ADHD or Attention-Deficit/Hyperactivity Disorder is a condition that affects an estimated 6 million children in the U.S., but its symptoms often continue into adulthood, presenting new challenges across life stages. ADHD is classified as a complex neurodevelopmental disorder, with symptoms that may present differently across life stages depending on age, environment, and internalized coping mechanisms.
Although primarily associated with childhood, ADHD can become more challenging during adulthood. From hyperactivity and behavioral issues in early childhood to emotional dysregulation and executive dysfunction in adulthood, ADHD requires a developmentally informed, neurodiversity-affirming approach. By understanding how ADHD evolves throughout the lifespan, therapists can be better equipped to assist clients at various stages of their journey
Core Wellness’s course, “ADHD Across the Lifespan,” led by clinical psychologist and ADHD specialist Dr. Amy Marschall, deeply explores how to identify, assess, and support clients of all ages through targeted, neurodiversity-affirming care. This training goes beyond theory, offering practical, evidence-based tools that you can immediately integrate into clinical work with children, adolescents, and adults.
Types of ADHD
According to the DSM-5-TR, ADHD is commonly categorized into three presentations. The form it takes ultimately depends on symptoms observed during diagnosis. These symptoms should have persistently occurred over time and be detectable over a six-month period to confirm the presence of ADHD.
A key diagnostic criterion for ADHD is that symptoms must be present before age 12 and occur in multiple settings—not just at home.
Predominantly Inattentive Presentation
In this form, inattention is the dominant trait and encompasses challenges related to focusing on tasks and activities, inability to follow through on instructions or organize tasks, getting lost in thoughts or losing things, to name a few.
Predominantly Hyperactive-impulsive Presentation
Hyperactivity refers to a tendency towards excessive or uncontrolled movements, while impulsivity refers to thinking and acting without considering its consequences./p
Combined Presentation
This type of ADHD diagnosis involves simultaneously combining criteria for both inattentive and hyperactive/impulse types.
While these categories guide diagnosis, the symptom expression evolves. Hyperactive children may become adults with internal restlessness. Inattentiveness in adults may mimic anxiety or depression, leading to misdiagnosis. A lifespan-informed approach allows for a nuanced clinical picture.
ADHD in Childhood
Generally, ADHD first begins to show signs early in childhood, typically between 3 and 6 years of age. Common signs include limited attention spans, tendencies towards impulsive behavior, and hyperactivity, all of which can impede a child's normal functioning.
- Children with ADHD find it difficult to focus on tasks at hand. These children may struggle in classroom settings that require sustained attention and self-regulation.
- They may also display overly active behavior, such as excessive fidgeting, running, or climbing.
- They are also more likely to become frustrated and are prone to emotional outbursts. This can prevent them from connecting with people and forming friendships.
That’s why early diagnosis is essential so children can acquire foundational skills to manage symptoms effectively over time.
ADHD in Adulthood
If ADHD is not diagnosed in childhood, it can carry over into adulthood, but its symptoms may be masked, and adults may not even be aware that they are affected. For example, while hyperactivity may lessen, adults may continue to experience challenges with attention, memory, and organization.
In adults, ADHD can lead to a persistent inability to engage in conversations and focus during meetings. There is also a heightened tendency to get easily distracted and forget things. It can also cause problems in relationships due to acting impulsively.
Adult ADHD can be overlooked or misdiagnosed. Many adults internalize their symptoms, presenting with chronic overwhelm, difficulty sustaining focus, underachievement, and mood instability. Symptoms may be mistaken for anxiety, depression, or even bipolar disorder.
Why a Lifespan Approach Matters
To determine whether someone has ADHD involves a multi-stage process. There is no single test to confirm that, and it’s important to note that many of its symptoms can be concurrent with other general conditions like anxiety, depression, learning disorders, sleeping problems and thyroid. The symptoms of ADHD can also match those that result from substance use and steroids. This reinforces the need for a comprehensive psychiatric evaluation that includes a person’s past medical and family history, use of checklists and scales, as well as description of symptoms from both individuals and caregivers.
A single diagnosis cannot possibly work in ADHD, as symptoms vary significantly across individuals based on age, environment or level of responsibilities that an individual manages. This explains the need for tailoring therapy support to the particular context and the development stage in which a client is.
- For children, interventions are directed towards altering behaviors, training parents and introducing classroom adjustments to facilitate the child.
- For teens, therapy goals can shift towards nurturing social skills, emotional awareness and assisting them in academics.
- For adults, a combination of cognitive-behavioral therapy and medication comprising psychostimulants (amphetamines and methylphenidate) is regarded as the first-line pharmacological treatment for managing ADHD.
Core Wellness’s ADHD Across the Lifespan course is geared to equip clinicians with practical and evidence-based tools to provide relevant care across the lifespan from childhood through adolescence to adulthood.
Therapy That Works: Strategies for Every Stage of Life
Considering that ADHD evolves across the lifespan, individuals with ADHD must be offered therapeutic support at every age to strengthen their functioning and boost self-awareness. Several well-established modalities have proven to be efficacious in tailoring support for clients across the lifespan. Some effective interventions include:
- Cognitive Behavioral Therapy (CBT)
CBT is recognized as the first line of treatment for ADHD, especially in adolescents and adults. It is an evidence-based strategy that focuses on identifying unhelpful thought patterns and behaviors and working to replace them with positive and constructive ones. For example, a client experiencing self-doubt may have recurring thoughts such as “I’ll never get anything done, or “I am good for nothing”.
CBT seeks to challenge negative thoughts that contribute to ADHD symptoms, like self-criticism, while encouraging clients to set realistic goals and create plans of action to meet them. CBT further teaches practical skills and coping strategies related to managing time, controlling impulses, as well as managing emotional dysregulation, a common symptom of ADHD.
- Solution-Focused Brief Therapy (SFBT)
SFBT emphasizes a shift in focus from the problem itself towards tapping into a client’s existing strengths and abilities. This approach can be particularly supportive for clients with a history of trauma or those feeling overwhelmed by their diagnosis.
During sessions, the therapist encourages the client to envision the future they like for themselves and then helps them identify step-by-step actions to realize their vision. This collaborative approach is best suited for teens and adults to motivate and stimulate them towards working for their goals.
- Client-centered Therapy
ADHD can cause individuals to undergo feelings of shame or rejection from others. This approach looks within the client to uncover the roots of ADHD and offers a safe space where clients feel truly seen and accepted without fear of being judged.
This therapy is rooted in an empathetic approach to build a trust-based relationship between the therapist and client and help clients recover their sense of worth and identity. This therapy can be effective across all ages and used in conjunction with other therapies to provide a solid foundation for promoting growth. /p
Continuing Education for Clinicians
Whether you are a therapist, counselor, or mental health professional, understanding the intricacies of ADHD across the lifespan is key to formulating the right diagnosis and treatment. The Core Wellness’s course is led by Dr. Amy Marschall, a licensed psychologist who specializes in diagnosing and treating ADHD across the lifespan.
Having been diagnosed with ADHD as an adult, Dr. Marschall draws upon both her personal experience and professional expertise to offer you the tools and skills to empower your clients at every stage of life.
Key highlights of this course
- A breakdown of symptoms to distinguish ADHD from co-occurring conditions like anxiety, depression, and trauma to promote accurate diagnosis.
- Research-based intervention techniques for diverse ADHD clients like children, teens and adults.
- Guidance in formulating appropriate treatment plans tailored to each ADHD client’s symptoms and age.
Final Thoughts
Navigating life with ADHD can present unique challenges in different ways across the lifespan. It is crucial to understand the diversity in ADHD cases for an early and accurate diagnosis so that individuals don’t have to bear the burden of ADHD throughout life. This involves providing the right and ongoing support to people with ADHD so they are supported not just to cope, but to thrive.
By combining therapy with education and empathy, therapists can enable clients to conquer the condition successfully and lead fulfilling lives.
At Core Wellness, we are driven to reduce stigma around ADHD and expand knowledge of therapists to help them deliver compassionate care for all ages. Explore our live and on-demand courses on ADHD to take the first step towards professional development and bring lasting change to your client’s life.
