The title of a recent article in The New York Times asks, “Have We Been Thinking About A.D.H.D. All Wrong?” How would you answer this question? My response would be a robust “You’re darn right we have!”

I am a member of a shrinking cohort of primary care pediatricians who practiced before the phenomenon of attention-deficit/hyperactivity disorder (ADHD) appeared on the landscape. I have always been troubled by how the handful of hyperactive grade schoolers I was seeing in the 1970s could mushroom into something that prompted the Centers of Disease Control and Prevention to report last year more than 11% of American children had been diagnosed with ADHD.

I don’t include myself in the “we” to whom the writer refers. I have never been able to imagine that a seismic genetic shift could explain the sudden emergence of a new disease that lacks solid diagnostic criteria or a biophysical marker. Radiation from solar flares and chemicals leached from the nonstick surfaces on our pots and pans just don’t seem to be likely answers. 

The New York Timesarticle comes the closest to encapsulating an explanation I have constructed over the past 50 years of observing the ADHD phenomenon unfold.