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Until the middle years of the twentieth century, external stimulation required both physical labor and a high degree of attention. Further, the social world was one that required heavy labor and was generally characterized by a poor diet that was usually deficient in nutrients if not calories (though calorie deficiency was common, too.) The educational system worked in such a way that a bright child could generally move beyond her/his age peers quickly and easily without much in the way of opposition by either parents or school; in the small schoolrooms where effectively all students were in a tutoring situation, advancement was a matter of individual accomplishment, while in the larger schools, there was no real stigma against accomplishment and able students were expected to do more and were given the encouragement to do so. (The negative side of this is that children who were not as able were not allowed educations much, if at all, and were often sent off to institutions or put to menial work.)
In wealthy families, a bored, bright ADD type child's abilities would be channeled through a tutor and appropriate education and work found; in poorer families, a bored and bright ADD type child would find a place in the professional world as soon as possible. A child who didn't sit still well could become a messenger or runner for any number of urban occupations, giving the child both stimuli and focus. A child with the obsessive variation could usually find employment in piecework of some sort. Agricultural labor is always varied and changing, with high levels of stimuli and required attention. Further, the high levels of daily labor required for existence in all but the highest classes of society ensured that an ADD/ADHD individual had the outlets to their energy that we really don't have now.
I don't believe that ADD/ADHD are more common now; the difference is that we don't have the mechanisms needed to cope with the behavioral manifestations that earlier people had. (I am pretty certain that Boyle, Newton and Merriwether Lewis were ADD/ADHD; Lewis had comorbid depression.) My own family has a history of something like it; my great-uncle went to university at 15, while his brother, my great-grandfather, went to university at 14 and came home at 18 to be a scientific farmer. Their career paths and their early dedication to them allowed them to cope with their symptoms effectively. Their sister, also ADD in nature, was privately tutored due to kidney disease and died very young, but her paintings were very skilled and had she lived, she probably would have been quite an artist. Their mother, who is the first person whose memoirs note something like ADD/ADHD was a diarist, columnist for the local paper, nurse, farmwife and midwife. She coped with her symptoms by being continually active. All were trained from a very early age to be attentive and focused. As Quakers, such training was not accomplished with corporal punishment, but in other families, it would have been.
My sister is coping with my nephew's incipient ADD/ADHD by reverting to as many pre-1940 social patterns as she can; they live within walking distance of his school and they walk to and from school; they eat whole foods and she only allows him to watch movies, not general children's TV. She feels that she is responsible for his education, and what happens in the classroom is only a starting point. (She's also ADD, so she's using her own tried methods to raise him effectively.)She's doing okay so far; he's in kindergarten and is behaving well, though he is a bit shy. We'll see.
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