What was your childhood like?
It’s a question that mental health professionals stereotypically ask, and if you go in to get evaluated for ADHD, it’s a question they probably will ask.
That’s because the DSM, the handbook commonly used to diagnose ADHD, requires that some symptoms show up by age 12. The idea of adult-onset ADHD remains controversial.
When you’re seeking a diagnosis during your childhood or early teenage years, looking for signs of ADHD that appeared before age 12 won’t necessarily be much of a problem. But as you enter adulthood, memories from childhood start to get fuzzier, and it can become difficult to go back a reconstruct a record of possible ADHD symptoms that far back.
I was diagnosed with ADHD in college. I can think back to my teachers and parents complaining that I wouldn’t sit still, or to an ongoing pattern of careless mistakes in school, but how valuable are these memories, in clinical terms, for evaluating my ADHD symptoms as an adult?
At least one recently published study suggests that they should be viewed with caution. Researchers tracked 3,810 people from birth, evaluating them for childhood ADHD symptoms at age 11. At age 22, the people were asked to recall their childhood ADHD symptoms, and their accuracy was only about 55 percent.
The takeaway isn’t that memories of childhood ADHD symptoms are worthless. At the very least, it’s interesting to think about how symptoms that first showed up when we were young developed over time to affect our lives the way they do today.
In terms of diagnosis, though, childhood recollections might not be as useful as more recent information about potentially ADHD-related behaviors. If someone has consistently had ADHD symptoms that have caused them problems as an adult and don’t have another explanation, not being able to go through and tell you which DSM criteria they checked off when they were kids shouldn’t disqualify them from being diagnosed.
Besides the passage of time, another reason recall of childhood ADHD symptoms is apparently suspect might just be the fact that so much changes from childhood to adulthood. Adulthood brings all sorts of new responsibilities, challenges, and opportunities. What inattention and hyperactivity look like in that context are very different from what they look like in childhood, and it’s not always obvious how to connect the dots across these different life stages.
I don’t think we should just throw up our hands and ignore our memories of possible ADHD symptoms from childhood. Those memories can have a story to tell us about how ADHD has shaped the course of our lives.
It’s just that when it comes to diagnosing and treating ADHD, we need to recognize that it’s not always possible to put recollections of childhood mental health symptoms in context decades after the fact. For practical purposes, symptoms in adulthood probably tell us most of what we need to know.
Image: Flickr/Cheryl Oakes