ADHD Questions
ADHD and Development
What does residual ADHD look like?
Charles Li, MD
April 20, 2023
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Children with ADHD tend to improve as they age, though specific symptoms and challenges from ADHD may remain into adulthood.
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Having ADHD that continues into adulthood has been linked with significant challenges at home and school.
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Those with persistent ADHD tend to have higher rates of anxiety and may have a shorter life expectancy.
Generally, as kids with ADHD get older, they tend to improve. While most will continue to have some ADHD symptoms in their life occasionally, most will get better at adapting to it and living with it.
However, many will continue to have severe ADHD into adulthood. Scientists call this persistent ADHD.
Those who have persistent ADHD have significantly poorer outcomes.
One study found they have 5 to 6 times the risk of anxiety and difficulty at home than those who get better.
They also have three times the risk of difficulty at school and twice the risk of conduct disorder.
A second study found that those with persistent ADHD have a significantly shorter life expectancy. ADHD, in general, is associated with an eight-year reduction in life expectancy. Those with ADHD that lasts into adulthood have a nearly 13-year decrease in life expectancy.
Individuals with childhood ADHD are expected to live eight years less than those without ADHD. Those with persistent ADHD are expected to live nearly 13 years less.
It is important to note that these are correlations, which are not necessarily indicative of causation.
We know from the data that those with persistent ADHD have more challenges in life, but we don’t know whether persistent ADHD causes that.
Correlation and Causation
What are the risk factors for residual ADHD?
Researchers have studied the risk factors for persistent ADHD. These studies looked at who is at risk of persistent ADHD and what factors increase your odds of having ADHD that continues into adulthood.
One meta-analysis that combined 16 studies found that those with severe ADHD or a combination of ADHD and depression have a much higher risk of persistent ADHD, among other risk factors. Other factors, such as IQ and socioeconomic status, we’re not linked to persistence.
What is a meta-analysis?
Predictors of persistence of ADHD into adulthood: a systematic review of the literature and meta‐analysis
How common is residual ADHD?
Fortunately, most individuals should expect to recover from ADHD as they get older, at least partially.
One study that followed kids with ADHD for many years found that persistent ADHD was relatively rare. Most participants in the study ended up with fluctuating ADHD symptoms, where they got better but continued to have some symptoms return from time to time.
Most with ADHD will experience some periods of improvement over time. However, recurrence is common.
Key Takeaways
ADHD recovery can be a slow process. Most tend to get better. For those who don’t, the research shows that they will face particular challenges. Fortunately, ADHD is treatable with medication and therapy in both children and adults.