The character of ADHD changes as the child reaches adolescence.10 Approximately 20% of children may ‘outgrow' the disorder and become completely symptom-free. Another 20% have a marked decline in hyperactivity but continue to exhibit a short attention-span, distractibility and impulsivity. As learning tasks become more complex in junior high and high school, these students are unable to concentrate. As a result, they become overwhelmed and fall significantly behind in reading, mathematics and spelling. The remaining 60% continue to display symptoms of ADHD, fall behind in reading, mathematics and spelling and develop a concomitant ‘conduct disorder' – starting fights, lying, running away. This group of adolescents is at increased risk of substance abuse, especially if unmedicated. Around the age of 25, fewer patients display anti-social behavior but they rank lower than peers on measures of educational attainment, job satisfaction, social skills and self-esteem.