Ritalin for whom? Revisited: further thinking on ADHD

This paper explores further the vast topic of child neuropsychiatric disorders – ADHD in particular. It refers to and expands on issues debated in an earlier paper ‘Ritalin for whom?’. In that paper, it was argued that those who benefitted most from children taking Ritalin were parents and teachers struggling with uncontained and out-of-control children under five, as well as doctors constrained by scarce resources and long waiting lists in NHS child services. This paper looks at the complex, inextricable and still somewhat mysterious interaction between genetic and environmental factors and what is meant by ‘genetic disorder’ when, for example, the diagnosis of autism, Asperger’s syndrome, ADHD is made. The author explores various avenues of research and focuses on the contribution of the psychological perspective offered by psychoanalytic thinking and attachment theory to understanding hyperactivity. This paper is mostly a review of theories, research and formulations, which help us explain some of the underlying factors in hyperactive children. Brief vignettes from infant observation, parent–infant psychotherapy and psychoanalytic treatment of children are used to support the main hypothesis that ADHD results from the interweaving of neuropsychological factors from birth onwards and can be treated by psychological interventions.