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Emilio Mira y López's Perspectives on Understanding ADHD

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Title: Emilio Mira y López's Perspectives on Understanding ADHD
Language: English
Authors: Joana Escamilla Lerner (ORCID 0009-0008-5617-9691), Pilar de Castro-Manglano (ORCID 0000-0003-3141-3492), Pilar León Sanz (ORCID 0000-0003-0247-6101)
Source: Journal of Attention Disorders. 2026 30(1):3-7.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 5
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Attention Deficit Hyperactivity Disorder, History, Vocabulary, Symptoms (Individual Disorders), Intervention, Teaching Methods, Medical Services, Psychiatry, Drug Therapy, Child Health, Mental Health, Learning Problems
DOI: 10.1177/10870547251345916
ISSN: 1087-0547
1557-1246
Abstract: Objective: The study aims to examine the contributions of Emilio Mira y López (1896-1964) to the early conceptualization and treatment of what is now known as Attention Deficit Hyperactivity Disorder (ADHD). It seeks to contextualize his ideas within broader historical, pedagogical, and psychiatric developments in Spain and internationally. Method: A historical-analytical approach was employed, reviewing Mira y López's publications El niño que no aprende ("The Child Who Does Not Learn, 1947"), as well as related psychiatric and educational literature from the early 20th century. His work was analyzed alongside contributions from contemporaries and predecessors, with a focus on terminology, neurophysiological concepts, and early treatment strategies. Results: Mira y López described the "unstable child" or "butterfly child" with symptoms that align closely with modern ADHD: impulsivity, distractibility, and lack of sustained attention. He proposed that these children suffer from an imbalance between excitatory and inhibitory brain functions, suggesting early therapeutic interventions including behavioral techniques and opotherapeutic (hormonal) medications. His research emphasized a medical and pedagogical approach to learning difficulties and prefigured ideas found in the emerging field of child psychopharmacology. Conclusion: Emilio Mira y López's understanding of childhood instability reflected the influence of French and Anglo-American psychiatry and anticipated key elements of today's ADHD frameworks. His physiological model of inhibition mirrors Charles Bradley's "inhibition hypothesis," which led to the use of stimulants for hyperactivity. Mira's early proposals contributed to shaping a more comprehensive, interdisciplinary view of childhood mental health and learning difficulties in Spain and Latin America.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1493021
Database: ERIC
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  Value: <anid>AN0189876908;gs001jan.26;2025Dec10.00:10;v2.2.500</anid> <title id="AN0189876908-1">Emilio Mira y López's Perspectives on Understanding ADHD </title> <p>Objective: The study aims to examine the contributions of Emilio Mira y López (1896-1964) to the early conceptualization and treatment of what is now known as Attention Deficit Hyperactivity Disorder (ADHD). It seeks to contextualize his ideas within broader historical, pedagogical, and psychiatric developments in Spain and internationally. Method: A historical-analytical approach was employed, reviewing Mira y López's publications El niño que no aprende (The Child Who Does Not Learn, 1947), as well as related psychiatric and educational literature from the early 20th century. His work was analyzed alongside contributions from contemporaries and predecessors, with a focus on terminology, neurophysiological concepts, and early treatment strategies. Results: Mira y López described the "unstable child" or "butterfly child" with symptoms that align closely with modern ADHD: impulsivity, distractibility, and lack of sustained attention. He proposed that these children suffer from an imbalance between excitatory and inhibitory brain functions, suggesting early therapeutic interventions including behavioral techniques and opotherapeutic (hormonal) medications. His research emphasized a medical and pedagogical approach to learning difficulties and prefigured ideas found in the emerging field of child psychopharmacology. Conclusion: Emilio Mira y López's understanding of childhood instability reflected the influence of French and Anglo-American psychiatry and anticipated key elements of today's ADHD frameworks. His physiological model of inhibition mirrors Charles Bradley's "inhibition hypothesis," which led to the use of stimulants for hyperactivity. Mira's early proposals contributed to shaping a more comprehensive, interdisciplinary view of childhood mental health and learning difficulties in Spain and Latin America.</p> <p>Keywords: ADHD; treatment history; childhood psychiatric symptoms; mental health; review</p> <hd id="AN0189876908-2">Introduction</hd> <p>Various studies demonstrate the existence of the syndrome that we now call ADHD in descriptions as early as 1753 ([<reflink idref="bib4" id="ref1">4</reflink>]; [<reflink idref="bib15" id="ref2">15</reflink>]; [<reflink idref="bib24" id="ref3">24</reflink>]; [<reflink idref="bib42" id="ref4">42</reflink>]). These studies reinforce the idea that ADHD is not a modern phenomenon but rather a clinical condition with consistent symptomatology, reflecting the evolution of terminology and medical concepts over time. This underscores the need to analyze and understand how terms and descriptions have changed while certain core symptoms have persisted, as proposed by [<reflink idref="bib5" id="ref5">5</reflink>]; [<reflink idref="bib6" id="ref6">6</reflink>] in his approach to continuity and conceptual evolution.</p> <p>Since the 18th century, literature has documented individuals exhibiting hyperactive, inattentive, and impulsive behaviors. The first clinical mention of these symptoms is attributed to Kloekhof in 1753, who linked them to weak and overloaded nerves, coining the term "attentio volubilis" ([<reflink idref="bib42" id="ref7">42</reflink>]). Adam Weikard further described inattention as a distraction and inability to focus, building on Kloekhof's work ([<reflink idref="bib4" id="ref8">4</reflink>]; [<reflink idref="bib48" id="ref9">48</reflink>]). In 1789, Alexander Crichton offered a scientific description of attention deficit, marking a significant advancement ([<reflink idref="bib29" id="ref10">29</reflink>]). John Haslam, describes a case of a child who, from age 2 years, was so unruly and mischievous that he was sent to live with his aunt. The child was indulged without correction, leading him to become volatile and feared by his family by age 9 years ([<reflink idref="bib20" id="ref11">20</reflink>], p. 199; also cited in [<reflink idref="bib47" id="ref12">47</reflink>], p. 1).</p> <p>Later on, Heinrich Hoffmann's 1845 illustrated stories ([<reflink idref="bib21" id="ref13">21</reflink>]), Der Struwwelpeter, depicted attention and hyperactivity issues in children ([<reflink idref="bib40" id="ref14">40</reflink>]). Between 1887 and 1910, French physicians developed the concept of "instability" to describe behaviors now associated with hyperactivity and inattention ([<reflink idref="bib1" id="ref15">1</reflink>]; [<reflink idref="bib15" id="ref16">15</reflink>]), with the 1905 work of Georges Paul-Boncour and Jean Philippe standing out ([<reflink idref="bib31" id="ref17">31</reflink>]). George Still, in 1902, referred to the symptomatology as a "defect of moral control" and a "lack of volitional inhibition" ([<reflink idref="bib24" id="ref18">24</reflink>]; [<reflink idref="bib37" id="ref19">37</reflink>]). A pivotal moment occurred during the 1917 to 1918 lethargic encephalitis epidemic, when Constantin [<reflink idref="bib46" id="ref20">46</reflink>] observed similar symptoms as a result of general brain dysfunction, leading to the concept of minimal brain damage ([<reflink idref="bib12" id="ref21">12</reflink>]).</p> <p>From 1900 to 1936, child psychiatry in Spain mainly developed through education and pediatrics, with less influence from general psychiatry ([<reflink idref="bib13" id="ref22">13</reflink>]). Over time, the circulation of knowledge among various authors can be observed, reflecting an understanding that evolves alongside the concept of childhood and new neuropsychiatric paradigms. For instance, in our research, we have identified the influence of French psychiatrists on both the terminology and the conceptualization of ADHD precursors in Spanish physicians and educators during the early 20th century, such as Rodríguez Lafora, Moragas, Vidal Perera, and Sarmiento Lausén ([<reflink idref="bib1" id="ref23">1</reflink>]; [<reflink idref="bib15" id="ref24">15</reflink>]).</p> <p>With this background, the objective of this research is to explore how Emilio Mira y López addressed what later became known as ADHD.</p> <hd id="AN0189876908-3">Emilio Mira y López: His Life and Work</hd> <p>Emilio Mira y López was born in Santiago de Cuba in 1896 and studied medicine and psychiatry in Barcelona. Mira y López focused on diagnostic methods and school guidance, advocating for improvements in psychodiagnostic practices in Spanish schools and directing the Institut d'Orientació Professional, established in 1919 by the Barcelona City Council ([<reflink idref="bib18" id="ref25">18</reflink>]; [<reflink idref="bib28" id="ref26">28</reflink>]). He later opened a private clinic, "La Sageta," inspired by American "Child Guidance" models. At this center, he collaborated with child psychiatry experts, including Alfred Strauss, who later described a syndrome related to hyperactivity ([<reflink idref="bib22" id="ref27">22</reflink>]; [<reflink idref="bib39" id="ref28">39</reflink>]; [<reflink idref="bib38" id="ref29">38</reflink>]).</p> <p>Due to political reasons, Mira y López left Spain in 1939 and went on to work in Argentina, Uruguay, and Brazil. Throughout his career, he gained recognition in both Latin America and Europe, receiving invitations to teach at various universities and participate in international conferences (Mastragelo, 2021; [<reflink idref="bib28" id="ref30">28</reflink>]).</p> <p>As early as 1968, Emilio Mira y López was recognized as one of the significant figures in psychology ([<reflink idref="bib8" id="ref31">8</reflink>]), with his books and articles widely spread in Brazil and Argentina (Mastragelo, 2021; [<reflink idref="bib28" id="ref32">28</reflink>]). During his exile, he adapted his work to make it more accessible, incorporating his knowledge and experiences in psychopedagogy ([<reflink idref="bib34" id="ref33">34</reflink>]).</p> <hd id="AN0189876908-4">Results: Description and Management of the "Unstable Child"</hd> <p>We find Mira's most significant contribution to the topic at hand in his book <emph>The Child Who Does Not Learn</emph>, written during his first exile in Buenos Aires in 1947. The publication had multiple reprints.</p> <p>There he offers a description of the unstable child that resonates with modern understanding of ADHD[<reflink idref="bib4" id="ref34">4</reflink>]:</p> <p>The unstable child, the butterfly child; it's the child who says, 'Oh! I want this,' grabs it, looks at it for a moment, and then leaves it. 'Oh! I want this other thing,' grabs it for a moment, and also leaves it. This child lacks inhibition, has an excess of cortical irradiation. This is not a child for the teacher to handle, but for the doctor, who should implement a regimen to increase their inhibitions, avoid the diffusion of excessive irradiations, and correct defective inhibition processes: exercises for slowing down and special control, opotherapeutic medications, etc. And then it will be seen that this child, who couldn't learn due to excessive excitability, becomes capable of learning once a balance is achieved between the two processes ([<reflink idref="bib26" id="ref35">26</reflink>], pp. 60–61).</p> <p>El niño inestable, el niño mariposa; es ese niño que dice: ¡ay! quiero esto y lo toma, lo mira un instante y lo deja. ¡Ay! quiero esto otro y lo toma un instante y también lo deja. Tiene una falta de inhibición, un exceso de irradiación cortical. A ese niño no es el maestro quien debe tratarlo, sino el médico, con un régimen que aumente sus inhibiciones, que evite la difusión de irradiaciones excesivas y corrija los procesos de inhibición defectuosos: ejercicios de lentificación y control especiales, medicaciones opoterápicas, etc. Y entonces se verá que ese niño que no aprendía por exceso de excitabilidad es capaz de aprender una vez que haya logrado la distribución del equilibrio entre los dos procesos. ([<reflink idref="bib26" id="ref36">26</reflink>], pp. 60–61).</p> <p>The book develops Mira's experience at the Psychotechnical Institute of Barcelona and addresses the complex issue of school failure, offering an optimistic perspective on the child facing learning difficulties. His work seems to be aimed more at educators, teachers, and parents than at psychiatrists, perceiving school failure as a solvable problem ([<reflink idref="bib14" id="ref37">14</reflink>]).</p> <p>He emphasizes the importance of balance between excitatory and inhibitory neurological centers, and how this balance affects the ability to learn and relate to others. He identifies the profile of the "unstable child" and proposes medical and therapeutic interventions to correct deficiencies in inhibition and cortical irradiation, which could facilitate the learning process.</p> <p>In every human being, there must be a balance between excitatory and inhibitory centers, maintaining a constant, unchanging sum of releasable energy. This releasable energy is always the result of an integration between stored, potential energy—retained due to the action of inhibition in the centers where it is stored—and explosive, circulating energy, which is constantly being expended in the realm of action due to the excitation of the centers where it is stored. ([<reflink idref="bib26" id="ref38">26</reflink>], p. 60).</p> <p>En todo ser humano tiene que haber un equilibrio entre los centros excitatorios y los inhibidos; debe tener una suma constante, invariable, de energía liberable. Esa energía liberable es siempre el resultado de una integración entre energía retenida, almacenada en forma de potencial, por estar sometida a la acción de una inhibición de los centros en los cuales se almacena, y de energía explosiva, circulante, que está constantemente gastando en la vertiente de la acción, por estar excitados los centros en los cuales se almacena ([<reflink idref="bib26" id="ref39">26</reflink>], p. 60).</p> <hd id="AN0189876908-5">Discussion and Conclusions: The Precedents of the Contemporary Situation</hd> <p>Emilio Mira y López's use of the term "unstable child" aligns with the paradigm employed in the Spanish context of that time, particularly before the Civil War, and reflects a significant influence of the French school ([<reflink idref="bib1" id="ref40">1</reflink>]) in the field of psychology and psychopedagogy in Spain. Physicians such as [<reflink idref="bib33" id="ref41">33</reflink>] and [<reflink idref="bib27" id="ref42">27</reflink>] contemporaries of Mira, used the same concept within the "unstable child" framework before the Civil War, and [<reflink idref="bib41" id="ref43">41</reflink>] after the Civil War. Similarly, the psychopedagogues [<reflink idref="bib35" id="ref44">35</reflink>], and [<reflink idref="bib43" id="ref45">43</reflink>], had previously used it.</p> <p>To understand early 20th-century Spanish perspectives on hyperactivity, it's important to see how Spanish authors engaged with influential French thinkers. [<reflink idref="bib43" id="ref46">43</reflink>] adopted the term "unstable," borrowed from Alfred Binet, to describe children's behaviors resembling current ideas of hyperactivity. [<reflink idref="bib35" id="ref47">35</reflink>] referred to [<reflink idref="bib31" id="ref48">31</reflink>] to explore behavioral instability, while [<reflink idref="bib33" id="ref49">33</reflink>] cited figures like [<reflink idref="bib7" id="ref50">7</reflink>], [<reflink idref="bib32" id="ref51">32</reflink>]. [<reflink idref="bib27" id="ref52">27</reflink>] mentioned [<reflink idref="bib31" id="ref53">31</reflink>], and [<reflink idref="bib41" id="ref54">41</reflink>] referenced [<reflink idref="bib9" id="ref55">9</reflink>]. Although not focused specifically on hyperactivity, [<reflink idref="bib2" id="ref56">2</reflink>] cited [<reflink idref="bib23" id="ref57">23</reflink>], [<reflink idref="bib7" id="ref58">7</reflink>], [<reflink idref="bib36" id="ref59">36</reflink>], and [<reflink idref="bib19" id="ref60">19</reflink>]. These references demonstrate how Spanish authors built on French concepts, gradually adapting them to their own cultural and intellectual context.</p> <p>Emilio Mira y López's pathophysiological understanding of the unstable child aligns with the hypothesis formulated by Bradley about inhibition. From 1937 to 1941, a series of articles were published on the treatment of hyperactive children that marked the beginning of psychopharmacology, especially the use of stimulants ([<reflink idref="bib3" id="ref61">3</reflink>]; [<reflink idref="bib10" id="ref62">10</reflink>]; [<reflink idref="bib11" id="ref63">11</reflink>]). The lead author was Charles Bradley, who published a study on the behavior of children treated with Benzedrine ([<reflink idref="bib3" id="ref64">3</reflink>]; Bradley & Bowen, 1940). In 1940, he investigated the effectiveness of amphetamine sulfate, the same compound, to improve children's academic performance ([<reflink idref="bib24" id="ref65">24</reflink>]) and found its effectiveness in improving attention in children with hyperactivity ([<reflink idref="bib24" id="ref66">24</reflink>]). As [<reflink idref="bib16" id="ref67">16</reflink>] points out, Bradley himself expressed surprise at the paradoxical effects of Benzedrine, which raised the question: "How is it possible that a stimulant causes improvements in the behavior of children who apparently are already overstimulated?" (p. 44). Thus, was born the inhibition hypothesis, which suggests that "important portions of the brain could have inhibitory functions and the stimulation of such portions would produce a clinical framework of reduced activity through the increase of voluntary control" ([<reflink idref="bib16" id="ref68">16</reflink>], p. 44). The approach suggests that certain regions of the brain have inhibitory functions and that stimulating these areas can lead to a reduction in excessive activity through increased voluntary control. The similarities between Mira y López's and Bradley's approaches show that many experts of that time supported the theory of regulating neurochemical balance with drugs.</p> <p>Mira's mention of "opotherapeutic medication" refers to hormonal treatments used in his era to regulate neuroendocrine functions. Although he does not specify the exact medications, his writing implies familiarity with such treatments, hinting at an early hypothesis about the role of hormones in managing impulsive and inattentive behaviors. While his approach highlights early efforts to address these behaviors through medical intervention, it raises questions that merit further research into the historical use of hormone-based treatments for behavioral regulation in children. Currently, there are some studies on the interplay between hormonal mechanisms, environmental factors, and neurodevelopment in children diagnosed with ADHD. However, further studies are still needed to determine the possible causal processes and mechanisms underlying specific associations ([<reflink idref="bib25" id="ref69">25</reflink>]).</p> <p>Emilio Mira and Alfred Strauss worked together in Barcelona, dedicating themselves to the study and treatment of childhood developmental disorders, including hyperactivity ([<reflink idref="bib39" id="ref70">39</reflink>]; [<reflink idref="bib38" id="ref71">38</reflink>]). While both recognized a neurological basis for these behaviors, Mira, with a strong emphasis on neurophysiology, approached hyperactivity as a functional issue that could potentially be addressed through targeted interventions or therapeutic approaches.</p> <p>Emilio Mira y López had a multifaceted approach to the study of the human psyche, he explored various aspects within psychology, including psychoanalysis, psychiatry, and pedagogy. Unlike adhering to any dogma or fundamentalism in a particular approach ([<reflink idref="bib17" id="ref72">17</reflink>]). His multidisciplinary approach allowed him to explore and understand the complexity of the pathology from different perspectives.</p> <p>We agree with [<reflink idref="bib14" id="ref73">14</reflink>] when he considers that Emilio Mira, despite being primarily dedicated to adult psychiatry, demonstrated an advanced vision by recognizing the importance of child psychiatry and the prevention of mental illness from an early age. He suggests that the treatment of this type of unstable child should be carried out by doctors rather than teachers and highlights the learning potential of children who we now would know as having ADHD. This notion aligns with advances in psychopharmacology and the neurobiological understanding of his time. Hyperactive and inattentive children and adolescents continue to represent a global challenge, and this historical analysis explores the precedents of a therapeutic and hopeful vision of ADHD.</p> <p>His approach represents a significant step toward the more comprehensive understanding of neurodevelopmental disorders like ADHD, which continue to be areas of active clinical and research interest today. Mira's legacy thus offers valuable insight into the evolution of approaches to mental health, underscoring the importance of combining medical and educational strategies to support children with attention and behavioral challenges.</p> <ref id="AN0189876908-6"> <title> References </title> <blist> <bibl id="bib1" idref="ref15" type="bt">1</bibl> <bibtext> Bader M., Hadjikhani N. (2014). The concept of instability: A French perspective on the concept of ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 6, 11–17. https://doi.org/10.1007/s12402-013-0121-y</bibtext> </blist> <blist> <bibl id="bib2" idref="ref56" type="bt">2</bibl> <bibtext> Baena M. (1961). Problemática de la inadaptación escolar: Con motivo del Día Universal del Niño. Biblioteca Auxiliar de Educación.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref61" type="bt">3</bibl> <bibtext> Barkley R. A. (Ed.). (2014). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Publications.</bibtext> </blist> <blist> <bibl id="bib4" idref="ref1" type="bt">4</bibl> <bibtext> Barkley R. A., Peters H. (2012). The earliest reference to ADHD in the medical literature? Melchior Adam Weikard's description in 1775 of "attention deficit" (Mangel der Aufmerksamkeit, Attentio Volubilis). Journal of Attention Disorders, 16(8), 623–630.</bibtext> </blist> <blist> <bibl id="bib5" idref="ref5" type="bt">5</bibl> <bibtext> Berrios G. E. (2010). Cómo escribir una historia útil de la esquizofrenia. Vertex Rev Arg de Psiquiat, 21, 349–358.</bibtext> </blist> <blist> <bibl id="bib6" idref="ref6" type="bt">6</bibl> <bibtext> Berrios G. E., Luque R., Villagrán J. M. (2003). Schizophrenia: A conceptual history. International Journal of Psychology and Psychological Therapy, 3(2), 111–140.</bibtext> </blist> <blist> <bibl id="bib7" idref="ref50" type="bt">7</bibl> <bibtext> Binet A., Simon T. (1907). Les enfants anormaux. Guide pour l'admission dans les classes de perfectionnement. Armand Colin.</bibtext> </blist> <blist> <bibl id="bib8" idref="ref31" type="bt">8</bibl> <bibtext> Boring E. G., Watson R. I. (1968). Important psychologists, 1600-1967. Journal of the History of the Behavioral Sciences, 4(4), 303–315.</bibtext> </blist> <blist> <bibl id="bib9" idref="ref55" type="bt">9</bibl> <bibtext> Bourneville D. M. (1905). Traitement médico-pédagogique des différentes formes de l'idiotie: avec 55 fig. Bureaux du Progrès médical. https://archive.org/details/BIUSante_58100</bibtext> </blist> <blist> <bibtext> Bradley C. (1937). The behavior of children receiving Benzedrine. The American Journal of Psychiatry, 94, 577–585. https://doi.org/10.1176/ajp.94.3.577</bibtext> </blist> <blist> <bibtext> Bradley C., Bowen M. (1940). School performance of children receiving Amphetamine (benzedrine) Sulfate. American Journal of Orthopsychiatry, 10(4), 782.</bibtext> </blist> <blist> <bibtext> Cantwell D. P. (1975). The hyperactive child. Spectrum.</bibtext> </blist> <blist> <bibtext> Domènech E., Corbera J. (1994). Aportación a la historia de la psiquiatría infantil en España. El periodo de formación de la especialidad. Gimbernat: Revista d'Historia de la Medicina i de les Ciències de la Salut, 22, 61–104.</bibtext> </blist> <blist> <bibtext> Domènech-Llaberia E. (2006). El impacto de Emilio Mira en la Psiquiatría Infantil. Revista de Psiquiatría Infanto-Juvenil, 23(1, 3 y 4), 60–64.</bibtext> </blist> <blist> <bibtext> Escamilla Lerner J., de Castro-Manglano P., León-Sanz P. (2024). The notion of excessive childhood restlessness in Spain at the beginning of the twentieth century. History of Psychiatry.</bibtext> </blist> <blist> <bibtext> Galicia Ó. (2015). Trastorno por déficit de atención e hiperactividad. El manual moderno.</bibtext> </blist> <blist> <bibtext> García J. E. (2014). Entre la aceptación y el rechazo: Emilio Mira y López y el Psicoanálisis. Revista de Historia de la Psicología, 35(4), 99–128.</bibtext> </blist> <blist> <bibtext> García Yagüe J. (1997). Emilio Mira y sus aportaciones a la orientación escolar y profesional durante la etapa española. Revista complutense de educación, 8, 179.</bibtext> </blist> <blist> <bibtext> Goddard H. H. (1913). Standard method for giving the Binet test. Training School.</bibtext> </blist> <blist> <bibtext> Haslam J. (1976). Observations on madness and melancholy. 1809. Arno.</bibtext> </blist> <blist> <bibtext> Hoffmann H. (2020). Der Struwwelpeter: oder lustige Geschichten und drollige Bilder für Kinder von 3–6 Jahren. Zweite Ausgabe.</bibtext> </blist> <blist> <bibtext> Kessler J. W. (1980). History of minimal brain dysfunctions. In Rie H. E., Rie E. D. (Eds.), Handbook of minimal brain dysfunctions: A critical view (pp. 18–51). Wiley.</bibtext> </blist> <blist> <bibtext> Itard J. (1806). The wild boy of Aveyron. American Psychological Association.</bibtext> </blist> <blist> <bibtext> Lange K. W., Reichl S., Lange K. M., Tucha L., Tucha O. (2010). The history of attention deficit hyperactivity disorder. ADHD Attention Deficit and Hyperactivity Disorders, 2(4), 241–255. https://doi.org/10.1007/s12402-010-0045-8</bibtext> </blist> <blist> <bibtext> Makris G., Eleftheriades A., Pervanidou P. (2023). Early life stress, hormones, and neurodevelopmental disorders. Hormone Research in Paediatrics, 96(1), 17–24.</bibtext> </blist> <blist> <bibtext> Mira y, López E. (1972). El niño que no aprende (4a ed.). Kapelusz.</bibtext> </blist> <blist> <bibtext> Moragas J. (1933). La infancia anormal. Monografies Mèdiques.</bibtext> </blist> <blist> <bibtext> Mülberger A. (2010). Un psicólogo abandona su mundo: El exilio de Emilio Mira y López. In Barona J. L. (Ed.), El exilio científico republicano (pp. 157–172). Universidad de Valencia: PUV.</bibtext> </blist> <blist> <bibtext> Palmer E. D., Finger S. (2001). An early description of ADHD (inattentive subtype): Dr. Alexander Crichton and 'Mental Restlessness' (1798). Child Psychology and Psychiatry Review, 6(2), 66–73. https://doi.org/10.1111/1475-3588.00324</bibtext> </blist> <blist> <bibtext> Paul-Boncour G. (1912). Excitabilite ́ psychomotrice et troubles digestifs chez l'enfant. Progre's Me ́dical.</bibtext> </blist> <blist> <bibtext> Philippe J., Paul-Boncour G. (1905). Les anomalies mentales chez les écoliers: étude médico-pédagogique. Alcan.</bibtext> </blist> <blist> <bibtext> Ribot Th. (1889). Psychologie de l'attention. Felix Alcan (L'Harmattan 2016).</bibtext> </blist> <blist> <bibtext> Rodríguez Lafora G. (1917). Los niños mentalmente anormales. Lectura.</bibtext> </blist> <blist> <bibtext> Saiz M., Saiz D. (1996). Personajes para una historia de la psicología en España. Servei de Publicacions de la Universitat Autònoma de Barcelona.</bibtext> </blist> <blist> <bibtext> Sarmiento Lausén J. (1914). Compendio de Paidología. Imprenta burgalesa de Marcelino Miguel. Dialnet.</bibtext> </blist> <blist> <bibtext> Seguin E. (1846). The moral treatment, hygiene, and education of idiots and other backward children. Balliere.</bibtext> </blist> <blist> <bibtext> Still G. F. (1902). Some abnormal psychical conditions in children. The Lancet, 1, 1008–1012.</bibtext> </blist> <blist> <bibtext> Strauss A. A., Werner H. (1942). Disorders of conceptual thinking in the brain-injured child. Journal of Nervous and Mental Disease, 96, 153–172.</bibtext> </blist> <blist> <bibtext> Strauss A., Lehtinen L. S. (1947). Psychopathogy and education of the brain-injured child. Grune & Stratton.</bibtext> </blist> <blist> <bibtext> Thome J., Jacobs K. A. (2004). Attention deficit hyperactivity disorder (ADHD) in a 19th century children's book. European Psychiatry, 19(5), 303–306. https://doi.org/10.1016/j.eurpsy.2004.05.004</bibtext> </blist> <blist> <bibtext> Vallejo-Nágera J. A. (1941). Niños y jóvenes anormales. Sociedad de Educación Atenas.</bibtext> </blist> <blist> <bibtext> van Kernebeek M. W., Crunelle C. L. (2024). The beginnings of attention deficit in a Dutch 18th Century Medical Treatise. Journal of Attention Disorders, 28(8), 1236–1241.</bibtext> </blist> <blist> <bibtext> Vidal Perera A. (1919). Compendio de Psiquiatría infantil (4ª ed. aumentada). Librería de los sucesores de Hernando.</bibtext> </blist> <blist> <bibtext> von Economo C. (1917a). Encephalitis lethargica. Wiener klinische Wochenschrift, 30, 581–585.</bibtext> </blist> <blist> <bibtext> von Economo C. (1917b). Neue Beiträge zur Encephalitis lethargica. Neurol Centralblatt, 36, 866–878.</bibtext> </blist> <blist> <bibtext> von Economo C. (1917c). Die Encephalitis lethargica. Journal of Psychiatry and Neurology, 38, 253–331.</bibtext> </blist> <blist> <bibtext> Warnke A., Riederer C. (2013). ADHD: Attention Deficit-Hyperactivity Disorder: An illustrated historical overview. <ulink href="http://www.ufrgs.br/prodah/site/wp-content/uploads/2015/03/brochuremilano.pdf">http://www.ufrgs.br/prodah/site/wp-content/uploads/2015/03/brochuremilano.pdf</ulink></bibtext> </blist> <blist> <bibtext> Weikard M. A. (1790). Der philosophische Arzt. Frankfurt am Main: in der Andreäischen Buchhandlung. Retrieved July 22, 2024, from https://<ulink href="http://www.digitale-sammlungen.de/de/view/bsb11106138?page=5">www.digitale-sammlungen.de/de/view/bsb11106138?page=5</ulink></bibtext> </blist> </ref> <ref id="AN0189876908-7"> <title> Footnotes </title> <blist> <bibtext> The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.</bibtext> </blist> <blist> <bibtext> The author(s) received no financial support for the research, authorship, and/or publication of this article.</bibtext> </blist> <blist> <bibtext> Joana Escamilla Lerner</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0009-0008-5617-9691 Pilar de Castro-Manglano</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0000-0003-3141-3492 Pilar León Sanz</bibtext> </blist> <blist> <bibtext>Graph https://orcid.org/0000-0003-0247-6101</bibtext> </blist> <blist> <bibtext> All English versions from the original Spanish texts are translated by the authors. The original Spanish versions are included following each translation.</bibtext> </blist> </ref> <aug> <p>By Joana Escamilla Lerner; Pilar de Castro-Manglano and Pilar León Sanz</p> <p>Reported by Author; Author; Author</p> <p></p> <p>Joana Escamilla Lerner, MD, PhD, Department of Psychiatry and Clinical Psychology, Fundación Hermanas Hospitalarias. Sant Boi de Llobregat, Barcelona, Spain.</p> <p>Pilar de Castro-Manglano, MD, PhD, Department of Psychiatry and Clinical Psychology, Clínica Universidad Navarra, University of Navarra, Madrid, Spain.</p> <p>Pilar León Sanz, MD, PhD, Professor, Department of Biomedical Humanities School of Medicine. University of Navarra, Pamplona, Spain.</p> </aug> <nolink nlid="nl1" bibid="bib15" firstref="ref2"></nolink> <nolink nlid="nl2" bibid="bib24" firstref="ref3"></nolink> <nolink nlid="nl3" bibid="bib42" firstref="ref4"></nolink> <nolink nlid="nl4" bibid="bib48" firstref="ref9"></nolink> <nolink nlid="nl5" bibid="bib29" firstref="ref10"></nolink> <nolink nlid="nl6" bibid="bib20" firstref="ref11"></nolink> <nolink nlid="nl7" bibid="bib47" firstref="ref12"></nolink> <nolink nlid="nl8" bibid="bib21" firstref="ref13"></nolink> <nolink nlid="nl9" bibid="bib40" firstref="ref14"></nolink> <nolink nlid="nl10" bibid="bib31" firstref="ref17"></nolink> <nolink nlid="nl11" bibid="bib37" firstref="ref19"></nolink> <nolink nlid="nl12" bibid="bib46" firstref="ref20"></nolink> <nolink nlid="nl13" bibid="bib12" firstref="ref21"></nolink> <nolink nlid="nl14" bibid="bib13" firstref="ref22"></nolink> <nolink nlid="nl15" bibid="bib18" firstref="ref25"></nolink> <nolink nlid="nl16" bibid="bib28" firstref="ref26"></nolink> <nolink nlid="nl17" bibid="bib22" firstref="ref27"></nolink> <nolink nlid="nl18" bibid="bib39" firstref="ref28"></nolink> <nolink nlid="nl19" bibid="bib38" firstref="ref29"></nolink> <nolink nlid="nl20" bibid="bib34" firstref="ref33"></nolink> <nolink nlid="nl21" bibid="bib26" firstref="ref35"></nolink> <nolink nlid="nl22" bibid="bib14" firstref="ref37"></nolink> <nolink nlid="nl23" bibid="bib33" firstref="ref41"></nolink> <nolink nlid="nl24" bibid="bib27" firstref="ref42"></nolink> <nolink nlid="nl25" bibid="bib41" firstref="ref43"></nolink> <nolink nlid="nl26" bibid="bib35" firstref="ref44"></nolink> <nolink nlid="nl27" bibid="bib43" firstref="ref45"></nolink> <nolink nlid="nl28" bibid="bib32" firstref="ref51"></nolink> <nolink nlid="nl29" bibid="bib23" firstref="ref57"></nolink> <nolink nlid="nl30" bibid="bib36" firstref="ref59"></nolink> <nolink nlid="nl31" bibid="bib19" firstref="ref60"></nolink> <nolink nlid="nl32" bibid="bib10" firstref="ref62"></nolink> <nolink nlid="nl33" bibid="bib11" firstref="ref63"></nolink> <nolink nlid="nl34" bibid="bib16" firstref="ref67"></nolink> <nolink nlid="nl35" bibid="bib25" firstref="ref69"></nolink> <nolink nlid="nl36" bibid="bib17" firstref="ref72"></nolink>
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  Data: Emilio Mira y López's Perspectives on Understanding ADHD
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  Data: English
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  Data: <searchLink fieldCode="AR" term="%22Joana+Escamilla+Lerner%22">Joana Escamilla Lerner</searchLink> (ORCID <externalLink term="https://orcid.org/0009-0008-5617-9691">0009-0008-5617-9691</externalLink>)<br /><searchLink fieldCode="AR" term="%22Pilar+de+Castro-Manglano%22">Pilar de Castro-Manglano</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-3141-3492">0000-0003-3141-3492</externalLink>)<br /><searchLink fieldCode="AR" term="%22Pilar+León+Sanz%22">Pilar León Sanz</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-0247-6101">0000-0003-0247-6101</externalLink>)
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  Label: Source
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Attention+Disorders%22"><i>Journal of Attention Disorders</i></searchLink>. 2026 30(1):3-7.
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  Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
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  Data: 5
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  Group: Date
  Data: 2026
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  Data: Journal Articles<br />Reports - Research
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  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Attention+Deficit+Hyperactivity+Disorder%22">Attention Deficit Hyperactivity Disorder</searchLink><br /><searchLink fieldCode="DE" term="%22History%22">History</searchLink><br /><searchLink fieldCode="DE" term="%22Vocabulary%22">Vocabulary</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms+%28Individual+Disorders%29%22">Symptoms (Individual Disorders)</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Teaching+Methods%22">Teaching Methods</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+Services%22">Medical Services</searchLink><br /><searchLink fieldCode="DE" term="%22Psychiatry%22">Psychiatry</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+Therapy%22">Drug Therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Child+Health%22">Child Health</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Health%22">Mental Health</searchLink><br /><searchLink fieldCode="DE" term="%22Learning+Problems%22">Learning Problems</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1177/10870547251345916
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1087-0547<br />1557-1246
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: The study aims to examine the contributions of Emilio Mira y López (1896-1964) to the early conceptualization and treatment of what is now known as Attention Deficit Hyperactivity Disorder (ADHD). It seeks to contextualize his ideas within broader historical, pedagogical, and psychiatric developments in Spain and internationally. Method: A historical-analytical approach was employed, reviewing Mira y López's publications El niño que no aprende ("The Child Who Does Not Learn, 1947"), as well as related psychiatric and educational literature from the early 20th century. His work was analyzed alongside contributions from contemporaries and predecessors, with a focus on terminology, neurophysiological concepts, and early treatment strategies. Results: Mira y López described the "unstable child" or "butterfly child" with symptoms that align closely with modern ADHD: impulsivity, distractibility, and lack of sustained attention. He proposed that these children suffer from an imbalance between excitatory and inhibitory brain functions, suggesting early therapeutic interventions including behavioral techniques and opotherapeutic (hormonal) medications. His research emphasized a medical and pedagogical approach to learning difficulties and prefigured ideas found in the emerging field of child psychopharmacology. Conclusion: Emilio Mira y López's understanding of childhood instability reflected the influence of French and Anglo-American psychiatry and anticipated key elements of today's ADHD frameworks. His physiological model of inhibition mirrors Charles Bradley's "inhibition hypothesis," which led to the use of stimulants for hyperactivity. Mira's early proposals contributed to shaping a more comprehensive, interdisciplinary view of childhood mental health and learning difficulties in Spain and Latin America.
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  Data: 2026
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  Label: Accession Number
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  Data: EJ1493021
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1493021
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        Value: 10.1177/10870547251345916
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      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 5
        StartPage: 3
    Subjects:
      – SubjectFull: Attention Deficit Hyperactivity Disorder
        Type: general
      – SubjectFull: History
        Type: general
      – SubjectFull: Vocabulary
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      – SubjectFull: Symptoms (Individual Disorders)
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      – SubjectFull: Psychiatry
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      – SubjectFull: Drug Therapy
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      – SubjectFull: Child Health
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      – SubjectFull: Mental Health
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      – SubjectFull: Learning Problems
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      – TitleFull: Emilio Mira y López's Perspectives on Understanding ADHD
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            NameFull: Pilar de Castro-Manglano
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            NameFull: Pilar León Sanz
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              Y: 2026
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            – TitleFull: Journal of Attention Disorders
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