The various proposed etiologies of attention deficit hyperactivity disorder (ADHD) are reviewed from the Department of Neurology, New York University Medical Center, New York. These include:

  1. genetics,
  2. pregnancy related risk factors: smoking, maternal anemia, breech delivery, chorioamnionitis, small head circumference, prematurity, low birth weight, birth asphyxia, cocaine, and alcohol (fetal alcohol syndrome),
  3. childhood illness sequelae: meningitis, encephalitis, Reyes syndrome, otitis media, anemia, cardiac disease, thyroid disease, epilepsy, autoimmune disorders, and metabolic disorders,
  4. head injury, especially involving frontal lobes,
  5. toxins and drugs: lead, theophylline, anticonvulsants.

COMMENT. The recognition of risk factors for ADHD can lead to early intervention and improved prognosis. Diet and nutrition enthusiasts would add the effects of food additives, food allergies and sucrose to the above list of potential etiological factors in ADHD. For a review of recent articles concerning pros and cons of dietary factors in ADHD and learning disorders, see Progress in Pediatric Neurology I and II, 1991 and 1994, Chicago, PNB Publishers.