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The majority of children with attention deficit hyperactive disorder (ADHD) won’t outgrow the disorder.

A study published in the American Journal of Psychiatry found that just 10 percent of children with ADHD will completely outgrow it. 

“We found that most individuals with ADHD had periods when they met criteria for ADHD and other periods when they did not. Essentially, it seems like there are factors that may turn up or down the volume on someone's ADHD,” Margaret Sibley, lead author of the study and an associate professor of psychiatry and behavioural sciences at the University of Washington School of Medicine told Theravive. 

“ADHD is a disorder that fluctuates in severity over time. Because of these fluctuations, about 30% of the sample had periods of time where their ADHD was reduced to a level where they would be considered asymptomatic--but usually symptoms would come back within four years.”

Previously, it was believed ADHD was a disorder first seen in childhood that would then continue to adulthood in 50 percent of cases. Sibley’s study suggests the number of people who continue to experience ADHD into adulthood is actually much higher than previously believed.

But the symptoms of ADHD may differ between childhood and adulthood. 

“ADHD in childhood is often characterize by both hyperactive behaviors (like excessive activity level, difficulty modulating the volume of one's voice when excited) and inattentive behaviors (forgetfulness, difficulty staying focused, disorganization). In adulthood, we see fewer hyperactive behaviors but continued inattentive behaviors,” Sibley said. 

“Some adults with ADHD struggle with impulsivity in their decision-making and verbally (not thinking before they speak, jumping the gun in a conversation). While children with ADHD typically struggle in the classroom, with peers, and with following rules and instructions at home, adults with ADHD often struggle with managing their finances, sustaining meaningful personal relationships, holding down stable employment, and keeping on top of their responsibilities in a timely manner.” 

The study in the American Journal of Psychiatry involved researchers from 16 institutions across the world. They followed a group of 558 children who have ADHD for a period of 16 years from the age of eight to 25.

The children were assessed every two years to determine their ADHD symptoms. The parents and teachers of the children were also asked about their ADHD symptoms. 

Roughly 30 percent of the children experienced full remission of ADHD during the follow up period and 60 percent of them had symptoms of ADHD return after they initially went into remission.

Just 9.1 percent of those in the study had complete recovery from ADHD. The majority of the study participants had periods where their symptoms fluctuated between remission and recurrence.  

“The research suggests that ADHD is a chronic disorder like asthma, allergies, diabetes, or vision problems. However, the message of hope here is that if you take the right steps, it is possible to manage your ADHD effectively,” Sibley said.

“Many people with ADHD succeed in spite of their symptoms when they work hard and create a life for themselves that is a good-fit. People with ADHD and their parents have to be thoughtful about what environments are healthy and set the individual up to succeed. ADHD with deliberate efforts to identify the factors that help you succeed and to put them in place. Good cognitive-behavioral therapy for ADHD will help a person do this.”

She says it is important those with ADHD and their carers should be aware symptoms might return, even if they seem to be under control.

“People with ADHD (and parents of children with ADHD) should get to know the ingredients that help them succeed, because when these factors are in place, overcoming the disorder is possible. Professionals, parents of youth with ADHD, and individuals with ADHD should always remain vigilant that even when the symptoms seem to be at bay, it is possible they could return, which may mean additional treatment would be necessary,” she said.   

“Preventing symptoms from returning could be possible by identifying life transition points (transition to high school, college, a new job, a new baby coming) that could present challenges for a person with ADHD and making a plan for how to succeed, possibly with the help of a professional.”