The course of ADHD differs greatly from individual to individual. The child diagnosed in the early grades may have symptoms that continue into the teen years and then into adult life. There is a "window" for remission between ages 12 and 20, with the onset of puberty bringing about the end of all of the symptoms of ADHD. Most children with ADHD, however, have only a partial remission. They may be vulnerable to antisocial behavior, substance abuse, and mood disorders, and their learning disorders tend to continue throughout their lives. For some of these children, the hyperactivity may disappear but problems of impulse control and decreased attention span may continue. The first symptom to abate is usually overactivity; distractibility is usually the last.

When remission does occur, the child often has a satisfying adolescence and adult life with good interpersonal relationships. There are few significant carry-overs from their childhood ADHD.

Symptoms persist into adulthood in about 15 to 20 percent of cases. A recent follow-up study found that persistence of the symptoms into adult life can be predicted by:

• A family history of the disorder
• The occurrence of negative life events
• The coexistence of conduct disorder, anxiety, or depression

The factors that contribute to a poor outcome for the child with ADHD are the amount of:

• Social disability
• Coexisting psychiatric problems—especially conduct disorder
• A chaotic family situation

Children with ADHD usually have social difficulties—and socially disabled children with ADHD often have higher rates of coexisting psychiatric disorders. They have more problems with behavior in school, with peers, and with family members.

The best outcome can be achieved by helping the child to reduce the incidence of aggression, increase positive social functioning, and improve family situations as early as possible.

The role of the educator is clearly important. Children with ADHD do not benefit from being exempted from the requirements and expectations that are held for other children. Despite their deficiencies in some respects, they too face the normal problems of maturation. They need to take responsibility and to develop a sense of mastery. Working with parents and healthcare professionals, you need to develop usable behavioral interventions—with positive reinforcement—to target school and social behavior. With your help and the help of the child's healthcare professionals and the family, these children will be better able to overcome their disabilities and succeed in life as healthy, happy, and productive people.

Adolescents with ADHD are likely to succeed in life with the proper support and treatment regimen in place. Your help is key.