HealthDay News) — For preschoolers diagnosed with attention-deficit/hyperactivity disorder (ADHD), symptom severity is relatively stable over a six-year period despite medication status, according to a study published in the Journal of the American Academy of Child & Adolescent Psychiatry.

Mark A. Riddle, MD, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues describe the clinical course of ADHD (from age 3-5 to age 9-12 years) during a six-year follow-up after the original Preschool ADHD Treatment Study.

Two hundred seven participants (75% male) were assessed at baseline (mean age, 4.4 years) and three months later, before treatment with medication, and then were reevaluated in three follow-up visits in years three, four, and six.

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From baseline to year three, the researchers found that parent- and teacher-rated symptom severity decreased, but through year six it remained stable and in the moderate-to-severe clinical range. Steeper decreases in T-scores were seen for girls.

At year six, 89% of participants met the diagnostic criteria for ADHD symptoms and impairment. In the multiple logistic model, comorbidity of oppositional defiant disorder and/or conduct disorder correlated with a 30% increased risk of having an ADHD diagnosis at year six. After adjustment for other variables, medication status during follow-up did not predict the change in symptom severity from year three to year six.

“ADHD in preschoolers is a relatively stable diagnosis over a six-year period. The course is generally chronic, with high symptom severity and impairment, in very young children with moderate-to severe ADHD, despite treatment with medication,” the authors write. “Development of more effective ADHD intervention strategies is needed for this age group.”

Several authors disclosed financial ties to the pharmaceutical industry.


  1. Riddle MA et al. J Am Acad Child Adolesc Psychiatry. 2013;52(3):264-278.e2