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Cited by 75Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentDevelopmental and Educational Neuropsychology

Implications of Early Versus Late Onset of Attention-Deficit/Hyperactivity Disorder Symptoms

WILLOUGHBY, MICHAEL T., CURRAN, PATRICK J., COSTELLO, E. JANE, ANGOLD, ADRIAN·2000·Journal of the American Academy of Child & Adolescent Psychiatry
DOI 10.1097/00004583-200012000-00013
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Abstract

Objective The current diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) require that symptoms emerge prior to age 7 in order for a formal diagnosis to be considered. However, this age-of-onset criterion (AOC) has recently been questioned on both theoretical and empirical grounds.Method Data from 4 annual waves of interviews with 9- to 16-year-olds from the Great Smoky Mountains Study were analyzed.Results Confirming previous studies, a majority of youths who had enough symptoms to meet criteria for ADHD were reported to have first exhibited these symptoms prior to age 7. Early onset of ADHD symptoms was associated with worse clinical outcomes in youths with the combined subtype of ADHD but not youths with the inattentive subtype.Conclusions Findings support the continued inclusion of the AOC for the assessment of the combined but not necessarily the inattentive subtype of ADHD. Too few youths had a late onset of solely hyperactive-impulsive symptoms to evaluate the AOC for that group. However, regardless of the age of onset, youths who had elevated levels of ADHD symptoms were at increased risk for negative outcomes that may necessitate intervention.

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  • The inattentive type of ADHD is characterised by a later onset of impairment, and inattentive symptoms may have been missed in the pre-school years and impairment may not have been noticed or reported until the age of secondary school.

    “This may be particularly important in relation to the inattentive type which is characterised by a later onset of impairment [172,174,188], as the inattentive symptoms may have been missed in the pre-school years and impairment may not have been noticed or reported until the age of secondary school.”

    From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [188]

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Authors
WILLOUGHBY, M. T., CURRAN, P. J., COSTELLO, E. J., & ANGOLD, A.
Affiliations
University of North Carolina at Chapel Hill (US)
Corresponding author
WILLOUGHBY, MICHAEL T.
ORCID
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2000-12
Volume
39
Issue
12
Pages
1512-1519
ISSN
0890-8567 (ISSN-L)
DOI
10.1097/00004583-200012000-00013
OpenAlex
W2154759148
Cited by
75
References
32
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2021: 1 · 2019: 2 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 3 · 2013: 1 · 2012: 5
FWCI
1.17
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute of Mental Health (R01MH048085, MH-48085)
  • National Institute on Drug Abuse (DA 11301, R01DA013148, DA13148)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
attention deficit hyperactivity disorder, age of onset, late-onset ADHD, diagnostic criteria, combined subtype, inattentive subtype, hyperactive-impulsive symptoms, clinical outcomes, youth, Great Smoky Mountains Study
MeSH terms
Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Male, North Carolina, Prognosis, Cohort Studies, Likelihood Functions, Matched-Pair Analysis, Age of Onset

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