ADHD: how race for the Moon revealed America’s first hyperactive children
As the world commemorates the 50th anniversary of the first moon landing, we can appreciate the numerous technological advances that have emerged through space exploration, ranging from artificial limbs and water purification systems, to satellite TV and freeze-dried food. But the race for space that was contested between the US and the Soviet Union also resulted in profound social changes, including the discovery of a new childhood psychiatric disorder: Attention Deficit Hyperactivity Disorder (ADHD).
On October 4, 1957, the Russians successfully launched two Sputnik satellites into orbit, beating America into space. For Americans who believed that they were the predominant scientific and technological power during the early years of the Cold War, Sputnik came as a profound shock. Politicians, military leaders, scientists and educators immediately began asking why the US had fallen behind the Soviets and soon found their culprit: the American education system.
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Since the 1920s, the prevailing ideology in American education had been progressive education, a philosophy pioneered by educational reformer John Dewey. Progressive education was a child-centred approach through which children learned by doing and by discovery in flexible, active educational spaces where they worked at their own pace.
Rather than learning from a textbook, children might learn about botany by growing a vegetable garden. By selling their wares to the local community, they would engage in writing and art by creating advertising for their produce, and arithmetic and economics in setting prices and calculating profits.
Changing the system
Although progressive education was compelling in theory, it was difficult to implement in practice. It was quickly identified by critics as one of the key explanations for US failings in the space race. Sputnik demonstrated to critics that American children should no longer be allowed to learn at their own pace and in their own way. The pressure to train new scientists, engineers and astronauts demanded that the country’s education system upped its game and cracked down on those not capable of making the grade.
A comprehensive response came in 1958, with the passage of the National Defense Education Act (NDEA), which emphasised a return to subject-centred, teacher-centred learning in rigid, fixed learning environments, where students were expected to match the pace set by the curriculum.
Specifically, NDEA provided US$1 billion to achieve three aims:
1. Renewed focus on core subjects, including science, maths, English and foreign languages;
2. Drastic reduction in the number of students dropping out of school for low-skilled jobs;
3. Raising of educational achievement for children from all social and ethnic backgrounds from the slums to the suburbs.
Thousands of guidance counsellors were hired (ideally at a ratio of one to every 250-300 pupils) to help schools achieve these goals. These counsellors were expected to:
… be on the lookout for the bright boy or girl whose high ability has been demonstrated through … aptitude tests … but whose achievement, as measured by grades … has been low.
But what was underlying such underachievement before this point? It soon became apparent that underachievers exhibited certain characteristics which were seen to undermine their academic progress: hyperactive, impulsive, inattentive behaviour along with occasional defiance and aggression. In other words, all the hallmarks of ADHD.
Helping to transform what was an educational problem into a medical one was a new psychiatric condition identified in 1957: hyperkinetic impulse disorder. Prior to the emergence of this term – which is virtually synonymous with ADHD – children had to demonstrate extremely pronounced hyperactive, impulsive and often violent behaviour for their behaviours to be considered pathological.
In many cases, brain damage or allergies were identified as the root causes for such symptoms. The definition of hyperkinetic impulse disorder drastically lowered this threshold, creating a disorder that could be found in most classrooms .
Guidance counsellors emerged as the lynchpin between the educational sphere, where such behaviours were identified, and the medical sphere, where they were diagnosed and treated. Although psychiatrists debated the best way to treat such children, stimulant drugs, such as methylphenidate (commonly known as Ritalin which was made available for use in children in 1962), quickly became the preferred option.
By the late 1960s, what we now call ADHD was the most common childhood psychiatric disorder and Ritalin had become a bestseller for its initial manufacturer, Ciba, which engaged in a vigorous marketing campaign to promote its use.
Although Ritalin was acknowledged to be an effective treatment for many, though not all, hyperactive children, it was almost immediately controversial due to its side effects and its chemical similarity to banned stimulants. Many also thought it was wrong to give children a drug to treat a contested disorder; debates about Ritalin and other ADHD medication have not faded away.
Along with the space race, a long list of other factors contributed to heightened academic expectations of children and in increased hyperactive, impulsive and inattentive behaviour in children more generally.
On the one hand, for example, the GI Bill provided millions of American servicemen with funding to engage in higher education, creating an expectation that their children would follow suit. Equally, the massive bulge of the 75m baby boomers born after World War II exerted huge pressures on an education system already buckling under the strain of the Great Depression and the war itself.
On the other hand, a raft of post-war developments – chemicals in the food supply, lead in the atmosphere, reduced tolerance for corporal punishment, less physical activity and time spent outdoors – arguably made children more likely to be hyperactive, impulsive and inattentive.
A decade later, on July 20, 1969, the US had won the space race. But this achievement had unexpected consequences. Regardless of whether one supports ADHD as a valid diagnosis or not, a wide range of factors – not least those bound up in the race to the moon – led to its discovery in American children.
Matthew Smith receives funding from the Wellcome Trust.