This study compared the high school academic experience of adolescents with and without childhood ADHD using data from the Pittsburgh ADHD Longitudinal Study (PALS). Participants were 326 males with childhood ADHD and 213 demographically similar males without ADHD who were recruited at the start of the follow-up study. Data were collected yearly from parents, teachers and schools. The current study used assessment points at which the participants were currently in or had recently completed grades 9, 10, 11, and 12. Results indicated that adolescents with ADHD experienced significant academic impairment in high school relative to comparison adolescents, including lower overall and main academic subject grade point averages (GPA), lower levels of class placement (e.g. remedial vs. honors), and higher rates of course failure. In addition, teacher reports indicated that adolescents with ADHD completed and turned in a significantly lower percentage of assignments and were significantly less likely to be working up to their potential. Adolescents with ADHD were also significantly more likely to be absent or tardy during the academic year, and they were over eight times more likely than adolescents without ADHD to drop out of high school. These findings demonstrate that children with ADHD continue to experience severe academic impairment into high school.

Objective This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing ADHD in order to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self vs. informant ratings, diagnostic threshold, and retrospective reporting of childhood symptoms were addressed. Method Using data from the Pittsburgh ADHD Longitudinal Study (PALS), parent, teacher, and self-reports of symptoms and impairment were examined for 164 adolescents with a childhood diagnosis of ADHD (age M=14.74) and 119 demographically similar non-ADHD controls (total N=283). Results Results indicated that 70% of the well-diagnosed childhood ADHD group continued to meet DSM-IV-TR diagnostic criteria for ADHD in adolescence; however, an additional 17% possessed clinically significant impairment in adolescence, but did not qualify for a current ADHD diagnosis. The optimal source of information was combined reports from the parent and a core academic teacher. Adolescents with ADHD met criteria for very few symptoms of hyperactivity/impulsivity, suggesting a need to revisit the diagnostic threshold for these items. Additionally, emphasis on impairment, rather than symptom threshold improved identification of adolescents with a gold-standard childhood diagnosis of ADHD and persistent ADHD symptoms. Parent retrospective reports of baseline functioning, but not adolescent self-reports, were significantly correlated with reports collected at baseline in childhood. Conclusions We offer recommendations for diagnosing ADHD in adolescence based upon these findings.

Objective Behavioral and pharmacological treatments for children with ADHD were evaluated to address whether endpoint outcomes are better depending on which treatment is initiated first, and, in case of insufficient response to initial treatment, whether increasing dose of initial treatment or adding the other treatment modality is superior. Methods Children with ADHD (ages 5–12, N = 146, 76% male) were treated for one school year. Children were randomized to initiate treatment with low doses of either (a) behavioral parent training (8 group sessions) and brief teacher consultation to establish a Daily Report Card or (b) extended-release methylphenidate (equivalent to .15 mg/kg/dose bid). After 8 weeks or at later monthly intervals as necessary, insufficient responders were rerandomized to secondary interventions that either increased the dose/intensity of the initial treatment or added the other treatment modality, with adaptive adjustments monthly as needed to these secondary treatments. Results The group beginning with behavioral treatment displayed significantly lower rates of observed classroom rule violations (the primary outcome) and parent/teacher ratings of oppositional behavior at study endpoint and tended to have fewer out-of-class disciplinary events. Further, adding medication secondary to initial behavior modification resulted in better outcomes on the primary outcomes and other measures than adding behavior modification to initial medication. Normalization rates on teacher and parent ratings were generally high. Parents who began treatment with behavioral parent training had substantially better attendance than those assigned to receive training following medication. Conclusions Beginning treatment with behavioral intervention produced better outcomes overall than beginning treatment with medication.

Objective-The study aims to characterize the late adolescent and young adult outcomes of girls diagnosed with ADHD in childhood.Method-The study included 58 females from a larger longitudinal study of ADHD. Thirty-four (M=19.97 years old) met DSM criteria for ADHD in childhood, while the remaining 24 (M=19.83 years old) did not. Self-and parent-reports of psychopathology, delinquency, interpersonal relationships, academic achievement, job performance, and substance use were collected.Results-The findings suggest that girls with ADHD experience difficulties in late adolescence and young adulthood, such as more conflict with their mothers, being involved in fewer romantic relationships, and experiencing more depressive symptoms than comparison women. However, differences did not emerge in all domains, such as job performance, substance use, and selfreported ADHD symptomatology. Conclusion-The findings of this study add to the literature on the negative late adolescent and young adult outcomes associated with childhood ADHD in females.Until recently, ADHD was considered a male disorder, occurring 2 to 9 times more frequently in males than females (Barkley, 2006). Now, researchers have turned their attention to studying ADHD in girls and have found that they manifest psychopathology and impairment similar to boys (Pelham, Walker, Sturges, & Hoza, 1989; Waschbusch, King, & Northern Partners In Action for Children and Youth, 2006). However, developmental outcomes for women with ADHD remain largely unexplored. There are popular books on women with ADHD (e.g. Understanding ADHD in Women by Kathleen Nadeau and Patricia Quinn), but these books typically lack empirical support or are based on case studies of women who present with ADHD for the first time in adulthood, and whether or not they had childhood ADHD is unclear. Although both adult and child ascertained women with ADHD have been reported to experience psychopathology such as high rates of anxiety, mood and substance disorders, (Biederman et al., 2006;Quinn, 2005), some research suggests that women diagnosed in childhood experience more psychopathology and impairment than women referred for the first time in adulthood (Barkley, 2006;Biederman et al., 2004). No study, however, has explored late adolescent and young adult outcomes of girlhood ADHD Send Correspondence to: Dara Babinski, Center for Children and Families, State University of New York at Buffalo, 106 Diefendorf Hall, 3435 Main Street, Building 20, Buffalo, NY 14214, Phone: 716-829-2244x113; Fax: 716-829-3692;deb24@buffalo.edu . Two longitudinal studies have followed girls with ADHD into adolescence. In one study (Hinshaw, 2002), girls with ADHD (mean age approximately 9 years old) were found to experience more psychopathology, and social, academic, and cognitive impairment than girls without ADHD. After five years (mean age approximately 14 years old), similar problems persisted and new difficulties, including substance use and eating problems, also emerged for girls with ADHD (Hinshaw, Owens...