The window of compliance with parental guidance in children usually is open before puberty, that it is much easier for parents to guide their child before he/ she hits 10 years. The specific age may vary with the child’s temperament, parent-child relationship and environmental stress. Beyond that age, the impact of the parental teaching will be diminishing.

To avoid medications, some parents let their children try different forms of alternative treatment which could take a few years. By the time they find that the results are not effective and turn to medication, the child may have reached puberty and it becomes more difficult to help the child comply the treatment regime and learn other skills. The child may also have developed other issues, such as low self-esteem and/ or mood problems.

When ADHD is assessed and managed before or at age 9, management is relatively simple. After that, secondary adverse outcome may have set in, such as low self esteem, underperformance at school and self care, suboptimal relationship with parents or teachers or friends, anxiety disorder, mild to moderate depression; they may even have substance abuse, accidents, impulsive behaviors such as unplanned pregnancy, and conflicts with parents. Problems may appear with the parents themselves too such as parental depression and marital problems.

If management is further delayed to late teenage or adulthood, some tertiary adverse effects, some of which could be irreversible, may surface, such as divorce, bankruptcy, gambling, violation of law, etc.

That is why time is of essence in treating ADHD.