Researchers followed up teenagers who had been diagnosed with ADHD as children at a Pittsburgh specialty clinic. The study included 164 adolescents with a childhood ADHD diagnosis and 119 similar teens without ADHD, drawn from the Pittsburgh ADHD Longitudinal Study. Most were boys, and their average age was about 15. Fewer than 10% were taking stimulant medication at the follow-up.
Most of the teens who had ADHD as children still met the full criteria in adolescence (70%). Another group had real, impairing problems but did not meet the current criteria (17.7%).
How the teens were assessed mattered a lot. Combining parent and teacher reports found many more teens who met the symptom and impairment thresholds than parent reports alone. Adding the teens' own reports did not help, and their self-reports did not line up with what parents or teachers said.
On combined parent and teacher reports, teens tended to show inattention but few hyperactive or impulsive symptoms. Inattention items were endorsed on 58.5% to 73.8% of ratings. Hyperactivity items were endorsed far less often (22.0% to 55.5%).
The authors suggest that clinicians diagnosing ADHD in these adolescents combine parent and teacher reports, use a lower symptom threshold focused on impairment, and avoid relying on teens' self-reports.
Source: Sibley M, Pelham W, Molina B, et al.. Diagnosing ADHD in adolescence.. Journal of Consulting and Clinical Psychology (2012). doi:10.1037/a0026577