Journal of Abnormal Child Psychology

, Volume 45, Issue 4, pp 765–776

Clinical, Sociobiological, and Cognitive Predictors of ADHD Persistence in Children Followed Prospectively Over Time

  • Tara McAuley
  • Jennifer Crosbie
  • Alice Charach
  • Russell Schachar


With increasing awareness that ADHD is chronically disabling, a burgeoning literature has examined childhood clinical indicators of ADHD persistence. This study investigates whether childhood factors reflecting biological risk and cognitive reserve have additive predictive value for the persistence of ADHD that is unique beyond childhood indicators of disorder severity. One-hundred thirty children with ADHD (mean age = 8.9 years, 75 % male) were followed into adolescence (mean age = 14.0 years). Childhood ADHD and co-morbidities were assessed via interviews with parents and teachers; parental psychopathology was assessed via parent interview; exposure to neurobiological and psychosocial adversity were indexed by parent questionnaire; and cognitive reserve was evaluated through children’s performance on measures of IQ and executive functioning. Univariate analyses identified childhood inattention and hyperactivity-impulsivity, co-morbid oppositional defiant disorder, overall impairment, and paternal anxiety and depression as more prevalent amongst adolescents with persistent compared with remitted ADHD. Only child-level predictors remained significant in a final multivariate model. These results suggest that children who are most likely to experience persistent ADHD have a more severe clinical presentation in childhood, reflected by increased levels of inattention, oppositional behavior, and impairment. They also are more likely to have fathers with internalizing concerns, but these concerns do not uniquely predict ADHD persistence beyond child-level factors. Contrary to expectations, childhood adversity and cognitive functioning did not predict the course of ADHD.


Attention-deficit/hyperactivity-impulsivity Executive function Psychosocial Neurobiological Clinical outcome Youth 


  1. Association, A. P. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  2. Baddeley, A. (1992). Working memory. Science, 255, 556–559.Google Scholar
  3. Banaschewski, T., Becker, K., Scherag, S., Franke, B., & Coghill, D. (2010). Molecular genetics of attention-deficit/hyperactivity disorder: an overview. European Child & Adolescent Psychiatry, 19, 237–257.CrossRefGoogle Scholar
  4. Bedard, A. C., Trampush, J. W., Newcorn, J. H., & Halperin, J. M. (2010). Perceptual and motor inhibition in adolescents/young adults with childhood-diagnosed ADHD. Neuropsychology, 24, 424–434.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Berlin, L., Bohlin, G., & Rydell, A. (2003). Relations between inhibition, executive functioning, and ADHD-symptoms: A longitudinal study from age 5 to 8. Child Neuropsychology, 9, 55–65.Google Scholar
  6. Biederman, J., Milberger, S., Faraone, S. V., Kiely, K., Guite, J., Mick, E., et al. (1995). Family-environment risk factors for attention-deficit hyperactivity disorder: a test of Rutter’s indicators of adversity. Archives of General Psychiatry, 52, 464–470.CrossRefPubMedGoogle Scholar
  7. Biederman, J., Faraone, S., Milberger, S., Curtis, S., Chen, L., Marrs, A., et al. (1996). Predictors of persistence and remission of ADHD into adolescence: results from a four-year prospective follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 343–351.CrossRefGoogle Scholar
  8. Biederman, J., Petty, C. R., Evans, M., Small, J., & Faraone, S. V. (2010). How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD. Psychiatry Research, 177, 299–304.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Biederman, J., Petty, C. R., Clarke, A., Lomedico, A., & Faraone, S. V. (2011). Predictors of persistent ADHD: An 11-year follow-up study. Journal of Psychiatric Research, 45, 150–155.CrossRefPubMedGoogle Scholar
  10. Biederman, J., Petty, C. R., O’Connor, K. B., Hyder, L. L., & Faraone, S. V. (2012). Predictors of persistence in girls with attention deficit hyperactivity disorder: results from an 11-year controlled follow-up study. Acta Psychiatrica Scandinavica, 125, 147–156.CrossRefPubMedGoogle Scholar
  11. Bird, H. R., Yager, T. J., Staghezza, B., Gould, M. S., Canino, G., & Rubio-Stipec, M. (1990). Impairment in the epidemiological measurement of childhood psychopathology in the community. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 796–803.CrossRefPubMedGoogle Scholar
  12. Blanz, B., Schmidt, M. H., & Esser, G. (1991). Familial adversities and child psychiatric disorders. Journal of Child Psychology and Psychiatry, 32, 939–950.CrossRefPubMedGoogle Scholar
  13. Boyle, M. H., Offord, D. R., Hofmann, H. G., Catlin, G. P., Byles, J. A., Cadman, D. T., et al. (1987). Ontario child health study: I. Methodology. Archives of General Psychiatry, 44, 826–831.CrossRefPubMedGoogle Scholar
  14. Bradley, R. H., & Corwyn, R. F. (2002). Socioeconomic status and child development. Annual Review of Psychology, 53, 371–399.CrossRefPubMedGoogle Scholar
  15. Brown, T.M., Ris, M.D., Beebe, D., Ammerman, R.T., Oppenheimer, S.G., Yeates, K.O., & Enrile, B.G. (2008). Factors of biological risk and reserve associated with executive behaviors in children and adolescents with spina bifida myelomeningocele. Child Neuropsychology, 14, 118–134.Google Scholar
  16. Charil, A., Laplante, D. P., Vaillancourt, C., & King, S. (2010). Prenatal stress and brain development. Brain Research Rreviews, 65, 56–79.CrossRefGoogle Scholar
  17. Coghill, D., Hayward, D., Rhodes, S., Grimmer, C., & Matthews, K. (2014). A longitudinal examination of neuropsychological and clinical functioning in boys with attention deficit hyperactivity disorder (ADHD): improvements in executive functioning do not explain clinical improvement. Psychological Medicine, 44, 1087–1099.CrossRefPubMedGoogle Scholar
  18. Dennis, M., Spiegler, B. J., & Hetherington, R. (2000). New survivors for the new millennium: cognitive risk and reserve in adults with childhood brain insults. Brain and Cognition, 42, 102–105.CrossRefPubMedGoogle Scholar
  19. Faraone, S. V., Biederman, J., & Monuteaux, M. C. (2000). Toward guidelines for pedigree selection in genetic studies of attention deficit hyperactivity disorder. Genetic Epidemiology, 18, 1–16.CrossRefPubMedGoogle Scholar
  20. Faraone, S. V., Biederman, J., & Mick, E. (2006). The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychological Medicine, 36, 159–165.CrossRefPubMedGoogle Scholar
  21. Faul, F., Edfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191.CrossRefPubMedGoogle Scholar
  22. Frazier, T. W., Demaree, H. A., & Youngstrom, E. A. (2004). Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. Neuropsychology, 18, 543–555.CrossRefPubMedGoogle Scholar
  23. Gunnar, M., & Quevedo, K. (2007). The neurobiology of stress and development. Annual Review of Psychology, 58, 145–173.CrossRefPubMedGoogle Scholar
  24. Halperin, J. M., Trampush, J. W., Miller, C. J., Marks, D. J., & Newcorn, J. H. (2008). Neuropsychological outcome in adolescents/young adults with childhood ADHD: profiles of persisters, remitters and controls. Journal of Child Psychology and Psychiatry, 49, 958–966.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Harnishfeger, K. K. (1995). The development of cognitive inhibition. Interference and inhibition in cognition. San Diego: Academic Press.Google Scholar
  26. Hart, E. L., Lahey, B. B., Loeber, R., Applegate, B., Green, S. M., & Frick, P. J. (1995). Developmental change in attention-deficit hyperactivity disorder in boys: a four-year longitudinal study. Journal of Abnormal Child Psychology, 23, 729–749.CrossRefPubMedGoogle Scholar
  27. Harvey, E., Danforth, J. S., McKee, T. E., Ulaszek, W. R., & Friedman, J. L. (2003). Parenting of children with attention-deficit/hyperactivity disorder (ADHD): the role of parental ADHD symptomatology. Journal of Attention Disorders, 7, 31–42.CrossRefPubMedGoogle Scholar
  28. Hoagwood, K. E., Jensen, P. S., Arnold, L. E., Roper, M., Severe, J., Odbert, C., et al. (2004). Reliability of the services for children and adolescents–parent interview. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 1345–1354.CrossRefGoogle Scholar
  29. Hosmer, D. W., & Lemeshow, S. (2000). Applied logistic regression (2nd ed.). New York: Wiley.CrossRefGoogle Scholar
  30. Hurtig, T., Ebeling, H., Taanila, A., Miettunen, J., Smalley, S. L., McGough, J. J., et al. (2007). ADHD symptoms and subtypes: relationship between childhood and adolescent symptoms. Journal of the American Academy of Child & Adolescent Psychiatry, 46, 1605–1613.CrossRefGoogle Scholar
  31. Ickowicz, A., Schachar, R., Sugarman, R., Chen, S., Millette, C., & Cook, L. (2006). The parent interview for child symptoms (PICS): a situation-specific clinical research interview for attention deficit hyperactivity and related disorders. Canadian Journal of Psychiatry, 50, 325–328.CrossRefGoogle Scholar
  32. Jensen, P. S., Hoagwood, K. E., Roper, M., Arnold, L. E., Odbert, C., Crowe, M., et al. (2004). The services for children and adolescents–parent interview: development and performance characteristics. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 1334–1344.CrossRefGoogle Scholar
  33. Johnston, C., & Mash, E. J. (2001). Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clinical Child and Family Psychology Review, 4, 183–207.CrossRefPubMedGoogle Scholar
  34. Kaplan, E., Fein, D., Kramer, J., Delis, D., & Moris, R. (1999). WISC-III as a Process Instrument. San Antonio: The Psychological Corporation.Google Scholar
  35. Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988.CrossRefPubMedGoogle Scholar
  36. Kessler, R. C., Adler, L. A., Barkley, R., Biederman, J., Conners, C. K., Faraone, S. V., et al. (2005). Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood: results from the national comorbidity survey replication. Biological Psychiatry, 57, 1442–1451.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Kofler, M. J., Rapport, M. D., Sarver, D. E., Raiker, J. S., Orban, S. A., Friedman, L. M., & Kolomeyer, E. G. (2013). Reaction time variability in ADHD: a meta-analytic review of 319 studies. Clinical Psychology Review, 33, 795–811.CrossRefPubMedGoogle Scholar
  38. Krain, A. L., & Castellanos, F. X. (2006). Brain development and ADHD. Clinical Psychology Review, 26, 433–444.CrossRefPubMedGoogle Scholar
  39. Kuntsi, J., Rijsdijk, F., Ronald, A., Asherson, P., & Plomin, R. (2005). Genetic influences on the stability of attention-deficit/hyperactivity disorder symptoms from early to middle childhood. Biological Psychiatry, 57, 647–654.CrossRefPubMedGoogle Scholar
  40. Lara, C., Fayyad, J., De Graaf, R., Kessler, R. C., Aguilar-Gaxiola, S., Angermeyer, M., et al. (2009). Childhood predictors of adult attention-deficit/hyperactivity disorder: results from the World Health Organization world mental health survey initiative. Biological Psychiatry, 65, 46–54.CrossRefPubMedGoogle Scholar
  41. Larsson, J., Larsson, H., & Lichtenstein, P. (2004). Genetic and environmental contributions to stability and change of ADHD symptoms between 8 and 13 years of age: a longitudinal twin study. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 1267–1275.Google Scholar
  42. Lipszyc, J., & Schachar, R. (2010). Inhibitory control and psychopathology: a meta-analysis of studies using the stop signal task. Journal of the International Neuropsychological Society, 16, 1064–1076.CrossRefPubMedGoogle Scholar
  43. Logan, G. D., Cowan, W. B., & Davis, K. A. (1984). On the ability to inhibit simple and choice reaction time responses: a model and a method. Journal of Experimental Psychology: Human Perception and Performance, 10, 276–291.PubMedGoogle Scholar
  44. Martinussen, R., Hayden, J., Hogg-Johnson, S., & Tannock, R. (2005). A meta-analysis of working memory impairments in children with Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 377–384.CrossRefGoogle Scholar
  45. McAuley, T., Crosbie, J., Charach, A., & Schachar, R. (2014). The persistence of cognitive deficits in remitted and unremitted ADHD: a case for the state-independence of response inhibition. Journal of Child Psychology and Psychiatry, 55, 292–300.CrossRefPubMedGoogle Scholar
  46. Mick, E., Byrne, D., Fried, R., Monuteaux, M., Faraone, S. V., & Biederman, J. (2011). Predictors of ADHD persistence in girls at 5-year follow-up. Journal of Attention Disorders, 15, 183–192.CrossRefPubMedGoogle Scholar
  47. Murphy, K., & Barkley, R. A. (1996). Attention deficit hyperactivity disorder adults: comorbidities and adaptive impairments. Comprehensive Psychiatry, 37, 393–401.CrossRefPubMedGoogle Scholar
  48. Nigg, J. T. (2000). On inhibition/disinhibition in developmental psychopathology: views from cognitive and personality psychology and a working inhibition taxonomy. Psychological Bulletin, 126, 220–246.CrossRefPubMedGoogle Scholar
  49. Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The worldwide prevalence of ADHD: a systematic review and metaregression analysis. The American Journal of Psychiatry, 164, 942–948.CrossRefPubMedGoogle Scholar
  50. Riggs, N. R., Blair, C. B., & Greenberg, M. T. (2004). Concurrent and 2-year longitudinal relations between executive function and the behavior of 1st and 2nd grade children. Child Neuropsychology, 9, 267–276.CrossRefGoogle Scholar
  51. Roussotte, F., Soderberg, L., & Sowell, E. (2010). Structural, metabolic, and functional brain abnormalities as a result of prenatal exposure to drugs of abuse: evidence from neuroimaging. Neuropsychology Review, 20, 376–397.CrossRefPubMedPubMedCentralGoogle Scholar
  52. Rutter, M., Cox, A., Tupling, C., Berger, M., & Yule, W. (1975). Attainment and adjustment in two geographical areas. I--The prevalence of psychiatric disorder. The British Journal of Psychiatry, 126, 493–509.CrossRefPubMedGoogle Scholar
  53. Satz, P. (1993). Brain reserve capacity on symptom onset after brain injury: a formulation and review of evidence for threshold theory. Neuropsychology, 7, 273.CrossRefGoogle Scholar
  54. Scahill, L., Schwab-Stone, M., Merikangas, K. R., Leckman, J. F., Zhang, H., & Kasl, S. (1999). Psychosocial and clinical correlates of ADHD in a community sample of school-age children. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 976–984.CrossRefGoogle Scholar
  55. Schmiedek, F., Oberauer, K., Wilhelm, O., Süß, H., & Wittmann, W. W. (2007). Individual differences in components of reaction time distributions and their relations to working memory and intelligence. Journal of Experimental Psychology: General, 136, 414–429.CrossRefGoogle Scholar
  56. Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H., & Aluwahlia, S. (1983). A children’s global assessment scale (CGAS). Archives of General Psychiatry, 40, 1228–1231.CrossRefPubMedGoogle Scholar
  57. Sprich-Buckminster, S., Biederman, J., Milberger, S., Faraone, S. V., & Lehman, B. K. (1993). Are perinatal complications relevant to the manifestation of ADD? Issues of comorbidity and familiality. Journal of the American Academy of Child & Adolescent Psychiatry, 32, 1032–1037.CrossRefGoogle Scholar
  58. Swanson, J., Baler, R. D., & Volkow, N. D. (2011). Understanding the effects of stimulant medications on cognition in individuals with attention-deficit hyperactivity disorder: a decade of progress. Neuropsychopharmacology, 36, 207–226.CrossRefPubMedGoogle Scholar
  59. Tannock, R., Hum, M., Masellis, M., Humphries, T., & Schachar, R. (2002). Teacher Telephone Interview for children’s academic performance, attention, Behavior, and learning: DSM-IV Version (TTI-IV). Toronto: The Hospital for Sick Children.Google Scholar
  60. Taylor, E., & Rogers, J. W. (2005). Practitioner review: early adversity and developmental disorders. Journal of Child Psychology and Psychiatry, 46, 451–467.CrossRefPubMedGoogle Scholar
  61. Thapar, A., Langley, K., Owen, M. J., & O’Donovan, M. C. (2007). Advances in genetic findings on attention deficit hyperactivity disorder. Psychological Medicine, 37, 1681–1692.CrossRefPubMedGoogle Scholar
  62. Thapar, A., Cooper, M., Eyre, O., & Langley, K. (2013). Practitioner review: what have we learnt about the causes of ADHD? Journal of Child Psychology and Psychiatry, 54, 3–16.CrossRefPubMedPubMedCentralGoogle Scholar
  63. Thompson, R. J., Goldstein, R. F., Oehler, J. M., Gustafson, K. E., Catlett, A. T., & Brazy, J. E. (1994). Developmental outcome of very low birth weight infants as a function of biological risk and psychosocial risk. Journal of Developmental & Behavioral Pediatrics, 15, 232–238.CrossRefGoogle Scholar
  64. Thorell, L. B., & Wahlstedt, C. (2006). Executive functioning deficits in relation to symptoms of ADHD and/or ODD in preschool children. Infant and Child Development, 15, 503–518.CrossRefGoogle Scholar
  65. Toplak, M. E., West, R. F., & Stanovich, K. E. (2013). Practitioner Review: Do performance-based measures and ratings of executive function assess the same construct? Journal of Child Psychology and Psychiatry, 54, 131–143.CrossRefPubMedGoogle Scholar
  66. van Lieshout, M., Luman, M., Buitelaar, J., Rommelse, N., & Oosterlaan, J. (2013). Does neurocognitive functioning predict future or persistence of ADHD? A systematic review. Clinical Psychology Review, 33, 539–560.CrossRefPubMedGoogle Scholar
  67. Wechsler, D. (1991). Wechsler intelligence scale for children (3rd ed.). San Antonio: Harcourt Assessment.Google Scholar
  68. West, R., Murphy, K. J., Armilio, M. L., Craik, F. I., & Stuss, D. T. (2002). Lapses of intention and performance variability reveal age-related increases in fluctuations of executive control. Brain and Cognition, 49, 402–419.CrossRefPubMedGoogle Scholar
  69. Young, S. (2000). ADHD children grown up: an empirical review. Counselling Psychology Quarterly, 13, 191–200.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Tara McAuley
    • 1
  • Jennifer Crosbie
    • 2
  • Alice Charach
    • 2
  • Russell Schachar
    • 2
  1. 1.Department of Psychology, Centre for Mental Health ResearchUniversity of WaterlooWaterlooCanada
  2. 2.Department of Psychiatry ResearchHospital for Sick ChildrenTorontoCanada

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