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Does ADHD Ever Go Away?

Just a few years ago it was thought that children with Attention Deficit Hyperactivity Disorder out-grew their symptoms by adolescence. However, by the early 1980’s the clinical evidence made it clear that this did not always happen. While some children appeared to “outgrow” their functional problems by the teen years, many had persistence of symptoms which continued to interfere significantly with their life. In addition, it was obvious that these children benefited from continued medical, psychological, and educational intervention into the teen years. Additional clinic data then pointed to the persistence of ADHD into adulthood. An important study was that by Weiss et al. (Psychiatric status of hyperactive as adults, J Am Acad Child Psychiatry 24:211-220, 1985) which reported that 66% of children with ADHD had persistence of some symptoms into adulthood.
Over the past decade, well-documented research more clearly delineated the life-cycle of attention deficit hyperactivity disorder and the various factors influencing resolution or persistence. Joseph Beiderman, M.D. and associates shed additional light on these issues in a study published in the Journal of American Academy of Child and Adolescent Psychiatry (March, 1996, vol 35:3, page 343-351).
In this well-controlled study 119 boys, aged 6 to 17 years, with ADHD for four years following diagnosis were evaluated. At the four year follow up, 85% of children with ADHD continued to have the symptoms characteristic of ADHD. Fifteen percent had remitted completely. Of those who had remitted, one half did in childhood and one-half in adolescence. These researchers documented several factors associated with persistence of symptoms. These significant factors were:

A strong family history of ADHD

nstable family life (A psychosocial adversity)
      The existence of conduct, mood, and anxiety disorders.
This well-done study helps clarified the extent to which ADHD persists into adolescence and the factors influencing such persistence. It also pointed out factors in the child=s life which, if they are present, need to be treated in order to increase the chance of a favorable outcome. Subsequent studies confirmed these earlier findings.
These studies reaffirmed what experienced clinicians have known for a good while: that most children with ADHD get better by late childhood or middle school but some still have symptoms into late adolescence. Thus parents, teachers, and physicians should work closely together to monitor children with ADHD as they progress into puberty. If it appears that the child is gaining appropriate organization and control, treatment, including medication, can be phased back. If the child is having signs of any of the complications mentioned in this article, aggressive evaluation and treatment planning will be needed.

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