Recently, I saw a movie in which two kids, about age 10, were walking along a path and the following dialogue ensued:

Young Boy: So what’s new?
Young Girl: I found out I have Adult ADD.
Young Boy: Don’t you mean you have ADD?
Young Girl: Somehow, I got the adult kind.

So what is the difference between “Regular ADD” and “Adult ADD”?

Like many areas in our field, the diagnostic criteria and how the disorder progresses across the lifespan is clear as mud. Researchers have long debated whether ADD is due to a brain “deficit” or rather a “delay” in development. That is, can one grow out of ADD or is it a permanent deficit?

A recent study led by Dr. Philip Shaw at the National Institute of Mental Health may shed some light on this issue. Basically, the researchers compared brain scans from two groups of children: one with Attention Deficit Disorder (ADD) and the other without. The scientists tracked the children from ages 6 to 16, taking multiple scans on each child. They found that on average, certain areas of the ADHD children’s brains developed more slowly that the non-ADHD groups’ brains. The delays were centered in areas of the brain that control higher-order executive functions, such as the regions that suppress inappropriate actions and thoughts, focus attention, remember things from moment to moment, work for reward and control movement. The lag in development in the ADHD group ranged from 3 to 5 years later than their peers. On the positive side, the motor cortex matured faster in the ADHD children, presumably because they are always on the go.

The researchers concluded that ADHD likely involves a delay, and not an abnormal brain. They indicated that about 3 in 4 children do grow out of the problem by early adulthood, but caution that more research is needed to uncover why some kids grow out of it and why some don’t. There were methodological issues present as well, such as 80% of the sample had been on, at some point, stimulant medication. Stay tuned for the next 100 years or so when it is uncovered what the effects of stimulant medication on children are. Brain chemistry and development could not be less complex. Shoot. There goes our parsimonious explanation for why Johnny can’t sit still.

Perhaps my PBS special tonight will shed some light on the matter. Don’t fret. You know I’ll take notes and get back to you.

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