Jefferson Prince, MD, Thomas A. M. Kramer, MD, Jane Feldman, MD


March 26, 2003

In This Article

Adolescent Patients With ADHD Pose Special Challenges to Their Families

Since adolescence is a period of great growth and development, adolescents with ADHD pose special challenges to their families. All adolescents are expected to form their own identity during this time of life by individuating from their parents/families, becoming sexually mature, developing closer peer relationships, and planning for the future. In addition to their ADHD symptoms, adolescents with ADHD often have problems with executive functions that adversely affect their normative development. First, these adolescents often have poor nonverbal working memory, which may compromise their ability to stay on task and to problem solve. Second, they have poor verbal working memory, which may hinder their ability to "learn from their mistakes," something that frustrates parents of non-ADHD adolescents. Third, their ADHD will likely make them more prone to experience difficulties regulating their affects and emotions. They are often intense and have poor control over their feelings, which, when combined with their impulsivity, frequently causes difficulties at home and with peers. Therefore, just at the time that parents are often expecting (hoping) that the adolescent will "grow up," the ADHD adolescent lags behind in development. This lag, contrasted with other aspects of normal development, can easily precipitate family conflict. Last, adolescents with ADHD often distort parental limitations and experience them as overly burdensome, again leading to family stress.

These cognitive difficulties associated with ADHD may necessitate delaying or slowing down normal developmental achievements. For instance, while adolescent drivers are more prone to accidents, adolescents (and adults) with ADHD drive more poorly compared with their non-ADHD peers. Parents may need to delay adolescents with ADHD from getting their licenses until their cognitive development has progressed and they mature.