Academic journal article Canadian Journal of Behavioural Science

The Development of ADHD Boys: A 12-Year Follow-Up

Academic journal article Canadian Journal of Behavioural Science

The Development of ADHD Boys: A 12-Year Follow-Up

Article excerpt

The Development of ADHD Boys: A 12-Year Follow-Up

DIANE CLAUDE, Child Study Centre, University of Ottawa PHILIP FIRESTONE, School of Psychology, University of Ottawa & Children's Hospital of Eastern Ontario

Abstract

Children assessed as ADHD were compared, in adolescence or early adulthood, with normal control subjects. The core deficits of the disorder persisted in more than half of the ADHD group. Although the ADHD group displayed significantly more Antisocial Personality Disorder and Drug Use Disorders than the control group in adolescence, these group differences were significantly attributable to the aggressive subgroup of ADHD children. In contrast, adolescents who were primarily inattentive/overactive in childhood did not differ significantly from the control group in psychiatric functioning, except for their persistent ADHD. The aggressive subgroup of ADHD children had received the most individual and residential treatment for their behaviour problems. At follow-up, ADHD subjects experienced significantly more problems in high school and they displayed significantly poorer spelling, arithmetic and reading comprehension skills than did the control group.

Longitudinal research on hyperactivity or what is now known as Attention Deficit Hyperactivity Disorder (ADHD, DSM-III-R, American Psychiatric Association, 1987) has grown during the last two decades as old data sets from early clinical investigations are being used to conduct follow-up studies with the original patient-subjects (e. g., Barkley, Fischer, Edelbrock, & Smallish, 1990; Fischer, Barkley, Edelbrock, & Smallish, 1990; Gittelman, Mannuzza, Shenker, & Bonagura, 1985; Loney, Kramer, & Milich, 1981; Loney, Whaley-Klahn, Kosier, & Conboy, 1982; Mannuzza et al., 1991; Satterfield, Hoppe, & Schell, 1982; Weiss, Hechtman, Milroy, & Perlman, 1985; Weiss, Hechtman, Perlman, Hopkins, & Wener, 1979; Weiss, Minde, Werry, Douglas, & Nemeth, 1971)(f.1). In addition, recent years have also seen some epidemiological investigations into psychopathology in childhood that have addressed ADHD children in some detail (McGee, Partridge, Williams, & Silva, 1991; Offord et al., 1992; Sanford, Offord, Boyle, Peace, & Racine, 1992).

Findings generally indicate that most ADHD children do not outgrow their problems by adolescence, and that many present with additional forms of psychopathology (Gittelman et al., 1985; Mannuzza et al., 1991; Weiss et al., 1979; Weiss et al., 1985). Althoughthere is some consensus across studies, the ratios and types of problematic behaviours that emerge do vary. This variability is understandable given the problems inherent in any long-term outcome studies. These difficulties include subject variables such as whether the subjects were clinical or community samples, the use of differing diagnostic criteria (e. g., DSM-II, DSM-III, DSM-III-R), and changes in the tools used to measure behaviour.

Two particularly vexing problems in clinical outcome studies are related to attrition and the selection of control subjects. For example, some researchers have been successful in obtaining relatively complete data for up to 80% of their ADHD samples after an 8-10-year follow-up period (Barkley et al., 1990; 1991; Gittelman et al., 1985; Mannuzza et al., 1991; Weiss et al., 1979), when telephone interviews were utilikod. When laboratory testing was necessary the rates dropped to 63% (e. g., Fischer et al., 1990) and to 59% when a 15-year follow-up period was involved (Weiss et al., 1985). In addition, properly matched control groups have rarely been planned on a prospective basis, either because the original investigations were not designed for long term follow-up, cause of the expense involved or some other similar issue. This may limit the usefulness of a subsequently formed control group and may render the interpretations of any changes problematic.

Nevertheless, there are several research teams that have carried out prospective studies with clinical samples that are meritorious. …

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