Is ADHD for kids only? Clearly, no. But we didn’t always know that.
Until the 1990s, most medical professionals viewed ADHD as a diagnosis only for children, specifically physically hyperactive children. (A few in the healthcare industry—thankfully, very few—still mistakenly believe that.) One explanation: They thought that children outgrow ADHD because physical hyperactivity, long considered an ADHD hallmark, tends to lessen with age.
This misperception started changing in the 1970s when a few pediatric physicians experienced in treating ADHD connected the dots—observing “little apples” falling suspiciously close to the tree. That is, their young patients’ parents often shared many of the same behaviors, albeit in adult form. For example, they might self-medicate not with candy or boisterous activity but with alcohol or cigarettes.
“In treating children with ADHD, I started asking parents if they used to have problems like this as children, and the spouse would say, ‘What do you mean, used to have?’” says psychiatrist Paul Wender, who has been called the “Dean of ADHD.” Wender is a lecturer in psychiatry at Harvard Medical School. He began studying ADHD four decades ago, establishing himself as a pioneer in its diagnosis and treatment, both in children and adults.
Here’s another important point: Most of today’s adults who actually have ADHD were never diagnosed as children. In fact, 88 percent of ADHD Partner Survey respondents say their partners were first evaluated and diagnosed as adults, during this relationship. According to the most recent research, only 1 in 10 adults with ADHD are diagnosed.
Given modern awareness and diagnostic methods, if these adults were youngsters today, their symptoms would stand a better chance of being recognized. But that didn’t happen, and so no wonder critics decry the “alarming” rise in diagnoses today. Notice, though, these critics weren’t worried about ADHD going under-diagnosed—then or now.
Even today, however, many bright children challenged by ADHD fly under the radar screen for years because:
- Their intelligence lets them compensate
- They have strong parental support and structure
- They are in highly structured schools
- No one is paying attention to the problems and connecting the dots
It’s only later in life—perhaps college, that first job, that first serious relationship, or that first baby—that they “hit the wall.”
In fact, according to ADHD authority Russell Barkley, ADHD is “far more apparent and even more impairing in adults than in children because adults have more domains of responsibility.” That is, adults are expected to hold a job, run a household, manage money, look after their health, and, in some cases, provide daily structure for children.
—Gina Pera
Good point, Reyes.
There are many good studies that counter these myths. The challenge is translating them for the public.
thanks for your comment,
g
I love the idea of your ADHD myth series Gina. This myth is so spot on, many believe adhd is only an issue for kids. Looking forward to the other myth series. Great job!
Hey, thanks, Kris!
g
It’s interesting, I hadn’t really thought much until I read this about the extent to which diagnosing ADHD is about “connecting the dots.” Any single ADHD symptom taken by itself might not seem like a big deal, but all the symptoms taken together add up to some serious impairments. No wonder diagnosing ADHD is part art and part science.
Barkley is spot-on about ADHD being especially problematic for adults because of their responsibilities, but at least ADHD adults can gravitate to environments that somewhat accommodate their symptoms, whereas children are stuck in a school environment that is definitely not ADHD-friendly. Besides the general lack of awareness around ADHD, it seems like this could be one reason for the pitifully low diagnosis rates in adults.
Hi ADaptHD, and thanks for your comment.
In fact, you describe why children are diagnosed more than adults, I would think.
Children are in a structured environment that “calls out” their ADHD-related challenges.
Adults, as you say, can pick their own environments, and those environments sometimes provide cover for any ADHD-related challenges. Sometimes, of course, adults with ADHD can find environments where they truly function better. But many times, what they do is keep bouncing around until they land in a place where little is demanded of them, and that’s both a blessing and a curse.
I’m thinking now of my friends with late-diagnosis ADHD who had degrees and interest in various fields but could not manage jobs in them. So they kept bouncing down the ladder of responsibilities until they ended up in, for example, tech support. Work that doesn’t involve ongoing management or planning. Just picking up the phone and answering questions. Trouble is, most of them are very unchallenged and bored with this work. It’s simply the only living they can make.
So complex, this ADHD thing! 🙂
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