Relatively few studies have examined the impact of childhood ADHD on long-term financial outcomes, even though becoming self-supporting and attaining financial independence is an important developmental task.
An especially comprehensive look at this issue is provided in a study by Pelham et al published recently in the Journal of Consulting and Clinical Psychology.
Participants were 364 adults who were diagnosed with ADHD in childhood along with 264 demographically matched controls. All participants with ADHD had attended an intensive summer treatment program and 90% had been treated with stimulant medication at some time.
Participants were followed over a 20-year period, and information related to their financial status, educational attainment, and ADHD symptoms were obtained at age 25 and again at age 30. This enabled the researchers to examine 4 questions:
1. How did financial outcomes at age 30 compare for ADHD participants and controls? To what extend did this depend on their educational attainment and the degree to which ADHD symptoms had persisted?
2. How did the financial trajectory of participants with and without ADHD differ from age 25 to 30?
3. What were the projected differences in lifetime earnings?
4. What were the projected differences in net worth at retirement?
Financial outcomes at age 30 - At age 30, participants with childhood ADHD were more likely to be unemployed (22% vs. 13%) and to be living at home (33% vs. 12%). On average, their monthly earnings were 37% less and they had 66% less money in savings.
They were also less likely to own a home (22% vs. 42%), their parents were more likely to be regularly supporting them (23% vs. 8%), and they were more likely to be receiving regular support from a non-parent adult (21% vs. 7%).
Were financial outcomes better for individuals no longer diagnosed with ADHD as adults? Not really. Even among adults who no longer met diagnostic criteria for ADHD, nearly all financial outcomes remained significantly below those of controls.
And, even when ADHD symptoms appeared to have fully remitted, they still fared worse than controls on multiple outcomes, e.g., more likely to be living with parents/family, to be regularly receiving money from parents/family, to be receiving financial assistance from a nonparent adult, and having less money in savings.
Were differences in financial outcomes explained by differences in educational attainment? Not fully. As expected, participants with ADHD in childhood had lower educational attainment at age 25 than controls. Not surprisingly, educational differences were a significant contributor to differences in financial outcomes.
However, even after controlling for educational attainment differences, several financial outcomes differences remained significant. These differences reflect adverse impacts of ADHD on financial outcomes that are not explained by educational attainment.
How did the financial trajectory of participants with and without ADHD differ from age 25 to 30? Those in the ADHD group made fewer financial/ independent living gains than peers. This included a smaller reduction in the percentage living at home — a decline of 40% to 33% for ADHD group vs. 28% to 12&% for controls.
Their monthly income increased less — $285 vs. $974 — as did their cumulative savings — an increase of $1508 in savings for the ADHD group vs. $3722 for controls. And, the percent who received regular financial contributions from parents actually increased slightly during this period while it declined significantly for controls.
How did projected lifetime earnings differ? Projections based on education and age 30 employment status suggested that control participants would earn $1.10 million more during their lifetime than those in the ADHD group, ($2.26 million vs. $3.36 million, a 49% difference),
What were the projected differences in net worth at retirement? Projected net worth at retirement indicated mean net worth would be 35% lower in the ADHD group — $410,000 vs. $630,000 — reflecting a deficit of $220,000. The projected net worth difference varied substantially as a function of the assumed savings rates and return on investment. Under any set of assumptions, however, the projected net worth was always lower in the ADHD group.
Summary and implications:
Results from this study indicated that at age 30, adults with ADHD in childhood were faring worse than non-affected peers on multiple financial indicators, including income, savings, employment status, and dependence on parents and other adults. More often than not, they remained financially dependent on parents and/or others.
This was true when they no longer met diagnostic criteria for ADHD and even when they displayed no significant ADHD as adults. Between ages 25 and 30, differences in financial outcomes between the groups actually increased and projections of lifetime earnings and net worth at retirement were dramatically different.
Given the concerning nature of these findings, it would have been helpful to know whether the quality and duration of treatment that participants received over their development materially impacted their financial outcomes.
For example, did more sustained medication treatment, or participation in other interventions, lead to better financial results? This is a very important question but analyzing the data in this way was not done.
It is also important to remember that the findings reported reflect average differences between participants with and without ADHD. Certainly, a number of those in the ADHD group were living independently and had attained positive financial outcomes. Thus, one should certainly not assume that financial challenges are an inevitable result of having ADHD as they are not.
One important factor contributing to greater financial difficulties among individuals with ADHD was their tendency to have lower educational attainment. Promoting academic success in youth with ADHD is essential for this as well as other reasons. Unfortunately, however, academic supports available to those with ADHD in many public school systems tend to decline as students move from elementary, to middle, to high school. This is a real problem.
In summary, results suggest there is great need for interventions that can improve financial functioning as children with ADHD reach young adulthood. Unfortunately, there has been very little work completed in this area and this would be important to examine in follow up research to this important study.
– Dr. David Rabiner is a child clinical psychologist and Director of Undergraduate Studies in the Department of Psychology and Neuroscience at Duke University. He publishes the Attention Research Update, an online newsletter that helps parents, professionals, and educators keep up with the latest research on ADHD.
The Study in Context:
- Neurofeedback or medication to treat ADHD?
- Large study with twins highlights the limited role of genetics in mental health and the importance of effective early interventions for ADHD
- What are cognitive abilities and how to boost them?
- Rates of ADHD diagnosis and medication treatment continue to increase substantially