Child, Child, Preschool, Europe epidemiology, History, 20th Century, Humans, Mass Screening, Prevalence, School Health Services, Sweden epidemiology, Terminology as Topic, United States epidemiology, Attention Deficit Disorder with Hyperactivity diagnosis, Attention Deficit Disorder with Hyperactivity epidemiology, and Attention Deficit Disorder with Hyperactivity history
Hyperkinetic disorders, MBD (minimal brain dysfunction), DAMP [deficits in attention, motor function (or muscular control) and perception], ADD (attention deficit disorder), and ADHD (attention deficit hyperactivity disorder), are currently the focus of interest among parents, clinicians and researchers in Sweden; and guidelines for the assessment and treatment of such disorders were published in the USA in 1997, and in Europe in 1998. However, despite the accumulated knowledge, and new hypotheses which have been proposed, e.g., that ADHD is "a disorder of adaptation," there is no consensus as to the understanding, treatment and prevention of these disorders. In a consensus statement published by an NIH (National Institutes of Health) panel in the USA it was concluded that, after years of clinical research and experience, our knowledge of the aetiology of ADHD remains speculative, and no documented strategies for its prevention are available. A review of Swedish views and concepts of these disorders since 1950 showed discussion to have been characterised by more similarities than differences, and that nothing really new had emerged. However, differences have existed in the sphere of general education. Since WWI, changes in the organisation of the statutory school system have been designed to improve both education and health among schoolchildren. Such changes seem to have had both beneficial and adverse effects on the overall health of the children. The prevalence of ADHD-like problems declined during the period, 1949-70, when all Swedish six-year-olds were screened for school-readiness with a standardised national test, and the class in which a child started school was dependent on intellectual capacity, overall mental age, and the presence or absence of reading, spelling and learning difficulties, and of behavioural problems. Since this was discontinued after reorganisation of the school system in 1970, the prevalence of problematic behaviour has once again increased. Thus, in the search for new approaches to the support of children with hyperactivity and attention deficit problems, analysis of the organisation of the school system should not be forgotten.