Do the symptoms of ADHD change as children mature?

Yes. Although some symptoms persist, many symptoms of ADHD change with development. For example, hyperactivity diminishes in some children after elementary school. Many people think that the hormonal changes of puberty are responsible for this, although we do not understand the mechanism. Older children may have either outgrown their hyperactivity or found ways in which to channel it. A sense of inner restlessness may replace the hyperactivity. In the preteen and adolescent years, poor grades, inability to sustain attention, difficulties in maintaining social relationships, disorganization, and risk-taking behavior may surface as primary symptoms. At school, ADHD may show up more as written work becomes increasingly complex and a teenager is required to plan ahead for long-term assignments. Socially, the range of accepted behavior in many ways is narrowed by the unwritten rules of a teenager’s peer group. The difficulties with emotional self-control and interpersonal communication common in ADHD makes these teenagers appear more immature and clumsy among their peers. Their impulsivity may cause them to blurt out answers inappropriately or to interrupt conversations. They can become disruptive in the classroom or even be perceived as the “class clown.” This can result in peer rejection and subsequent distress in ADHD children.