Young Adult Outcome of Hyperactive Children: Adaptive Functioning in Major Life Activities

Medical University of South Carolina, Charleston, SC, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 03/2006; 45(2):192-202. DOI: 10.1097/01.chi.0000189134.97436.e2
Source: PubMed


The authors report the adaptive functioning of hyperactive and control children in southeastern Wisconsin (Milwaukee) followed to young adulthood.
Interviews with participants concerning major life activities were collected between 1992 and 1996 and used along with employer ratings and high school records at the young adult follow-up (mean = 20 years, range 19-25) for this large sample of hyperactive (H; n = 149) and community control (CC; n = 72) children initially seen in 1978-1980 and studied for at least 13 years. Age, duration of follow-up, and IQ were statistically controlled as needed.
The H group had significantly lower educational performance and attainment, with 32% failing to complete high school. H group members had been fired from more jobs and manifested greater employer-rated attention-deficit/hyperactivity disorder and oppositional defiant disorder symptoms and lower job performance than the CC group. Socially, the H group had fewer close friends, more trouble keeping friends, and more social problems as rated by parents. Far more H than CC group members had become parents (38% versus 4%) and had been treated for sexually transmitted disease (16% versus 4%). Severity of lifetime conduct disorder was predictive of several of the most salient outcomes (failure to graduate, earlier sexual intercourse, early parenthood) whereas attention-deficit/hyperactivity disorder and oppositional defiant disorder at work were predictive of job performance and risk of being fired.
These findings corroborate prior research and go further in identifying sexual activity and early parenthood as additional problematic domains of adaptive functioning at adulthood.

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    • "Assessment of impairment is known to have direct impact on disorder identification rate in that ADHD prevalence estimates are more conservative when symptoms must be associated with significant impairment (McKeown et al. 2015). In addition, intervening to remediate children's lower academic and social functioning may help address ADHD's well-documented sequelae of grade retention , academic underachievement, identification for special education services, and school drop-out (Barkley et al. 2006;Frazier et al. 2007;Kent et al. 2011). Understanding to what extent children with ADHD display variability in their impairments in social as well as academic functioning is important to Electronic supplementary material The online version of this article (doi:10.1007/s10802-016-0126-z) contains supplementary material, which is available to authorized users. "
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    ABSTRACT: Children with attention-deficit/hyperactivity disorder (ADHD) are known to exhibit significantly lower academic and social functioning than other children. Yet the field currently lacks knowledge about specific impairment trajectories experienced by children with ADHD, which may constrain early screening and intervention effectiveness. Data were analyzed from a nationally representative U.S. cohort in the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (ECLS-K) for 590 children (72.7 % male) whose parents reported a formal diagnosis of ADHD. Children's math, reading, and interpersonal skills were assessed at 5 time points between kindergarten and fifth grade. Growth mixture model analyses indicated 4 latent trajectory classes for reading, 8 classes for math, and 4 classes for interpersonal skills. Membership in reading and math trajectory classes was strongly related; overlaps with interpersonal skills classes were weaker. Trajectory class membership was correlated with demographic characteristics and behavioral functioning. Children with ADHD display substantial heterogeneity in their reading, math, and interpersonal growth trajectories, with some groups of children especially likely to display relatively severe levels of academic and social impairment over time. Early screening and intervention to address impairment, particularly reading difficulties, among kindergarten students with ADHD is warranted.
    No preview · Article · Jan 2016 · Journal of Abnormal Child Psychology
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    • "Outcomes of young people with ADHD during high school transition There is a large body of research examining academic outcomes for children with ADHD across the lifespan[6,9,36]. Multiple studies have shown a significant association between ADHD and academic underachievement[37,38]. For example, compared to typically developing peers, children and adolescents with ADHD have been consistently found to score lower on academic tests of reading and math and score lower on standard achievement tests[13,39]. "
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    ABSTRACT: Background Attention-Deficit/Hyperactivity Disorder (ADHD) has a significant impact on child and adolescent development, especially in relation to school functioning and academic outcomes. Despite the transition to high school being a potentially critical period for children with ADHD, most research in this period has focused on academic outcomes. This study aims to extend previous research by describing academic, school engagement, behaviour and social-emotional outcomes for young people with ADHD in the first and third years of high school and to identify risk and protective factors predictive of differing outcomes across these four domains. Methods and design The Moving Up study is a longitudinal, prospective cohort study of children with ADHD as they transition and adjust to high school (age 12–15 years). Data are collected through direct assessment and child, parent and teacher surveys. The primary outcome is academic achievement, obtained by linking to standardised test results. Secondary outcomes include measures of behaviour, ADHD symptoms, school engagement (attitudes and attendance), and social and emotional functioning, including depressive symptoms. The mean performance of the study cohort on each outcome measure will be compared to the population mean for same aged children, using t-tests. Risk and protective factors to be examined using multiple regression include a child, family and school factors know to impact academic and school functioning. Discussion The Moving up study is the first Australian study prospectively designed to measure a broad range of student outcomes for children with ADHD during the high school transition period. Examining both current (cross sectional) and earlier childhood (longitudinal) factors gives us the potential to learn more about risk and protective factors associated with school functioning in young people with ADHD. The richness and depth of this information could lead to more targeted and effective interventions that may alter academic and wellbeing trajectories for young people at risk of poor outcomes. The study is approved by The Royal Children’s Hospital Melbourne Human Research Ethics Committee (33206). Findings will be disseminated through peer-reviewed journals and conference presentations.
    Full-text · Article · Dec 2015 · BMC Pediatrics
    • "During the development and progression of ADHD from childhood to adulthood, it is generally observed that, in comparison to controls, adults with ADHD display lower levels of performance and success, have fewer friends, display lower performance at work, are less capable of showing psychological adaptation, are less likely to complete their education by their mid-twenties, and have lower self-confidence and social skills (Mannuzza and Klein, 2000). In a study that evaluated hyperactive children up until adulthood; it was demonstrated that, in comparison to controls, hyperactive individuals lost their jobs more often, had lower occupational performance and efficiency, and had less developed interpersonal relationship skills (Barkley et al., 2006). These social, occupational and relational problems might be associated with the fundamental characteristics of ADHD. "
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    ABSTRACT: Purpose: Interpersonal relationship disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) can be associated with the impairment of non-verbal communication. The purpose of our study was to compare the emotion recognition, facial recognition and neuropsychological assessments of adult ADHD patients with those of healthy controls, and to thus determine the effect of neuropsychological data on the recognition of emotional expressions. Methods: This study, which was based on a case-control model, was conducted with patients diagnosed with ADHD according to the DSM-IV-TR, being followed and monitored at the adult ADHD clinic of the Psychiatry Department of the Istanbul University Istanbul Medical Faculty Hospital. The study group consisted of 40 adults (27.5% female) between the ages of 20-65 (mean age 25.96±6.07; education level: 15.02±2.34 years) diagnosed with ADHD, and 40 controls who were matched/similar with the study group with respect to age, gender, and education level. In the ADHD group, 14 (35%) of the patients had concomitant diseases. Pictures of Facial Affect, the Benton Face Recognition Test, and the Continuous Performance Test were used to respectively evaluate emotion recognition, facial recognition, and attention deficit and impulsivity of the patients. Results: It was determined that, in comparison to the control group, the ADHD group made more mistakes in recognizing all types of emotional expressions and neutral expressions. The ADHD group also demonstrated more cognitive mistakes. Facial recognition was similar in both groups. It was determined that impulsivity had a significant effect on facial recognition. Conclusion: The social relationship disorders observed in ADHD can be affected by emotion recognition processes. In future studies, it may be possible to investigate the effects that early psychopharmacological and psychotherapeutic interventions administered for the main symptoms of ADHD have on the impairment of emotion recognition.
    No preview · Article · Sep 2015 · Turk psikiyatri dergisi = Turkish journal of psychiatry
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