If your child has attention deficit hyperactivity disorder, it’s likely he or she will also have the disorder as an adult.
For example, a study published in the 2016 Journal of Child Psychology and Psychiatry noted that of the 579 children with ADHD who were studied, 60 percent of them “demonstrated symptom persistence” into adulthood.
Another study, published in The Lancet Psychiatry in 2016, states that while ADHD may follow a child into adulthood, it’s important to note that methods used to determine its prevalence through the years may have involved several variables including – but not limited to – differences in the source of information and ADHD rating scales used.
Margaret Sibley, a licensed clinical psychologist and an assistant professor of psychiatry and behavioral health at the Florida International University Center for Children and Families, who is also a co-author of both studies, says there’s “probably a 50-50 chance that childhood symptoms will continue to be severe enough to meet ADHD criteria as an adult.” At the same time, she explains that the entire notion of childhood ADHD symptoms carrying through into adulthood is complex; much more needs to be observed and understood when factoring in each individual’s ADHD symptoms and the possibility that they’ll persist in later years.
With Age, Changes in Brain Development and Behaviors
Genetic predisposition is a factor, but brain development is also critical in understanding ADHD at various ages. Sibley explains that the prefrontal cortex, which is responsible for executive functions such as planning and problem solving, is the last part of the brain to develop. This suggests that ADHD symptoms can vary as a person ages; a young child’s behavior will differ from that of an adult or even an adolescent, whose brain is more fully developed, she says. Therefore, “some of the issues that were more challenging in childhood aren’t so much as an adult,” Sibley says. As such, she notes that an adult tends to develop more effective coping strategies than a child which may help him or her better manage or perhaps even overcome ADHD symptoms.
She also says that ADHD behaviors manifest differently with age not only because of changes in brain development, but also because of environmental variations between childhood and adulthood. “You change environments as you get older,” Sarkis says. “So ADHD may not impact you as much as an adult.”
Dr. Rebecca A. Baum, chief of developmental behavioral pediatrics at Nationwide Children’s Hospital and a clinical associate professor of pediatrics at The Ohio State University, expands on this point, saying that it’s important to consider that a child’s environment – school in particular – differs from the ones experienced as an adult.
“As an adult,” she says, “you’re not expected to sit in the same setting upwards of eight hours a day.” Baum says school settings present a unique situation for children because they’re a stark contrast to the environmental freedoms an adult faces. “An adult has more flexibility in terms of changing locations,” she says, explaining that both social and environmental expectations between children and adults differ, which can help explain why ADHD behaviors may also differ with age.
How a Child’s ADHD Behaviors May Manifest as an Adult
For example, Sarkis explains that an inner restlessness may persist in adults, which is demonstrated differently than in their childhood. A hyper child, she says, may run around rooms at home and in school, but an adult with this same urge will likely not do that in a conference room or in a restaurant. At work, for example, an adult who exhibited hyperactivity as a child may instead swivel in an office chair, click their pen repeatedly or play a cellphone game under a desk. While these are behaviors which adults who don’t have ADHD may sometimes exhibit, the difference here is that these adults had ADHD as a child and, therefore, may be more likely to demonstrate certain behaviors with more frequency or intensity – or both, Sarkis notes.
An adult who had ADHD as a child may also arrive unusually early or late to events or meetings in an effort to avoid traffic or long wait times. As a child, this same person likely didn’t enjoy standing in lines, Sarkis says, so their adult behavior of managing time fits within the struggles faced in their younger years. Again, many non-ADHD adults may also make an effort to circumvent traffic, but the difference is that an adult with the disorder may depart from a location significantly earlier than necessary. Similarly, she explains that he or she may take routes while driving that, while it may keep them in constant motion void of traffic, may actually end up being more of a roundabout trek that leads to a later arrival time.
Another example involves a child with ADHD who keeps a room messy. It’s not uncommon for this same child to grow up and live in a cluttered house, Sarkis explains. “The messiness will have expanded,” she says.
Across all behaviors, the one constant, according to Sarkis, is that there will be a noticeable difference between an adult with ADHD and same-age peers without the disorder. Using the example of an unkempt house, she explains that adults without the disorder will typically keep their home fairly clean and organized, but an adult with ADHD often maintains a considerably messier environment. Her comment about behavioral variations between similar ages is congruent with the American Psychiatric Association’s statement pertaining to a child with ADHD: “The difference in children with ADHD is that their hyperactivity and inattention are noticeably greater than expected for their age and cause distress and/or problems functioning at home, at school or with friends.”
Parents who are concerned about their child’s ADHD symptoms following him or her into adulthood can take steps to help their son or daughter. Sibley states that a parent should work proactively with their child to ensure they reach their best potential academically and socially. Making sure they stay out of trouble, whether in school or with the law, is a part of this picture, she says.
“You want to strike a balance as a parent between promoting independence so a child can experience the natural consequences of their actions and learn as a result,” Sibley says. “But at the same time, parents should protect, monitor and set good goals at home.”