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. 2018 Aug;57(8):571-582.e1.
doi: 10.1016/j.jaac.2018.04.015. Epub 2018 Jun 18.

Predicting the Adult Functional Outcomes of Boys With ADHD 33 Years Later

María A Ramos-Olazagasti  1 , Francisco Xavier Castellanos  2 , Salvatore Mannuzza  3 , Rachel G Klein  4
Affiliations

Predicting the Adult Functional Outcomes of Boys With ADHD 33 Years Later

María A Ramos-Olazagasti et al. J Am Acad Child Adolesc Psychiatry. 2018 Aug.

Abstract

Objective: Little is known of the factors that influence the course of childhood attention-deficit/hyperactivity disorder (ADHD). Objectives were to identify early features predictive of the adult outcome of children with ADHD. In the longest prospective follow-up to date of children with ADHD, predictors of multiple functional domains were examined: social, occupational, and overall adjustment and educational and occupational attainment.

Method: White boys (6-12 years, mean age 8 years) with ADHD (N = 135), selected to be free of conduct disorder, were assessed longitudinally through adulthood (mean age 41) by clinicians blinded to all previous characteristics. Predictors had been recorded in childhood and adolescence (mean age 18).

Results: Childhood IQ was positively associated with several outcomes: educational attainment, occupational rank, and social and occupational adjustment. Despite their low severity, conduct problems in childhood were negatively related to overall function, educational attainment, and occupational functioning. Two other childhood features that had positive associations with adult adjustment were socioeconomic status and reading ability, which predicted educational attainment. Of multiple adolescent characteristics, 4 were significant predictors: antisocial behaviors predicted poorer educational attainment; educational goals were related to better overall function; early job functioning had a positive relation with social functioning; and early social functioning was positively related to occupational functioning.

Conclusion: Other than childhood IQ, which predicted better outcomes in several domains, there were no consistent prognosticators of adult function among children with ADHD. Providing additional supports to children with relatively lower IQ might improve the adult functional outcome of children with ADHD. However, predicting the course of children with ADHD remains a challenge.

Keywords: ADHD; adulthood; follow-up study; functional outcomes.

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Comment in

  • Hyperactive Boys Grown Up.
    Charach A. Charach A. J Am Acad Child Adolesc Psychiatry. 2018 Aug;57(8):540-541. doi: 10.1016/j.jaac.2018.05.013. J Am Acad Child Adolesc Psychiatry. 2018. PMID: 30071972

References

    1. Mannuzza S, Klein RG, Bessler A, Malloy P, LaPadula M. Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status. JAMA Psychiatry. 1993;50(7):565–576. - PubMed
    1. Mannuzza S, Klein RG, Bessler A, Malloy P, Hynes ME. Educational and occupational outcome of hyperactive boys grown up. J Am Acad Child Adolesc Psychiatry. 1997;36(9):1222–1227. - PubMed
    1. Klein RG, Mannuzza S, Olazagasti MA, et al. Clinical and Functional Outcome of Childhood Attention-Deficit/Hyperactivity Disorder 33 Years Later. JAMA Psychiatry. 2012:1–9. - PMC - PubMed
    1. Rasmussen P, Gillberg C. Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study. J Am Acad Child Adolesc Psychiatry. 2000;39(11):1424–1431. - PubMed
    1. Barkley RA, Fischer M, Smallish L, Fletcher K. Young adult outcome of hyperactive children: adaptive functioning in major life activities. J Am Acad Child Adolesc Psychiatry. 2006;45(2):192–202. - PubMed

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