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Can We Predict Outcomes of Children with ADHD?

How does attention-deficit/hyperactivity disorder (ADHD) shape the course of a child’s future? American doctors and researchers wanted to identify early signals of future behaviors among children with ADHD. The researchers had several theories relating to how children with ADHD would function in their careers, social circles, and overall well-being in adulthood.

A prospective longitudinal ADHD study

For the prospective, long-running study, 207 Caucasian boys with an average age of eight were recruited. The aim was to predict functional outcomes of children with ADHD at ages 18, 25, and 41 years old. The researchers selected these participants based on past documented behavioral problems in the classroom or learning disabilities related to lower verbal intelligence scores. The boys were of middle and lower-middle-class socioeconomic status.

At the final follow-up, the researchers interviewed the remaining 126 participants. The interview questions were based on several variables over the course of a participant’s journey to adulthood:

  • education levels
  • occupational attainment
  • and social functioning.

Social functioning showed how the subjects participated in social activities like sports participation, travel, and dating history. The data was used to build their findings, which were published in the Journal of the American Academy of Child & Adolescent Psychiatry.

Results of the study

The results were in line with the initial theories but not every variable measured could be directly related to ADHD as a predictor in the early years. Conduct problems in childhood were associated with lower educational attainment overall; job performance improved over time as each age marker was reached; childhood IQ was shown to lead to better career paths and opportunities. Those who excelled in social functioning did so partly because of higher IQ and partly because of adolescent job functioning.

Overall, the outcomes of the subjects’ lives varied in a way that was not statistically significant to conclude children with ADHD had outcomes of hardships. While the researchers inferred a few weak connections, the strongest factor that influenced all outcomes was the IQ level of the children.

ADHD outcomes cannot be predicted

Finding early predictors at a young age continues to be difficult, but the authors of this study hope future research can be built on their findings. Researchers suggest better goal-oriented systems and educational planning are needed to facilitate better functioning in all variables for children with ADHD to have better outcomes as adults.


  1. Ramos-Olazagasti MA, Castellanos FX, Mannuzza S, Klein RG. Predicting the adult functional outcomes of boys with ADHD 33 years later. J Am Acad Child Adolesc Psychiatry. 2018;57(8):571-582.e1. doi:10.1016/j.jaac.2018.04.015


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