Soleil Gregg, MA, interviews Jason Fletcher, PhD
HOW DOES HAVING ADHD IN CHILDHOOD AFFECT INDIVIDUALS IN ADULTHOOD? More information about the long-term effects of ADHD is becoming available as those diagnosed as children enter adulthood and researchers are able to look at how they are faring in life. These studies provide parents valuable information about future risks associated with ADHD, which they can use to weigh current options and make treatment decisions for their child. The findings can also help adults and young adults with ADHD to understand the disorder’s impact on their lives and explore whether additional interventions and treatments would be beneficial.
Jason Fletcher, PhD, is an associate professor of public health at Yale University in the School of Public Health, Department of Health Policy and Management. He is also a Faculty Research Fellow for the National Bureau of Economic Research, a Research Fellow for the Institute for the Study of Labor, an Affiliate of the Institute for Research on Poverty, and a Research Associate for the Columbia Population Research Center.
In 2012, Fletcher was one of six researchers selected nationally to receive a William T. Grant Foundation Scholars award, which supports the career development of highly promising researchers in the social, behavioral, and health sciences. Scholars receive $350,000 each to complete a five-year research project, plus mentoring from experts in their field of research. Although he is considered to be early in his career, Fletcher is already a prolific researcher, has published numerous papers and journal articles, and has received federal funding for public health/mental health studies. He also received the Health Economics Distinguished Author award in 2012.
Soleil Gregg, a member of Attention’s editorial advisory board, asked Dr. Fletcher about his general research interest in ADHD and his recent study, "The Effects of Childhood ADHD on Adult Labor Market Outcomes," which explores the impact of ADHD symptoms in childhood on employment and socioeconomic status in adulthood.
Several of your studies have focused on ADHD. What is your interest in ADHD from a public health perspective?
ADHD is now one of the most prevalent mental health conditions affecting children in the United States. Although there is a lot of research showing short-term effects of ADHD on a variety of outcomes, such as behavioral problems and low academic performance in school, we do not know very much about its effects on longer-term outcomes. This is important in understanding the need for further interventions to reduce the symptoms during childhood that may have long-term benefits.
You talk about human capital in this study and in other studies involving ADHD. What do you mean by human capital, and how is it affected by ADHD?
Human capital is an academic term that refers to the investments we make in ourselves to be more productive individuals. The main components include formal schooling—both how much schooling and the quality of the schooling. Other components could include on-the-job training, learning new routines, computer courses, etc. Human capital may be reduced by ADHD because of the effects ADHD has on the ability to concentrate and learn, both inside school and outside of school.
What was this particular study about?
This study followed over 10,000 individuals between high school and age thirty to examine whether individuals who were diagnosed with ADHD as children/adolescents had lower adult socioeconomic status. We measured several adult outcomes, such as whether the individual was employed, the earnings of the individual if he/she was employed, and whether the individual was receiving government assistance (food stamps, public housing subsidies).
What prompted you to do this study?
My main interest was to fill in a gap in research examining the long-term impacts of ADHD on adult outcomes. There is very little research that is available on this topic.
What were your findings?
We found extremely large impacts of ADHD on adult outcomes. For example, individuals who were diagnosed with ADHD during childhood/adolescence were much less likely to be employed at age thirty, and those who had jobs earned over thirty percent less each year than individuals who were not diagnosed with ADHD. The effects are staggeringly large.
Another major finding of the study was that earlier symptoms of ADHD during childhood may have larger long-term impacts than later symptoms.
What are the implications for families and individuals with ADHD and for society in general?
Parents, particularly those with ADHD themselves, may need to be on the lookout for symptoms in their children that develop early in their schooling and might make a point to get help early by working with the school and local health providers.
The main implication is the need to help children and adolescents with ADHD combat their symptoms. This could be through medication or other behavioral therapies. If we do not, we face large impacts as these individuals become adults and are less likely to be able to find work and support themselves.
What message or advice do you have families and individuals with ADHD based on your research?
The main advice is to treat these symptoms seriously and to focus attention on supporting these children to do well in school. Early symptoms of ADHD that cause children to fall behind in school, have problems with social relationships, and generally to dislike school, are cause for concern because of the potential long-term, cumulative impacts of these early symptoms. Getting help early may be key to reducing the impact of ADHD in adulthood.
Can young adults or adults whose employment status has been impacted by ADHD do anything to increase their human capital?
This depends on the effectiveness of different medical/therapeutic treatments, I think. It does not work for everyone, but medication and therapy may help many people affected by ADHD, which over time may allow them better employment outcomes.
Fletcher, J. M. (2013). The Effects of Childhood ADHD on Adult Labor Market Outcomes. Health Economics.
This article originally appeared in the February 2013 issue of Attention magazine. Copyright © 2013 by Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). All rights reserved. No portion of this article may be reproduced without written permission from CHADD.