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Attention Deficit Hyperactivity Disorder (ADHD), previously referred to as Attention Deficit Disorder, was once labeled “hyperkinetic disease of infancy.” In the past, it was believed that this condition only affected children, who would eventually outgrow it. The focus was primarily on excessive movement and some degree of impulsivity. While the term “hyperkinetic disease” evolved into ADHD, it was often seen as a disorder primarily affecting white boys who struggled to remain still.
Up until the early 1990s, the prevailing view was that children would outgrow ADHD by their late teens or early twenties. Although this perspective has shifted, many researchers still estimated that a significant number of children would leave their ADHD symptoms behind. The Child Mind Institute still asserts that up to one-third of children diagnosed with ADHD “will no longer meet the criteria by the time they reach young adulthood.” However, this may not be entirely accurate.
A study published in the Journal of Developmental and Behavioral Pediatrics suggests that “between 30 percent to 60 percent of children diagnosed with ADHD no longer meet the diagnostic criteria by late adolescence.” According to Thomas Power, the study’s senior author and director of the ADHD management center at Children’s Hospital of Philadelphia, the question of whether kids outgrow ADHD is complex.
Psychologist Margaret Sibley, an associate professor at the University of Washington School of Medicine, conducted extensive long-term research that suggests previous estimates were overly optimistic. “Ninety percent of those diagnosed with ADHD still experience at least mild symptoms into adulthood—even if they have periods where they appear symptom-free,” she told The Washington Post.
In summary, your child is unlikely to completely outgrow their ADHD.
Understanding Different Presentations of ADHD
Remember the term “hyperkinetic disease of infancy”? Initially, it concentrated on disruptive behaviors in children. Over time, healthcare professionals refined ADHD into “subtypes” focused on hyperactivity, inattention, or a combination of both. However, this assumption implies that the disorder’s presentation remains static. For instance, when a child who once disrupted class by throwing chairs learns better self-regulation, it may be assumed that they have outgrown the disorder altogether.
Instead, think of ADHD in terms of “presentations,” as outlined in the DSM-V. This perspective allows for a more fluid understanding of symptoms. For example, while Joey may have exhibited hyperactive behaviors in childhood, he might later struggle with organizing assignments and reading social cues, indicating a shift in presentation rather than a complete disappearance of ADHD.
Through her research tracking subjects from ages 7-9 across eight different locations beginning in 1998 until they reached around twenty-five, Sibley found that ADHD is often an “on-again, off-again condition,” with symptoms fluctuating based on life circumstances. For instance, Joey may be hyperactive in elementary school, transition to inattentive symptoms in high school, and appear organized during his freshman year of college. But if he struggles to balance work and academics in junior year, it’s not a matter of laziness; it’s a manifestation of his ADHD symptoms changing over time.
The Brain and ADHD: A Persistent Difference
While symptoms may come and go, the underlying brain differences associated with ADHD persist. According to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), brain scans of individuals who seemingly outgrew ADHD revealed that their caudate nucleus—a brain area involved in learning, memory, and communication—still showed reduced gray matter compared to those who never had the diagnosis.
Courtney Lopez, MS, who has researched these brain differences, notes that the reduction in gray matter is evident regardless of whether individuals meet the diagnostic criteria for ADHD. “ADHD doesn’t vanish just because symptoms become less pronounced; its effects on the brain endure,” she explains.
Thus, while children might appear to outgrow ADHD, their symptoms can fluctuate and evolve as they age, often giving the impression that they have left the disorder behind. However, in about 90% of cases, symptoms may return in a different form.
What This Means for Your Child
Will your child require medication for life? Perhaps. Dr. Larry Silver recommends reassessing children’s medication once a year and reinstating it if symptoms reemerge. Some children may successfully learn coping mechanisms and self-regulation techniques, allowing them to forgo stimulant medication, while others might continue needing it through various life stages. Ultimately, most children do not outgrow ADHD; they may experience symptom-free periods, but it’s crucial to be prepared for changes.
Sibley emphasizes the importance of ongoing monitoring, even if your child appears to be doing better. “Doctors should continue to see patients who seem to have improved,” she advises. It’s essential for those with a history of ADHD to recognize that symptoms can resurface, especially during significant life transitions.
It’s important to remember that adult ADHD is manageable. This understanding should not be viewed as a bleak outlook for your child; rather, it’s vital to realize that if symptoms return, it does not reflect poor parenting or laziness. The neurological differences that contributed to their ADHD diagnosis remain, manifesting in various ways. This insight can lead to seeking professional help rather than attributing struggles to a lack of effort.
The good news? We now understand far more about ADHD in both children and adults, paving the way for enhanced care—especially for teenagers and adults who often face stigma when their symptoms shift from hyperactive to inattentive. Your once-hyperactive child is not simply neglectful about their responsibilities; they’re exhibiting different ADHD symptoms. This evolving research will help more individuals receive support for their ADHD symptoms, leading to a better understanding that they haven’t outgrown ADHD and can stop blaming themselves when their symptoms shift or return.
For adults with ADHD, shedding blame can make a world of difference.
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Potential Search Queries:
- What is ADHD?
- ADHD in Adults: Symptoms and Treatment
- Understanding ADHD Subtypes
- Signs of ADHD in Children
- Managing ADHD Symptoms
In summary, research indicates that children diagnosed with ADHD are unlikely to completely outgrow the disorder. While symptoms may change over time, the underlying brain differences persist, and individuals often continue to experience challenges into adulthood. Recognizing this can foster a more supportive environment for those affected by ADHD.
Keyphrase: ADHD persistence in children
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