Review of:
Goodman, Gay and Poillion, Mary Jo  (1992). ADD: Acronym for any
dysfunction or difficulty. The Journal of Special Education, 26, 37-56.
 

This review surveys 48 articles and books on ADD by leading authors. It explores two main concerns: the characteristics of ADD and the causes of ADD. The authors identify 69 characteristics and 38 causes listed in the literature, and they tell us that there is little agreement in either the diagnostic identification of ADD or about what causes it.

They argue that for a labeling system to be effective, "the common characteristics attributed to the system must be known and agreed upon by all who use the system (p. 38). How did a diagnostic category with such poor reliability get established?  They discuss the evolution of the ADD label. It first appears, they tell us, in the third edition of the DSM (1974).  

This literature review revealed that "no single author or group of authors has contributed more than two or three publications to this topic of either ADD characteristics or its causes" (p. 39). No clear authority has emerged, apparently, on this condition.  There is an absence of agreement about ADD characteristics, and in some cases, contradictory definitions. The authors draw interesting parallels to a previous term - Minimal Brain Damage or Minimal Brain Injury - which was abandoned in 1966 due to the 99 characteristics of the condition being considered too vague and too broad. They muse about whether ADD is heading in the same direction.

The review did not uncover one single characteristics that all authors agreed upon. "Only four of the 69 characteristics are listed by more than 50%" (p. 41) of the texts reviewed. Some of those characteristics were: short attention span (82%), hyperactive (74%), impulsive (71%), distractible (51%), fails to follow through (38%). The percentages of the remaining 64 characteristics drop to between 7% and 3%. Additionally, "more than 10% of the characteristics appear to contradict each other" (p. 45). For example, below average IQ vs average IQ; and "excessive talking" vs "inability to speak out". The authors cite further evidence of contradictory findings by citing a study of distractibility, which compared hyperactive and normal children. No differences between the two groups was found on this variable.

In respect of causes, 38 instances were cited in the studies under review. Examples included, organic, psychological, environmental, intellectual/
developmental, birth complications. "Only one presumed cause - genetic - is cited by almost half of the authors (48%) as a cause of ADD" (p. 51).

Goodman and Poillion (1992) recommended that "[b]ecause of the uncertainty of the nature of ADD, the label has limited value for the purposes of  communication, planning, and decision making among educators" (p. 52).