Causes – Including Misconceptions

Two commonly held beliefs are unfounded and revolve around the causes of ADHD related to poor caregiving and diet. This section will share information that dispels each and will then offer research-based explanations.

Controversial explanations for the development of ADHD have risen in popularity since the 1960s. Some of these ideas arise from cultural folklore; others can be traced to “specialists” trying to market an easy fix for ADHD based on their proposed cause. Some other ideas contain a kernel of truth but have been falsely cast as causing most ADHD cases. Some critics have proposed that poor caregiving is a major cause of ADHD. This explanation is popular because it is intuitively appealing—one can imagine how a child who is not being disciplined at home may be noncompliant in other settings. Caregivers of children with ADHD may use discipline less consistently, and a lack of structure and discipline in the home can exacerbate symptoms in children with ADHD. However, it is unlikely that poor caregiving alone causes ADHD in the first place. On the contrary, research suggests that noncompliance and impulsivity on the child’s part can cause caregivers to use discipline less effectively due to sheer exhaustion (Additudemag.com).

In a classic series of studies, Cunningham and Barkley (1979) showed that mothers of children with ADHD were less attentive to their children and imposed more structure on their playtime than mothers of typically developing children. However, these researchers also showed that their compliance increased when the children were given stimulant medication. Their mothers’ caregiving behavior improved to the point where it was comparable to mothers without ADHD. This research suggests that instead of poor caregiving causing children to develop ADHD, it is the stressful effects of managing an impulsive child that causes parenting problems in their caregivers. One can imagine how raising a child with ADHD could be stressful for caregivers. One study showed that a brief interaction with an impulsive and noncompliant child caused caregivers to increase their alcohol consumption. Presumably, these parents were drinking to cope with the stress of dealing with the impulsive child. It is, therefore, important to consider the reciprocal effects of noncompliant children on parenting behavior rather than assuming that caregiving ability has a unidirectional effect on child behavior (Additudemag.com).

Other purported causes of ADHD are dietary. For example, it was long believed that excessive sugar intake could cause children to become hyperactive. This myth is largely disproven. However, other diet-oriented explanations for ADHD, such as sensitivity to certain food additives, have been proposed. These theories have received a bit more support than the sugar hypothesis. The possibility that certain food additives may cause hyperactivity in children led to a ban on several artificial food colorings in the United Kingdom. However, the Food and Drug Administration rejected similar measures in the United States. Even if artificial food dyes cause hyperactivity in a subgroup of children, the research does not support the finding that these food additives are a primary cause of ADHD. Further, research support for elimination diets as a treatment for ADHD has been inconsistent (Additudemag.com).

Scientists are still working to determine what causes children to develop ADHD. Despite substantial progress over the past four decades, there are still many unanswered questions. The development of sophisticated technology, such as Positron Emission Topography (PET scans), has made it possible to discern tiny differences in brain structure and functioning when comparing an individual with ADHD to an individual without the disorder. There has also been evidence of a genetic link, as ADHD symptoms tend to run in families, along with emerging environmental factors. For example, a child with a genetic predisposition to ADHD may develop the disorder after their mother uses tobacco during pregnancy. In contrast, a child without a genetic predisposition may not develop the disorder in the same environment. Fortunately, the causes of ADHD are relatively unimportant for the caregivers of children with ADHD who wish to receive treatment because what caused the disorder for an individual child generally does not influence how ADHD is treated. The same holds for educators who design supports (Additudemag.com). Refer to Table 1 for more information on the three research-based causes of ADHD.

In summary, ADHD is not a result of a poor diet, inadequate exercise, excessive screen time, caregiving approach, or socio-economic factors — though some of these factors and other stressors may worsen ADHD symptoms in some individuals. While widely considered a childhood condition, researchers continue to explore whether ADHD onset can occur in adulthood.

 Table 1

Research-based Causes of ADHD

Note. Table 3 is adapted from https://www.additudemag.com/adhd-in-adults/pports .