Science for Society: ADHD Across the Lifespan: Developmental and Cultural Insights

Much of the research and treatment of attention deficit hyperactivity disorder (ADHD) from previous years has focused on an individual’s childhood, but researchers and practitioners are now broadening their scope to better understand ADHD across the lifespan.  

In this webinar, presenters share findings and best practices to expand the treatment of ADHD across different ages and cultural contexts.  

Nicholas Aderinto, a physician from the Ladoke Akintola University of Technology’s Teaching Hospital in Nigeria, began the presentation with a summary of ADHD prevalence in the African continent. Across Africa, ADHD is estimated to be 7.5% among children and adolescents and 1.5% for the general population.  

However, because of a lack of resources as well as other factors, “there is an underreporting of this condition,” Aderinto said.  

Though signs of ADHD typically begin to appear before age 4, individuals are often not diagnosed until ages 6 to 12, because early symptoms overlap with behaviors that are seen as developmentally typical for younger children.  

Aderinto emphasized that ADHD treatment across the lifespan has been associated with better outcomes for education, employment, and personal relationships, but cultural factors in African contexts sometimes make early identification and treatment difficult.  

“In most areas where I practice, it is difficult to convince that it’s not a supernatural cause,” Aderinto said.  

Additional challenges include cultural stigma, a lack of culturally validated tools, and difficulty accessing medication in rural areas. 

Joy Banks, an associate professor of education and human development at George Mason University, has focused her research on ADHD in the United States around two questions: Who is diagnosed more? And who receives treatment? 

While about 10% of U.S. children and adolescents are diagnosed with ADHD overall, large variances are seen in the number diagnosed within specific demographic categories, especially race, ethnic background, and gender.  

For example, 10.5% of young Black Americans receive the diagnosis, compared to only 2.7% of young Asian Americans. Males are also twice as likely as females to be diagnosed.  

One factor contributing to these differences is teacher bias. “We see teachers referring students who are Black or African American more frequently than we do other students in the classroom,” Banks explained.  

To address this, Banks walked through ways educators can become more aware of cultural differences in the classroom, including a practice called cultural humility.  

“When we think about cultural humility, it is a lifelong commitment to self-evaluation and self-critique to address some of the power imbalances that occur between professionals and students and their families,” she said.  

Hong Bui, a clinical psychology PhD candidate at the University of Maryland, addressed major gaps in identifying and treating ADHD across the lifespan.  

“Historically it has been considered to be a childhood disorder that an individual might outgrow once they reach adulthood,” she said. “However, now it’s widely understood that ADHD is a disorder that persists into adulthood.” 

Bui’s research has focused on identifying risk factors in early childhood through adolescence. She described a 2024 study, which focused on exuberance as an early predictor for ADHD. Bui and her team found that children who displayed higher exuberance and whose parents were less directive saw an increase in ADHD between ages 5 to 9 (Lorenzo et al., 2024).   

In addition to identifying ADHD early on, Bui said it is important to continue to monitor ADHD symptoms into early adulthood. As individuals become adults, mental health treatment is often pursued less frequently, leading to challenges for those with ADHD symptoms and their families.  

“We really need to consider how to redesign or better coordinate longitudinal care for ADHD,” Bui said, suggesting early and continuous screenings as one option.  

Reference 

Lorenzo, N. E., Bui, H. N., Degnan, K. A., McDermott, J. M., Henderson, H. A., Fox, N. A., & Chronis-Tuscano, A. (2024). The Developmental Unfolding of ADHD Symptoms from Early Childhood Through Adolescence: Early Effects of Exuberant Temperament, Parenting and Executive Functioning. Research on Child and Adolescent Psychopathology, 52(4), 621-634.