lecture III). Lancet (26
April): 11631168.
Strecker, E. 1946. Their Mothers Sons. New York: Lippincott.
Swanson, J., Keith McBurnett, Tim Wigal, Linda J. Pffner, et al. 1993. Effect of Stimulant Medication
on Children with Attention Decit Disorder: A Review of Reviews. Exceptional Children
Thurer, Shari. 1994. The Myths of Motherhood. Boston: Houghton Mifin Press.
Tolchin, H. 1959. When parents should not worry. New York Times Magazine (October): 70.
Tolchin, H. 1961. Children Under Pressure. New York Times Magazine (June): 32.
United Nations Report. 1995. Use of Methylphenidate for the Treatment of Attention Decit
Disorder, Report of the United Nations International Narcotics Control Board. New York: United
Nations, 2022.
602 Ilina Singh
United Nations Report. 1999. Comments on Reported Statistics. Report of the United Nations
International Narcotics Control Board. New York: United Nations.
United States Congressional House Government and Operations Committee. 1970. Federal
Involvement in the Use of Behavior Modicaton Drugs on Grammar School Children in the Right
to Privacy Inquiry. 91st Congress, 2nd session. Washington: U.S. Government Printing Ofce.
Watson, John. 1928. Psychological Care of Infant and Child. New York: Norton.
Weiss, Nancy. 1985. Mother: The Invention of Necessity. In Growing Up in America: Children in
Historical Perspective, edited by Hiner and Howes, 283307. Chicago: University of Illinois Press.
Welton, S. 1964. Opening Doors to the Brain-Damaged. Parents (February): 78.
Whitman, A. 1960. What do you mean, normal? Wo mans Day (November): 46.
Whitman, A. 1965. Why do good parents have trouble with their children? Woma ns Day (February):
Zuckerman. M. 1975. Dr. Spock: The Condence Man. In The Family in History, edited by C.
Rosenberg, 179207. Philadelphia: University of Pennsylvania Press.
1959. Drugs: Putting on the Heat. Newsweek (21 December): 67.
1961. Too Many Drugs. Time (26 May): 73.
1968. Those Mean Little Kids. Time (18 October): 9293.
March 2nd, 1998. Letter from Amishi Shah, Novartis Medical Information Services
Bad Boys, Good Mothers, and the Miracle of Ritalin 603
... Researchers in the field support the notion that ADHD is a behavioral description based on criteria that are sensitive to subjectivity and cognitive biases since there are no measurable biological markers or objective tests to establish the presence or absence of ADHD (Gambrill, 2014).Thus, ADHD remains one of the most talked-about and controversial subjects in education. The debate ranges between two ends of a continuum (Singh, 2002a(Singh, , 2002b. On one end are those who support the biological perspective stating that neurological and chemical imbalances in the brain cause ADHD and therefore propose medication as the most effective treatment (Cooper, 2001). ...
... Another important point of this study is that educators' views on children's behavior cannot be understood without considering the educational and social context within which they are professionally educated and that ADHD diagnosis and treatment are culturally contingent, as suggested by Singh (2002a). This becomes more crucial since little is known about the level of activity, inattention, and impulsivity that should be considered "normal" in early childhood (Barkley, 1998). ...
Full-text available
As more children enter preschool programs, there is an increasing need for early education professionals to recognize and understand Attention-Deficit/Hyperactivity Disorder (ADHD). This study examined 120 Greek early childhood educators' knowledge of ADHD using a Greek self-report ADHD Knowledge Questionnaire (ADHD-KQ). All participants worked in infant/child centers operated by municipalities in Greece. Results point out early childhood educators' lack of fundamental knowledge about the causes, symptoms/diagnosis, cognitive deficits, and interventions regarding ADHD. Among the personal and professional variables (years of teaching experience, age, and educational level) studied as predictors of overall knowledge about ADHD age was found as the only significant. Older participants seemed to have better knowledge regarding the basic aspects of ADHD. Results suggest greater efforts must be made to provide training specifically in the management of children with ADHD.
... Within this study, it is not the goal to add evidence to either side of the argument of whether ADHD 'exists' as a disorder in the truest sense, nor to discuss its legitimacy within psychiatry. Like Singh (2002), this thesis will simultaneously treat ADHD as both a 'real' and a 'constructed diagnosis', regardless of my self-conceptualisation. The definitive neurological explanation of ADHD as a disorder is not important to the aims and exploration of this study, but what is important is the way in which the parental participants incorporate and utilise the various ADHD constructs. ...
Full-text available
Attention Deficit Hyperactivity Disorder [ADHD] is a common childhood diagnosis affecting an estimated 5-7% of school aged children. This thesis explores the needs and experiences of parents as their children traverse the often arduous and challenging process of referral, assessment, and diagnosis of ADHD otherwise characterised as the 'ADHD diagnostic journey'. Narrative qualitative data was collected through 21 semi-structured longitudinal serial interviews over a two-year period with seven parents of children currently on the ADHD diagnostic journey.
... Psychosocial and psychopharmacological interventions for ADHD and ODD date back to the 1960s (Singh, 2002). Clinical trials consistently demonstrate powerful acute effects of methylphenidate on ADHD and ODD symptoms (Ipser & Stein, 2007). ...
... Psychosocial and psychopharmacological interventions for ADHD and ODD date back to the 1960s (Singh, 2002). Clinical trials consistently demonstrate powerful acute effects of methylphenidate on ADHD and ODD symptoms (Ipser & Stein, 2007). ...
Objective Physical activity (PA) has been proposed as an adjunct treatment and secondary prevention intervention for attention-deficit hyperactivity/impulsivity disorder (ADHD) and oppositional defiant disorder (ODD). However, meta-analyses testing effects on symptoms and functional impairment have yielded conflicting results. Methods A systematic search of eight databases yielded 15 randomized controlled trial and 2 quasi-experimental design studies—including N = 881 youth (M = 9.75 years, 71% male)—that tested the effects of multi-week PA programs on symptoms and impairment of children with [or at-risk for] ADHD and/or ODD. Results Random effects meta-analyses favored PA groups on omnibus ADHD measures (g = −0.42, 95%CI[-0.62;-0.21]), combined ADHD symptoms (g = −0.50, 95%CI[-0.82;-0.17]), inattention (g = −0.41,95%CI[-0.82; 0.00]), and hyperactivity/impulsivity (g = −0.30, 95%CI[-0.56;-0.04]). Heterogeneity was moderate across studies (I² = 49%, 95%CI[12%-to-70%]). Significant differences favored PA programs whether inclusion required diagnosis, programs augmented frontline treatments, and active or passive comparison groups were utilized. Conclusion Diverse PA programs can reduce ADHD symptoms, especially where they intentionally pursue this end.
... La historia del TDAH es larga y compleja, lo cual ha sido discursivamente utilizado para dotar de cierta legitimidad al masivo diagnóstico de niños y niñas. No obstante, en las últimas décadas, una importante diversidad de autores como por ejemplo Lakoff (2000), Singh (2002), Timimi (2008), Smith (2008), Rafalovich (2002) y Cumstock (2003 han realizado análisis históricos de esta categoría psiquiátrica. La idea central de estos autores es demostrar que la historia del TDAH, así como de los llamados trastornos mentales en general, no es lineal ni armoniosa; no se trata de un conocimiento científico que se fue acumulando hasta llegar a una verdad. ...
Full-text available
La producción socio-escolar del fracaso escolar masivo y sus consecuencias interpersonales y subjetivas.
... Der Unterschied zu älteren Theorien über ADHS, in denen die Störung etwa aus einem psychoanalytischen Paradigma heraus als ein Erziehungsproblem zwischen Müttern und Söhnen erklärt wurde (Singh 2002), ist substanziell. In Bezug auf die Kupfer-Kurve bedeutet dies, dass Krankheit und Normalität im Fall von ADHS auf der Grundlage des Neurotransmitter-Stoffwechsels verstanden werden. ...
The focus of this chapter is on blame and shame. There are many kinds of interactions that occur between family members and blaming others in the family for their difficulties may be one of those social actions. This may be the result of a range of different responses to the emotional reactivity that inevitably occurs between family members. As these responses often occur in quite patterned ways, some family therapists have found helpful ways to support family members to move from these predictable reactive patterns to mindful ways of responding (Tomm et al., 2014). However, our focus for this chapter is not so much an investigation of these kinds of problematic patterned blame and shame sequences of interactions between family members, but towards family members. We examine the ways in which family members, particularly parents, may find themselves being positioned as accountable for their children’s difficulties by others in wider society, and potentially also by the mental health professionals supporting them.
In this present work, the main objective is to investigate the methodological strategies and resources used in the pedagogical practice for the learning and teaching of children with ADHD, identifying the main difficulties in the pedagogical practices in the learning process of these children and finally to analyze the contributions of teaching practice, as a facilitator of learning. In this context, the research was carried out based on the following problem question: What methodological strategies and resources are used in the pedagogical practice for teaching and learning children with ADHD? The study presented significant theoretical and practical contributions to the aforementioned process. The problem and the objectives proposed for the research led us to develop a field research that is guided by a qualitative approach. Among the types of qualitative research, we opted for the Case Study, understanding that it meets the objectives defined in this study, which aim to know how, in fact, the methodological strategies and resources used in the pedagogical practice for the learning and teaching of children with ADHD. Qualitative research provides direct contact between the researcher and the researched environment. This type of Study, when defined, is characterized as a Case Study. In this case, the study included the teacher who has a child diagnosed with ADHD in her classroom and the pedagogical coordinator of the researched school. In the results it was possible to perceive that the teacher knows about the disorder and has her own means of dealing with children with ADHD in the classroom, so we will show studies that can contribute to the aid of these pedagogical practices being more directed to the specificities of these children, aiming at a better learning. The study presented significant theoretical and practical contributions to the aforementioned process. The theoretical contributions refer to the new discoveries that were made from the investigation of the teacher’s pedagogical practice and the physical and pedagogical structure of the school to serve students with ADHD.
Full-text available
In the last four decades, nanotechnology has gained momentum with no sign of slowing down. The application of inventions or products from nanotechnology has revolutionised all aspects of everyday life ranging from medical applications to its impact on the food industry. Nanoparticles have made it possible to significantly extend the shelf lives of food product, improve intracellular delivery of hydrophobic drugs and improve the efficacy of specific therapeutics such as anticancer agents. As a consequence, nanotechnology has not only impacted the global standard of living but has also impacted the global economy. In this review, the characteristics of nanoparticles that confers them with suitable and potentially toxic biological effects, as well as their applications in different biological fields and nanoparticle-based drugs and delivery systems in biomedicine including nano-based drugs currently approved by the U.S. Food and Drug Administration (FDA) are discussed. The possible consequence of continuous exposure to nanoparticles due to the increased use of nanotechnology and possible solution is also highlighted.
Autism is arguably one of the most stigmatized conditions included within the Diagnostic Statistical Manual (DSM). Indeed, research indicates that stigma is one of the most significant problems mothers of autistic children face (Dehnavi et al., 2011) and stigma is felt by autistic people as a pervasive part of their existence, as they describe always feeling on the ‘outside of the neurotypical world and shunned by society’ (Botha et al., 2020, p. 11). In part, this reflects the physically ‘normal’ appearance of many autistic individuals (rendering it, in many cases, an ‘invisible disability’), and in part due to some of the behaviours displayed that fall outside of the traditional social norms and thereby subject to public judgment (Gray, 2002). In other words, some autistic children and/or adults, due to their autism, are likely to display behaviours that in turn can lead to abusive behaviour or negative attitudes from the community around them, leading to embarrassment or a feeling of being judged by others (Broady et al., 2017).
The University of California, Irvine ADD Center recently conducted a synthesis of the literature on the use of stimulants with children with attention deficit disorder (ADD), using a unique “review of reviews” methodology. In this article, we compare three reviews from each of three review types (traditional, meta-analytic, general audience) and illustrate how coding variables can highlight sources of divergence. In general, divergent conclusions stemmed from variations in goal rather than from variations in the sources selected to review. Across quantitative reviews, the average effect size for symptomatic improvement (.83) was twice that for benefits on IQ and achievement measures (.35). A summary of what should and should not be expected of the use of stimulants with ADD children, derived from the literature synthesis, is provided.
It is our impression from a review of these cases that benzedrine is a useful adjunct to treatment of the neurotic child, in that it gives him a feeling of well-being, and temporarily allows him to feel secure and loved. In this frame of mind he can face his difficulties, express his aggressive impulses without overwhelming fear of consequences, and obtain relief from inner tension and anxiety. The art productions and other means of expressing the fantasy life of these children reflect these processes as they take place. Benzedrine alone does not lead to any but a temporary solution of the child's problems, and must always be combined with a personal therapeutic approach. In the more severely neurotic child, benzedrine acts only as an expedient to help the child adjust in an environment where he can later find help for his deeper conflicts, and leads to an evasion of these problems during the period of administration. Here, too, the art and fantasy production show an inhibition which parallels the evasion noted in the personal therapeutic approach during medication. Benzedrine is of great benefit in stimulating interest and drive in learning in the child with a learning disability, providing the original impulse has been obscured through the operation of neurotic mechanisms. Fear, depression and sexual tension in the child are often completely relieved during the period of benzedrine administration, as is hyperkinesis occurring on a neurotic basis. Activity is frequently integrated and made more productive, and the relationship to the group is thus facilitated. In the group studied, benzedrine had no appreciable effect upon the behavior of children with developmental brain defects or with schizophrenia and its effect upon the psychopathic personality was in all respects unfavorable. Consequently its use in a controlled ward set-up may be an aid in the differential diagnosis of some obscure problems. It has also clarified our concepts in regard to the classification of behavior problems in children as they are here described. However, it is worth emphasizing again that the successful use of this drug in the behavior problems of children depends on a clear understanding of the causes of the child's problems, the proper choice of children to receive the drug, and the use of the drug only as an adjunct to adequate personal psychotherapy, tutoring and social adjustments.