Kids' ADHD Doesn't Always Last

Children with ADHD may not keep the diagnosis over time

(RxWiki News) Just because a child is diagnosed with attention deficit hyperactivity disorder (ADHD) when they're young doesn't mean they continue to show symptoms of the disorder later in life.

In fact, some children can lose their diagnosis of ADHD for a number of different reasons. A recent study found some of the factors that can help parents and doctors predict whether a child is likely to remain diagnosed with ADHD a decade later.

Among these factors were behaviors of the young child, the families' socioeconomic position and the mental health histories of the children's parents.

"Ask your doctor for resources to help your child's ADHD."

The study, led by Evelyn C. Law, MD, of the Division of Developmental Medicine at Boston Children's Hospital, looked at what factors can be used to determine the likelihood a child will have ADHD over the long-term.

Past research has shown that about half of all children diagnosed with ADHD before age 7 do not meet the criteria for the disorder when they are older.

Researchers wanted to learn what factors children who lose the diagnosis might have in common. Therefore, they followed up with 120 children, aged 3 to 6, who had originally been diagnosed with ADHD between 2003 and 2008.

When the researchers contacted these children's families in 2012 and 2013, they found that 70 percent of the children still met the criteria for ADHD.

Then the researchers analyzed the results of a series of surveys and other assessments the children's families and teachers had filled out when the children were first enrolled in the study.

The results revealed that several factors appeared related to whether a child continued to be diagnosed with ADHD later on.

One had to do with the severity of their externalizing (acting out, misbehaving) and internalizing (being withdrawn, not participating) behaviors when measured between ages 3 and 6. The greater these symptoms were, the more likely it was that children would continue to be diagnosed with ADHD about a decade later.

Two others had to do with the mental health history of the children's parents and the family's socioeconomic status. Children of parents with more mental health conditions in their history and in families with lower socioeconomic status were more likely to remain diagnosed with ADHD.

This latter finding means that it's possible parents could benefit from training and support in how to help their children with ADHD.

Meanwhile, just over half of the children who lost their ADHD diagnosis were actually diagnosed with other disorders — including anxiety, learning disorders and autism.

Glen Elliott, MD, PhD, a clinical professor at the Stanford University Department of Psychiatry and Behavioral Sciences, noted that diagnosing ADHD reliably in preschool children has been an ongoing challenge.

"These authors report that about 70 percent of the children under age 6 that they diagnosed as having ADHD continued to meet criteria for ADHD five to seven years later," Dr. Elliott said. "However, the average age of their sample was nearly 6 years old at first diagnosis, and it is unclear how well they would have done with a population several years younger."

Dr. Elliott said the study's findings reveal the importance of having children reassessed over time.

"As the authors note, even with their sample, a number of subject initially diagnosed with ADHD shifted diagnoses when reassessed several years later, emphasizing the need to continue to monitor actual symptoms over time to ensure that the child is receiving treatment for the correct disorder," he said.

The study was published March 17 in the journal Pediatrics. The research was funded by the Society for Developmental and Behavioral Pediatrics and the National Institute of Mental Health. The authors reported no conflicts of interest.

Review Date: 
March 16, 2014