ADHD through the years: How symptoms change from childhood to adulthood

Dubai: A child keeps getting out of their seat in class. Another stares out of the window, seemingly lost in thought, while the rest of the class follows the lesson. Years later, a teenager struggles to organise revision for exams, or an adult repeatedly misses deadlines despite trying hard to stay on top of work.

These situations may seem unrelated. But for some people, they can reflect different ways attention deficit hyperactivity disorder (ADHD) affects everyday life.

ADHD is a neurodevelopmental condition that affects attention, impulse control, and the ability to organise and manage tasks. Although it often begins in childhood, its signs can change with age, making it difficult to recognise, particularly when a person does not display the hyperactivity commonly associated with the condition.

For families in the UAE, understanding these differences can be an important first step towards seeking help. Psychologists say misconceptions about behaviour, concerns about stigma, and the cost of assessment can all stand in the way of timely support.

For younger children, the signs of ADHD can become noticeable between the ages of three and six, according to Carolyn Yaffe, counsellor and cognitive behaviour therapist at Medcare Camali Clinic.

A child may struggle to concentrate, become easily distracted, talk excessively, appear restless, or act before thinking. These behaviours can become more apparent when children enter school and are expected to sit through lessons, follow instructions, and complete tasks within a set time.

But how can parents distinguish between ordinary childhood restlessness and difficulties that may need professional attention? Yaffe has noted that awareness is key. Behaviours that appear to be a lack of discipline may instead reflect difficulties with attention and impulse control.

“ADHD is a neurodevelopmental condition, not simply a matter of behaviour or a lack of discipline. It affects a child’s ability to focus, manage impulses, and regulate activity levels, and can influence learning, behaviour, and social interactions,” Yaffe told Gulf News.

She has warned against assuming that all children with ADHD behave in the same way. While some signs are readily noticeable, others can be subtler.

Girls, for instance, may experience difficulties with concentration, learning, or social interactions without displaying the more obvious hyperactivity often associated with ADHD. This can mean their challenges are overlooked.

Parents, teachers, and caregivers need to understand how the condition can present differently from one child to another. Rather than jumping to conclusions about behaviour, families should observe persistent difficulties, communicate with their child’s school, and seek professional guidance when concerns arise.

The aim is not to label a child, but to understand what they may be struggling with and provide appropriate support at home, in the classroom, and in social settings.

Not every child with ADHD is the one disrupting the lesson. Some may sit quietly, appear distracted, and rarely draw attention to themselves.

Zobia Amin, clinical psychologist at RAK Hospital, has bared that this is one of the reasons ADHD can be missed.

“Some children, particularly those with predominantly inattentive symptoms, may appear quiet, distracted, or dreamy rather than disruptive,” described Amin.

Because these children may not interrupt lessons or display obvious hyperactivity, their difficulties can go unnoticed. They may still struggle to remember instructions, keep track of belongings, or complete schoolwork.

As children grow into their teenage years, the challenges can take a different form. Managing several subjects, meeting deadlines, studying independently, and navigating relationships may become increasingly difficult. Physical restlessness may be less obvious, while disorganisation, procrastination, and problems regulating emotions become more prominent. 

“These challenges can be mistakenly attributed to laziness, poor discipline, excessive screen time, or the normal turbulence of adolescence.”

In adulthood, the difficulties may become woven into everyday routines. Managing household responsibilities, keeping appointments, organising finances, and balancing work with family life can require considerable effort. Some adults may experience chronic overwhelm, impulsive decisions, or inconsistent performance.

Importantly, Amin has stressed that ADHD does not suddenly develop in adulthood, even if it is diagnosed for the first time later in life.

“A person who did not have ADHD symptoms in childhood, even when their history is explored through an interview, might have anxiety or any other issues with similar symptoms, but it cannot be ADHD.”

Support should be tailored to each individual’s needs and may include psychological assessment and therapy, family support, medication when appropriate, and adjustments at school or work.

Recognising the signs is only part of the challenge. For some families and adults in the UAE, seeking an assessment can bring concerns about cost, stigma, and what a diagnosis might mean for the future.

Vinusha Kandaswamy, clinical psychologist at Prime Hospital, has pointed out that ADHD affects executive functioning, the mental skills that help people plan, organise, manage time, and complete tasks.

In adults, symptoms such as forgetfulness, procrastination, poor concentration, and missed deadlines may be attributed to stress, anxiety, depression, or sleep problems. Some people also develop coping strategies that mask their difficulties, delaying recognition of the condition.

Kandaswamy has mentioned that ADHD has a strong genetic component and is a recognised neurodevelopmental condition, not the result of poor parenting or a lack of effort.

Yet misconceptions persist. Parents may fear their child will be labelled, while adults may worry about judgement at work or in their social circles. The cost of assessments and variable insurance coverage can create additional barriers.

“ADHD is not a sign of low intelligence, poor discipline, or personal failure. It is a manageable neurodevelopmental condition that deserves understanding, not judgment,” said Kandaswamy.

Addressing these concerns requires better public awareness and more accessible services. She has called for culturally sensitive assessments, affordable psychological services, and stronger collaboration between healthcare professionals, educators, and families.

In the UAE, appropriately qualified clinical psychologists, psychiatrists, paediatricians, occupational therapists, and multidisciplinary healthcare teams can support assessment and management.

ADHD does not have one defining behaviour. A restless child, a quiet student, or an adult who struggles with deadlines cannot be diagnosed on those signs alone.

The important question is whether difficulties with attention, impulsivity, activity levels, or organisation persist and interfere with everyday functioning.

Experts have emphasised that assessment is about understanding a person’s needs, not assigning blame. With appropriate support, people with ADHD can develop strategies to manage daily responsibilities, build on their strengths, and improve their quality of life.

Recognising that the signs may change over time is an important step towards ensuring that children, teenagers, and adults are not overlooked.