Mlodnicka, A., Mansolf, M., Chandran, A., Aris, I. M., Calub, C. A., Ahmad, S., Shapiro, A., Cochran, D., Restrepo, B., Schmidt, R., Hertz-Picciotto, I., Bennett, D., Gold, D. R., O’Shea, T. M., Leve, L., & Schweitzer, J. B. (2025). Prediction of internalizing and externalizing symptoms in late childhood from attention-deficit/hyperactivity disorder symptoms in early childhood. Development and Psychopathology, 37(3), 815–824. https://doi.org/10.1017/S0954579424000695
This study followed children from early childhood (around age 5) into late childhood and adolescence (around age 12 and up). The question was: Do early ADHD symptoms predict later emotional and behavioral struggles? And does the timing of puberty matter?
Here’s what they found:
- ADHD symptoms early on matter. Kids who showed higher ADHD symptoms in preschool and kindergarten were more likely to face emotional struggles (like anxiety or depression) and behavioral challenges (like aggression, rule-breaking, or defiance) later on.
- Puberty timing changes the picture.
- For girls, going through puberty earlier than peers increased the risk of conduct problems and made the link between ADHD and aggression even stronger.
- For boys, going through puberty later than peers made the link between early ADHD and problems like aggression, depression, and conduct issues stronger.
- No big difference between boys and girls overall. Both were vulnerable to later struggles if ADHD symptoms were present early, but puberty timing shaped the risks differently.
Why puberty makes a difference
Puberty is not just about growth—it’s a storm of hormonal, emotional, and social changes.
- Early-maturing girls may feel pressure to act older before they’re ready, drawing unwanted attention or new expectations.
- Late-maturing boys may feel behind their peers, which can hurt self-esteem and add stress.
- For children already dealing with ADHD’s challenges in self-control and emotions, puberty can turn up the volume on these struggles.
What this means for parents, teachers, and caregivers
- Early support is key. Even ADHD symptoms in very young children can signal later risks, so noticing and supporting kids early matters.
- Watch during puberty. Pubertal timing can add unique pressures. Girls who mature early and boys who mature late may need extra understanding and encouragement.
- Look at the whole child. ADHD isn’t just about focus or energy—it’s tied to broader emotional and social well-being.
- Stay involved long-term. ADHD challenges don’t disappear with age, so ongoing support into adolescence is important.
The hopeful note
This study doesn’t say all children with ADHD will develop bigger problems—it shows where the risks are. That knowledge gives parents, teachers, and clinicians the chance to step in earlier, tailor support during puberty, and help kids build resilience. With awareness and care, these challenges can be softened, and kids can find steadier ground.