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23 Sep 2016

Kysow K et al. Atten Defic Hyperact Disord 2016 [Epub ahead of print].

Adults with ADHD experience pronounced impairments in different realms of life, and the knowledge regarding strategies used by patients to cope with ADHD-related deficits is still limited. A recent study conducted in Canada sought to explore the following:

  • The natural strategies used by adults with ADHD to compensate for their impairments
  • The differences between adulthood and recalled childhood compensatory strategies
  • The dependence of compensatory strategies on gender and ADHD symptom domains
  • The relationship between the use of compensatory strategies and measures of general functioning*
  • The way compensatory strategies moderate the association between ADHD symptom levels and measures of functioning.*

This study recruited adults (n=49 [27 women, 22 men]; mean age 42.73 years) with ADHD diagnosis derived based on the Conners’ Adult ADHD Diagnostic Interview for the Diagnostic and Statistical Manual of Mental Disorders – 4th Edition. Responses to the interview were coded for the following compensatory strategies: adaptation, paying attention, organisation, external support and avoidance. Information on the participants’ educational level, employment status, negative parenting and family routines was gathered.

Across all symptoms, most adults with ADHD (92%) reported employing at least one compensatory strategy. Adults reported using strategies on average 5.65 times in total (range 0–17); however, for most symptoms, no strategies were used. Nineteen adults reported using at least one strategy that they failed to consistently use, or found ineffective – it was noted that the majority of these failed strategies were organisational. Males and females did not differ in their strategy use.

Total strategies used in childhood were significantly correlated with those used in adulthood (p<0.001). Positive correlations were observed in adaptation (p=0.001), organisation (p=0.003) and avoidance (p=0.002). No significant relationships were found in either paying attention or external support.

Most relationships between compensatory strategies and measures of functioning were insignificant; however, education was significantly or marginally related to the use of adaptation, organisation, external support and total strategies used (p=0.01–0.10). Employment was significantly related to adaptation (p=0.05), and negative parenting and family routines were significantly or marginally related to adaptation (p=0.05–0.10).

Because this study relied on the spontaneous report of the participants, some compensatory strategies might have been missed. Also, the study’s cross-sectional design, possible error accumulation on some statistical tests and limitation of the measures of education and occupation restrict the interpretation of the results. However, the findings provide insight on how adults with ADHD manage their disorder, and encourage the implementation of treatment programmes that take the pre-existing compensatory strategy of the patient into consideration.

Read more about compensatory strategies in adults with ADHD here

*Education, employment, negative parenting and family routines

Kysow K, Park J, Johnston C. The use of compensatory strategies in adults with ADHD symptoms. Atten Defic Hyperact Disord 2016 [Epub ahead of print].

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