Existing research on the adult outcome of children with Attention Deficit Hyperactivity Disorder (ADHD), or hyperactivity, indicates that they are at significant risk for academic failure, poor eventual educational attainment, antisocial behavior, poor social adjustment, and increased minor substance abuse (e.g., alcohol and cigarettes). Many will also experience poor occupational adjustment and increased risk of psychiatric disturbance. However, other areas of adult adjustment have not been explored or have received only cursory attention in past follow-up studies. The present proposal is for the continuation of a follow-up study of 158 hyperactive children and 81 matched normal control children first evaluated in 1979-80 and re-evaluated as adolescents 8 years later in 1987-88. This study would re-evaluate these subjects as young adults between 19 and 24 years of age over the 5 year period 1991-1996. The project would permit not only a detailed evaluation of these hyperactive and normal children as young adults, but would also permit their being tracked until they have children of their own. At that time, they would be solicited to participate in a second project, to be submitter later, on the parenting competence of these subjects and the psychiatric and social morbidity of their offspring. In the present project, efforts will be made to relocate as many prior subjects as possible to have them participate in two studies. Study #1 is a detailed, comprehensive assessment of the subjects as young adults with particular attention to evaluating their educational attainment, continuation of ADHD symptoms, psychiatric morbidity at adulthood, social and heterosocial adjustment, including sexual functioning, driving competence, antisocial behavior and substance abuse, and management of personal finances. An extensive battery of structured interviews, behavior rating scales completed by the subjects and their parents, laboratory tests of attention, impulse control, and activity level, direct behavioral observations, official registries of criminal acts and traffic violations/accidents, as well as direct assessment of intelligence, academic achievement, and response to mild punishment (response cost) contingencies will be used to evaluate all subjects. In Study #2, subjects in Study #1 will be solicited to participate in a direct assessment of driving competence using written tests, computer-simulated driving situations, and actual behind-the-wheel evaluations of driving abilities. Afterwards, all subjects will continue to be tracked as to their own marital and parental status for participation in our second project.
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