November 22, 2021
A recently published study in the American Journal of Psychiatry confirms what many parents of kids with ADHD have learned through experience: While children with ADHD may go through periods of remission as they move toward adulthood, the majority experience recurring ADHD over time, often fluctuating between remission and recurrence.
Past research has provided many families with hope that their child will “outgrow” ADHD by the time they are in their early twenties. But those studies were largely based on the fact that by the time study participants were young adults they no longer met the DSM full criteria for ADHD. However, as the authors of the current study point out:
The vast majority (about 78%) had clinically elevated ADHD symptoms, impairment, and/or continuation of ADHD treatments. Thus, most participants who were classified as having remitted ADHD on the basis of traditional DSM guidelines still experienced impairing subthreshold ADHD symptoms or experienced “remission” only when receiving ADHD treatment (e.g., stimulant medication).
Fluctuating Periods of ADHD
The current long-term Multi-Modal Treatment Study of ADHD (MTA) followed participants at intervals ranging from 2 to 16 years. According to the journal article, “The authors identified participants with fully remitted, partially remitted, and persistent ADHD at each time point.”
The findings suggest a more nuanced picture of ADHD over time:
Approximately 30% of children with ADHD experienced full remission at some point during the follow-up period; however, a majority of them (60%) experienced recurrence of ADHD after the initial period of remission. Only 9.1% of the sample demonstrated recovery (sustained remission) by study endpoint, and only 10.8% demonstrated stable ADHD persistence across study time points. Most participants with ADHD (63.8%) had fluctuating periods of remission and recurrence over time.
The MTA challenges the idea that most children with ADHD outgrow the condition as they mature. Instead, the study provides strong evidence that with aging, the majority (90%) of young people experience fluctuating symptoms into young adulthood.