Medical Health Encyclopedia

Persistence of ADHD into Adulthood

Some research suggests that ADHD persists in one- to two-thirds of those diagnosed with the condition in childhood. Many experts, in fact, describe the pattern of ADHD as they would a chronic illness, in terms of whether it goes into remission or not. They define this remission in three categories of severity:

• Syndromatic Remission. Person does not have all the symptoms of full-fledged ADHD, but significant functional impairment in social or occupational activities is present.
• Symptomatic Remission. Person has few symptoms and some functional impairment.
• Functional Remission (Full Recovery). Few symptoms and no functional impairment.

In one study using these criteria, 60% of ADHD Caucasian boys were in syndromatic remission four years after the onset of the study, and 10% were fully recovered (in functional remission). Older individuals were more likely to retain symptoms of inattentiveness than those of impulsivity and hyperactivity. Because inattentiveness affects organizational skills, this could be a significant problem in adulthood. It should be noted, however, that the study lasted only 4 years and stopped between ages 18 and 20. The study did not include girls or boys in other ethnic groups, so it is not known if these results are generally applicable.

Effect on Family

The time and attention needed to deal with the ADHD child can change internal family relationships and have devastating effects on parents and siblings.

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Effect on Parents. Studies increasingly suggest that any intervention for an ADHD child must include the parents. Parents who are responsive to their child in a positive way can help reduce the chances for oppositional behaviors. But it can be very difficult. The ADHD child is wonderful one day and terrible the next, for no apparent reason. The parent can feel betrayed and hurt, and believe they have no control over their child. Parents must protect themselves and their child by establishing tough but kind rules about where their space ends and the child's begins. The are many effects on parents:

• Mothers generally get the brunt of the emotional and physical abuse that an ADHD child can produce, which is sadly ironic because the ADHD child tends to love the mother intensely and feel safe with her.
• Parents may have to give up on the idea of an immaculate house and a hot meal every night. (One advantage of an ADHD child in the family is that the parents learn that they are not perfect, nor do they have to be. In fact, striving for perfection is among the most counterproductive goals to pursue in raising an ADHD, or any, child.)
• Parents must face the hostility and anger of other parents and see their own child rejected. It is very easy to fall into an emotional black hole, and feel alone, inadequate, and helpless.
• Marriages are often stressed to the breaking point because of exhaustion and disagreements between the husband and wife on how to raise the ADHD child.