Investigating late-onset ADHD: a population cohort investigation

Miriam Cooper, Gemma Hammerton, Stephen Collishaw, Kate Langley, Ajay Thapar, Soren Dalsgaard, Evie Stergiakouli, Kate Tilling, George Davey Smith, Barbara Maughan, Michael C O'Donovan, Anita Thapar, Lucy Riglin

Research output: Contribution to journalArticle (Academic Journal)peer-review

40 Citations (Scopus)
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Adult ADHD has been assumed to be a continuation of childhood-onset ADHD. However, recent studies have identifies individuals with ADHD in adulthood who have not had ADHD in childhood. Whether or not these individuals have a 'typical' neurodevelopmental profile is not clear.

We tested two explanations for the emergence of apparent late-onset ADHD symptomatology using the ALSPAC epidemiological cohort, by grouping individuals according to their scores on the Strengths and Difficulties Questionnaire (SDQ) hyperactivity subscale at ages 12 and 17 years. First, we tested whether some of those with apparent late-onset ADHD symptoms had been potentially misclassified on the basis of earlier SDQ hyperactivity scores (ages 7,8 and 9 years) or of subthreshold symptoms at age 12 years. Second, we investigated the possibility that those with 'genuine' late-onset ADHD symptoms, by investigating whether they had a similar profile if neurodevelopmental impairments (in the domains of autistic symptomatology, language, reading, spelling, executive functioning and IQ) as those with typical childhood-onset ADHD.

N=56/75 (75%) of those with apparent late-onset ADHD had had high ADHD scores at at least one point in childhood, suggesting that they may have been misclassified on the basis of their score at age 12 years. The remaining 19 individuals (25%) with genuine late-onset ADHD symptoms did not show a profile of neurodevelopmental impairment typically seen in ADHD, instead showing similar levels of autistic symptoms, language skills, executive functioning ability and IQ to those without ADHD symptoms. The only exceptions were that this group showed reading and spelling problems at age 9 years.

Our work suggests that this small number of individuals with genuine late-onset symptoms may not be most appropriately considered as having typical neurodevelopmental disorder.
Original languageEnglish
Pages (from-to)1105-1113
Number of pages9
JournalJournal of Child Psychology and Psychiatry
Issue number10
Early online date23 Apr 2018
Publication statusPublished - 1 Oct 2018


  • Avon Longitudinal Study of Parents and Children
  • Late-onset ADHD
  • neurodevelopment
  • Strengths and Difficulties Questionnaire


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