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Risky Behavior in Teens With AD/HD

Psychologist Sam Goldstein describes the kinds of risky behaviors teens with AD/HD often engage in.

By Sam Goldstein, Ph.D.

The first article in this two-part series reviewed and described the vulnerability teenagers with AD/HD experience due to their difficulty developing effective self-discipline, self-regulation, and self-control. AD/HD acts as a catalyst, increasing the probability that "non-thinking" behavior will lead teens with AD/HD to experience risks similar to their peers but at a significantly higher rate. As discussed in my earlier article, this isn't a problem of not knowing what to do. For example, researchers have demonstrated that teenagers with AD/HD clearly understand the risks of school failure, driving, sexual activity, and substance use. Rather, these teens seem unable to efficiently regulate their behavior and safely negotiate what for them is a gauntlet of adolescence. This article will provide a brief overview of several types of risky behaviors teenagers with AD/HD typically engage in.

Struggling in School

Growing up with AD/HD appears to take a significant toll on many teenagers' educational functioning and final educational attainment. Within the educational realm, disciplinary problems are common in youth with AD/HD. Sometimes these problems result from purposeful behavior, but often their actions are not intentional. Citizenship grades are marked down and disciplinary action taken when youth with AD/HD are repeatedly late to class, lose textbooks, speak out of turn in class, or cause other minor disruptions. Such behavior occurs when youth with AD/HD struggle with conduct problems that may be fueled by poor impulse control.

Teenagers with AD/HD are more likely to repeat a grade, receive extra tutoring, under-perform relative to their intellect and academic abilities (as measured by group achievement tests), drop out of school earlier and be suspended from school for disciplinary problems, they are expelled at a rate two-and-a-half times that of unaffected teenagers. Youth with AD/HD fail to complete high school at a rate that is four times the norm (nearly 40% versus 9%). Their class rankings are usually in the bottom third and their grade point averages in the bottom half. In one longitudinal study of youth receiving treatment for AD/HD, only 20% of teenagers with AD/HD attempted a college program of any sort and just 5% completed a college degree compared to 40% or more of normal teens entering college and 35% eventually completing some form of college degree. (Study by Dr. Russell Barkley and colleagues in Milwaukee.)

It appears that growing up with AD/HD takes a significant toll on educational functioning and final educational attainment; which ultimately affects the occupational status and life stability of these individuals in adulthood.

Dangerous and Distracted Driving

Teenagers diagnosed with AD/HD in clinic settings who were followed over a three- to five-year-period were found to experience a significantly higher rate of automobile accidents, moving violations (particularly speeding), and license revocations and suspensions compared to unaffected teenagers. The reaction times of teens with AD/HD (as measured on driving simulators) are also slower than those of their unaffected peers. Slower reaction times certainly increase risk for accidents. Parents have rated their teens with AD/HD as using less sound driving practices than other teenagers, which likely leads to this pattern of vulnerability. Some accidents may be the result of driving too fast (due to poor impulse control) or daydreaming (due to inattention) rather than attending to the road. This is an emerging field of study and thus there are many unanswered questions about the driving behavior of teenagers with AD/HD.

Sam Goldstein, Ph.D. is a Clinical Professor of Psychiatry at the University of Utah, a Research Professor of Psychology at George Mason University and Director of the Neurology, Learning and Behavior Center in Salt Lake City, Utah. He is Editor-in-Chief of the Journal of Attention Disorders, author, co-author or editor of 26 books and dozens of book chapters and peer reviewed research articles.

Comments from readers

"I feel as if this article speaks of all the negative aspects of a child with ADHD! There are children out there who have ADHD with a very creative, inventive and educational mind. My son has ADHD and if you ask me, I feel that the school system is failing him more than he would to society! I was raised having ADHD and I am currently a registered nurse who is just about to complete my education with a Master's in Nursing! There are many books out there that illustrate the positive qualities of a child/adult with ADHD. And if you want to speak about their addictive behaviors, my son refuses to take any medication anymore! "