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The question: Can a child outgrow ADHD? My son is now 18 and drug-free, but has no real ambition or goals. ADHD also allowed him to have lowered expectations all throughout his schooling. Can I expect a breakthrough soon, or should we consider drug treatment for him again?

The answer: In my experience, people with Attention Deficit Hyperactivity Disorder (ADHD) continue to have some degree of long-term symptoms.

Typically this is a tendency toward being easily distracted, forgetful and poorly organized. Many teens gradually develop coping strategies that allow them to manage their inattention. For example, using a daily organizer or electronic calendar can help to ensure that important tasks are completed in a timely fashion and not forgotten.

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Many children with ADHD do benefit from taking medication to improve their focus. The length of time a person takes medication is extremely variable. I follow children in my practice whose symptoms seem to improve over time and who develop effective time management and organizational skills. Such youngsters can be weaned from their medication in middle school or high school.

I have other young adults who continue to benefit from taking medication throughout their school careers. There are no hard and fast rules about what happens with medication after high school. Adults who choose postsecondary education may choose to continue their medication to help with their studies. I have also followed others who pursue more "hands-on" vocations, where long-term use of medication is not required.

Your son sounds like he may also have issues with motivation. I have patients who are frustrated after many challenging years in the classroom and are now poorly motivated to do anything productive. Perhaps your son has a particular area of interest that you could encourage him to pursue. This could be a part-time job, a community college course, or perhaps volunteering with a business or community organization.

Hopefully this will be a positive experience that will bolster his self-confidence and motivate him to continue to acquire skills and knowledge that will help him in the future. Encourage him to talk with his physician if symptoms of inattention and distractibility are continuing to be problematic.

Dr. Michael Dickinson is the head of pediatrics and chief of staff at the Miramichi Regional Hospital in New Brunswick. He's a staunch advocate for children's health in Atlantic Canada through his involvement with the Canadian Paediatric Society.

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