ADHD Life-Course

ADHD Life-Course. Introduction

ADHD symptoms can manifest before school age, typically becoming recognizable by the age of five to six. However, these children often stand out even in early childhood, and ADHD-related problems intensify during the preschool years. The elementary school years are typically the most challenging. During adolescence, some core ADHD issues may diminish. However, in many cases, impairing problems may persist into adulthood. In the following article we present the ADHD course in different life stages.

ADHD course in early childhood

In infancy and early childhood, some children who later develop ADHD exhibit a very high level of activity. They constantly appear restless and struggle to find calmness. Some children experience regulatory disorders, such as difficulties with feeding, digestion, and sleep. They often seem irritable and cry a lot. These behaviours can significantly burden parents.

The development of ADHD is more likely when these regulatory disorders in the child coincide with significant parental stress. In some children who later develop ADHD, early developmental delays may already be noticeable, such as delayed walking or speaking.

ADHD in preschool age

Motor restlessness and extreme hyperactivity are typically pronounced during the preschool years. Children find it challenging to play calmly and persistently. Sometimes, these behaviours are more noticeable in the kindergarten setting due to the increased stimulation compared to the home environment. Additionally, many children exhibit extreme tantrums and disregard for boundaries and instructions. Parents often experience significant strain due to their child’s uncontrolled behaviour, which requires a high level of supervision and patience that may not always be sustainable. The high impulsivity of children with ADHD significantly increases the risk of accidents at home and in traffic.

Some children may also experience developmental delays. For example, they may exhibit motor clumsiness or have difficulty speaking compared to their peers. Motor problems can manifest, for instance, in a dislike of colouring, particularly staying within the lines, or struggles with using pens and scissors compared to same-age children.

ADHD course during elementary school

With the start of elementary school, affected children often experience a significant increase in difficulties. The onset of typical symptoms or additional problems frequently occurs at this time because the children are suddenly confronted with demands for calmness, endurance, and concentration that overwhelm them.

Homework completion often becomes a core problem within the family. Poor academic performance, particularly difficulties in reading and writing, commonly occur but not always. Due to these challenges, many children quickly lose interest in learning. Aggressive behaviours and self-esteem issues may escalate. School difficulties can become so severe that grade repetition or changing schools becomes necessary.

Furthermore, during this time, affected children frequently encounter rejection from their peers, which can amplify the development of low self-esteem and the expansion of aggressive behaviours.

ADHD course in secondary school

Transitioning to secondary schools usually brings significant changes to the educational environment. Academic requirements increase, and teachers change in nearly every subject. Consequently, establishing a stable teacher-student relationship, which is particularly crucial for these children, is often challenging. As a result of these changes, symptoms often worsen in many cases.

ADHD in adolescence

With the onset of adolescence, physical restlessness generally diminishes, while attention problems and impulsive actions often persist.

Children with a favorable progression of the condition may no longer exhibit differences compared to their peers, although they are still considered highly energetic. Adolescents who displayed aggressive behaviours as children are prone to developing antisocial behavioral problems. These problems mainly manifest as truancy, significant lying, and stealing. Frequently, these teenagers tend to associate with peers facing similar issues, which often leads to alcohol and drug abuse.

If significant impulsivity and inattention persist during adolescence, the risk of traffic accidents increases. Heightened sexual curiosity and risky behaviours are more likely to result in infectious diseases and early pregnancies.

For children who have experienced school as highly negative over many years, extreme aversion to anything related to academic performance (“zero motivation”) develops, and their self-esteem suffers as a result. Those who experience numerous failures in school, within the family, and among peers during childhood and adolescence are at an increased risk of depressive moods.

ADHD in adulthood

The behavioral problems of adolescence can continue into adulthood for some individuals, while others see a reduction in problems as they enter adulthood. The least favorable outcome occurs for those who developed antisocial behavioral issues during adolescence and completed school with poor academic performance.

Motor restlessness becomes less prominent in adulthood and is replaced by a sense of inner restlessness. Impulsivity may persist and manifest, for example, in an inability to wait in line or frequently interrupting conversations. However, adults primarily struggle with attention and concentration problems. These difficulties are most pronounced in the workplace, but also affect family life and leisure activities. Organizing tasks becomes challenging, forgetfulness is common, and they often act without a plan.

ADHD in Boys and Girls

According to most studies ADHD is much more common in boys than in girls, occurring two to four times more frequently in boys.

The causes for the gender difference are still unknown. It is believed that genetic factors play the dominant role. However, it is possible that differences in the upbringing of boys and girls still play a – albeit subordinate – role.

Among children with ADHD boys are presented for diagnosis and therapy more frequent than girls. This is probably because boys tend to be “noisier” than girls. They show also more frequent hyperactivity and impulsivity than girls.

Moreover, when it comes to additional problems, boys more commonly exhibit disruptive symptoms such as aggressive and oppositional behaviour. In contrast, girls tend to show slightly higher rates of inattentiveness and emotional problems such as daydreaming, insecurity, or sadness.