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Presentation / Course Longitudinal course of ADHD Longitudinal course of ADHD

Hyperactivity tends to decrease with age41,42

Inattention symptoms tend to increase with age41,42

Trajectories of hyperactivity and inattention in early childhood are significantly associated with each other; higher measures on one predict higher measures on the other41

Large prospective studies have followed children with ADHD and healthy controls into adolescence and adulthood; however, assessment and diagnostic (e.g., earlier and later DSM criteria) metrics have not been consistent41

Functional adult outcomes vary, including impact on educational attainment, job performance, income, marriage and family relationships, and social interactions41

Adapted from Faraone SV, et al. Attention-deficit/hyperactivity disorder. Nature Reviews. Disease Primer. 2015;1:Article number 15020

Early life/preschool age41,42

Most ADHD preschoolers present with the combined presentation

Hyperactive-impulsive more common; inattentive presentation is rare and more likely in girls

Hard to diagnose at this stage because some manifestations are also part of normal developmental stages

Comorbid conditions such as oppositional defiant disorder (ODD), communication disorders, and anxiety disorders are common and cause greater impairment

Preschool ADHD persists into school age in 60-80% of children

School age41,42

Most ADHD diagnoses made at this stage

Academic achievement, family interactions, and peer relationships are impaired

Higher rates of psychiatric comorbidity; the most common comorbidities are ODD, anxiety disorders, and learning disorders

~70% have ≥1 comorbid disorder


Roughly two-thirds of children with ADHD continue to have symptoms of ADHD into adulthood

ADHD as a syndrome persists in ~15% by age 25; impairing symptoms persist in ~65%

Inattention symptoms are more persistent and decline more slowly with age than symptoms of hyperactivity and impulsivity

The majority of long-term outcomes of ADHD improve with all treatment modalities43

In the figure, each bar represents the % of outcomes reported to exhibit benefit (either significantly improved from untreated baseline or significantly improved compared with a group of untreated individuals with ADHD) with each treatment modality43

Outcome Groups Graph

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Clinical Presentations

Longitudinal course of ADHD


41. Cherkasova M, Sulla EM, Dalena KL, Pondé MP, Hechtman L. Developmental course of attention deficit hyperactivity disorder and its predictors. J Can Acad Child Adolesc Psychiatry. 2013;22(1):47-54.
42. Faraone SV, et al. Attention-deficit/hyperactivity disorder. Nature Reviews. Disease Primer. 2015;1:Article number 15020.
43. Arnold LE, Hodgkins P, Caci H, Kahle J, Young S. Effect of treatment modality on long‐term outcomes in attention‐deficit/hyperactivity disorder: a systematic review. PLoS ONE. 2015:10(2):1‐19.