Age-dependent expression of attention-deficit/hyperactivity disorder symptoms

Examining attention-deficit/hyperactivity disorder (ADHD) across the lifespan presents unique challenges, because the diagnostic criteria require that the disorder be evident by 7 years of age. This article summarizes the authors' research with a developmental perspective on symptom expression. The authors found a differential rate of symptomatic decline for inattention and hyperactivity/impulsivity. Although symptoms of inattention declined at a very modest rate, those of hyperactivity and impulsivity remitted much more abruptly. The authors also found that most adult ADHD subjects continue to struggle with substantial numbers of ADHD symptoms and high levels of dysfunction despite a sizable syndromatic remission. The authors' work examining differential rates of decline of ADHD symptom cores indicates that the choice of definition of remission should be influenced by an individual's age and his or her developmental expectation regarding hyperactivity, impulsivity, and inattention.