ADHD May Be Longer Lasting Than We Previously Thought

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Here at Kids BRAIN, we often spend time with kids with attentional functions that are less than ideal (or helpful). From toddlers through young adults, we work with, plan with, and help compensate with lots of individuals struggling with the symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). Although it’s always called ADHD, each person has one of several types based on their symptoms; the predominantly inattentive presentation, predominantly hyperactive/impulsive presentation, or the combined presentation (which covers both areas).

When ADHD symptoms are present (especially for the combined presentation), it is often readily apparent in very young children. However, as professionals, we may hold off on diagnosing ADHD until we are certain that other factors aren’t accounting for behavioral and attention problems in the littlest kids. Maybe they have suspected or confirmed sleep apnea and we recommend a medical consultation. Sleeping poorly makes kid brains act like ADHD brains. Maybe they have difficulties with feeding and aren’t getting nourishing food. Brains that don’t have a well-rounded diet are often hyperactive and dysregulated. Maybe there are sensory issues, and we aren’t sure whether bodily control problems are linked with ADHD or are instead related to a sensory dysfunction. Maybe it really is ADHD. If so, knowing that can help guide parents toward a manageable place with their children.

The current theories underlying ADHD are that children and adolescents with this diagnosis have immaturities in brain connections that allow the frontal lobes (management parts) to connect and stay connected with the awareness parts in the back of the brain. The research on the longevity of these symptoms over time has suggested that a lot of the children diagnosed with ADHD would grow out of it over time, with some studies indicating about a 50/50 chance of having adult issues with attention, impulse, and behavioral control for these kids.

In an August 2021 study in the American Journal of Psychiatry, these numbers have been updated. Instead of what was thought to be a relatively complete alleviation of symptoms in adulthood in about 50% of kids diagnosed with ADHD, this research suggests numbers closer to 10%. This study followed almost 600 kids with ADHD from age 8 to 25, with assessments every 2 years to document symptoms over time. The numbers have shifted over time because the findings indicate that those with ADHD in childhood don’t often have a full remission of symptoms in adulthood. Instead, there appears to be a shift in symptoms over time and a disjointedness in the intensity of issues as the brain matures into adulthood.

In children, inattentive symptoms look a lot like adult symptoms and include disorganization, forgetfulness, and having trouble staying on task. However, the hyperactive and impulsive symptoms of ADHD in children, like having a lot of energy, running around, and climbing on things, change as you mature. In adults, symptoms often look more like verbal impulsivity (saying what’s on your mind without “filtering” it first), difficulty with decision-making, and not thinking before acting. Overall, for most children with ADHD, they are very likely to continue to struggle with inattentive, hyperactive, and/or impulsive behaviors through the developmental period and into adulthood. This underscores the need for regular, updated assessment to help figure out what a person’s strengths are and what obstacles may be in their way at that time. Work with a psychologist/neuropsychologist/ADHD specialist in order to establish the need for supports, to develop educational planning elements, and to strategize skill set development for the gaps present at that time may then become essential. The team at Kids BRAIN does just that!

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