ADHD

Updated 14 July 2017

From 8 to 80! ADHD has no age limit

ADHD persists into adulthood in up to 60 percent of individuals diagnosed in childhood, and may affect adults' social, occupational, and relational functioning.

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Attention deficit hyperactivity disorder (ADHD) usually starts in early childhood before the age of five. Although it may be outgrown, it can carry on through all the stages of development, and even into adulthood. 

Stages of development

According to a 2006 article, ADHD persists into adulthood in approximately 10 to 60 percent of individuals diagnosed in childhood, “and has global effects on their daily lives, affecting social, occupational, and relational functioning”.

ADHD manifests in three different ways:

  • Hyperactivity  
  • Inattention
  • Impulsivity

Infancy to preschool age

Although some infants are irritable, overactive and difficult to calm down, ADHD is not diagnosed at that age. Overactive and temperamental infants are however more likely to develop into “difficult” prescoolers.  

It can be difficult to decide where “normal” behaviour ends and hyperactivity begins. For example, when is inattentiveness regarded as attention deficit? At what point does behaviour become “over the top”? Some children may just be immature or struggle with language acquisition, which may cause them to act out. The majority of these children will show improvement as they mature.

Read: ADHD: What now?

Parents of pre-schoolers with “genuine” ADHD often find themselves exhausted by the process of rearing their child and find that the usual discipline structures are ineffective. They end up being unable to control their child. Preschool teachers are equally frustrated when these children become aggressive and disruptive, and parents often struggle to find a school that is able to handle their kid’s problems.

Junior school

By the age of nine or 10 many children with ADHD will have been identified. If all three characteristics (hyperactivity, inattention and impulsivity) are present, the results will most likely be chaotic both at home and at school.

Apart from constant stress at home, lack of achievement at school can lead to low self-esteem and even depression.

Children who only have the inattentive kind of ADHD may go unnoticed, while those with hyperactive-impulsive ADHD are more likely to be referred for an assessment, leading to diagnosis and treatment. Treatment may consist of different medications, various kinds of therapy, and behaviour management by teachers and parents.

Read: ADHD is over-diagnosed

It is essential that parents, healthcare professionals and teachers communicate with each other to ensure that the child’s needs are addressed appropriately and effectively.

Adolescence

Up to 80 percent of children diagnosed with ADHD in middle childhood will continue to display overactivity, inattention and impulsivity on to adolescence. Studies find that teens with ADHD struggle with higher rates of disruptive and non-disruptive problems, including substance abuse, anxiety, depression, oppositional behaviour and academic failure.

High school places even more stress on ADHD students. There are more activities and responsibilities and less supervision by teachers and parents.

At home there is likely to be more conflict between ADHD teenagers and parents. Additional problems like substance abuse, delinquency, learning difficulties and other causes of stress in the family only make matters worse.

Read: ADHD: family dynamics

Teenagers may also be unwilling to accept responsibility for their problem and subsequent behaviour and may be reluctant to take prescribed medication and submit to other treatments like counselling and academic assistance.

Adulthood

Adulthood ADHD into adulthood is being increasingly recognised, but studies are rare and at this stage there are more questions than answers. 

  • It is still not certain how many adults suffer from ADHD and figures vary widely.
  • There are no standard criteria for the diagnosis of adult ADHD.
  • Other co-morbid disorders such as anxiety, depression, bipolar disorder etc. can make it more difficult to make a diagnosis, mainly because many of the symptoms of adult ADHD are also present in other disorders. Problems concentrating are also symptomatic of anxiety disorders and mood disorders.

Adults with a diagnosis of ADHD tend to struggle more than the average population with higher education and at work, unless it is a job that is fast-paced and involves risk-taking and an “outgoing style of communication” – characteristics that match the ADHD personality.

Read: Coping with adult ADHD  

ADHD may cause problems in an adult social situation like the “give and take” of conversation.

ADHD has a high heritability, and parents with ADHD have an above average chance of having children with the same problem. This is a “double whammy” because these parents end up having to manage their own symptoms as well as those of their children. Treatment of ADHD symptoms may lead to better parenting, but can also cause high stress levels, leading to the eventual disintegration of the family unit.

Read more:

ADHD today

Taking control of ADHD

ADHD Expert Delia Strondl

 

Ask the Expert

ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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