Introduction
Deep inside my core was a little person saying, "It does not make sense, you are not stupid, there must be something."  Two years ago I found myself facing a life of emptiness, unresolved conflicts, and a feeling that I had only one shot at life and I sort of blew away half of it.  If I wanted to salvage any part of it, I had better do so in a hurry.  I found myself in therapy, and I finally got the nerve to call the local community college and ask to be tested for learning disabilities.  Guess what I found out?  I had learning problems with a wide range of differences in levels of achievement!  I finally had a piece of paper that said I was not brain-dead, or lazy, or stupid, and no, it was not in my psyche trying to do myself in!  I had a piece of paper in my hand that said you have subtle learning disabilities as well as ADD/AHDH  (Stolowitz, 1995, p. 5)!

One suspects that these poignant, painful words of self- revelation spoken by Margaret Stolowitz (1995) might be typical of a late-blooming young adult.  Instead it is revealed that Margaret, a 50-year-old who has worked for many years as an LPN, is now attending Hampshire College in Amherst, Massachusetts, as a full-time, very nontraditional student with subtle learning disabilities as well as ADD (Attention Deficit Disorder) and hopes to become an advocate for other students like herself.

Background
Or when learning of her middle age, one might surmise that she is merely typically reflecting any of the leading human development theories outlined in Papalia and Olds (1998).  Jung would suggest that she expresses characteristics previously suppressed when she says, "Because of this quest for self-identity and personal satisfaction, I have grown in many ways.  It had not been easy and remains a hard path to follow"  (Stolowitz, 1995,  p. 4).  Erickson proposes that 50-year-olds like Margaret wish to mentor younger people when she writes, "I wish to reach those people that feel deep inside of them is a person waiting to evolve into a beautiful self-assured intelligent being" (Stolowitz, 1995, p. 4).  Peck would suggest that Margaret is shifting emotional investments to others when we hear these words from her:  "I would like to reach those adults who felt that they could have done more with their lives, yet remain frustrated by limitations that are not understood, and bad memories of their learning experiences"  (Stolowitz, 1995, p. 4).  Vaillant asserts that much of the pain comes from having the maturity to face pain that was suppressed for years, as  reflected in these words from Margaret:  "My school life was awful from the beginning to the bitter end.  I did not read until the sixth grade" (Stolowitz, 1995, p. 4).  Or Levinson proposes that middle adultsâ (age 45-50) reappraisals lead them to a new life structure involving new choices, as we saw reflected in Margaretâs wrenching words at the beginning of this paper.

 While it is true that she does appear to reflect these differently described middle-age characteristics, it is also true that her story, when read from beginning to end, differs from the norm in severity, intensity, and duration.  The kinds of issues that Margaret confronts at age 50 are different from the norm, as evidenced in remarks such as, "Only recently did I learn that the flat side (of a puzzle) was an outside piece of a puzzle,"  and,  "Even now I know what sounds correct but not why, so most of what I write I need to read out loud to myself to hear if it sounds correct"  (Stolowitz, 1995,  p. 4). And finally, I cannot express strongly enough the feeling of having found another voice. I hurt very much when I think of all the good thoughts and ideas, as well as the creativity, that had been locked in my brain for so many years, trapped, unable to be expressed  (p. 5).

Her experience prompts one to find out if and how other ADD adults have had their development affected.

Proposal:  Scope and Definitions
 This research paper will explore in a limited capacity the effects of Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) on adult development. (ADHD was first referred to in the literature as ADD and is still used interchangeably by the media.)   References to learning disabilities research in general will be included due to the comorbidity of the two disorders.  Additionally, due to the amazingly small amount of research done on adults and the rather vast amount on children, the author has chosen to interject excerpts from Margaret Stolowitzâ personal narrative and will refer to it intermittently throughout this paper.  Her intensely emotional experience seems to typify the norm for adults with ADD/ADHD.

 ADHD, a neurobiologically based disorder, is characterized by a symptomatic triad of inattention, impulsivity, and hyperactivity (American Psychiatric Association, 1994). Only recently has a set of  criteria been established that applies to adults.  According to the DSM-IV, (1994) adults must experience these specified symptoms for at least six months to a degree that is maladaptive and inconsistent with their developmental level.  Also, there must be evidence of some hyperactive-impulsive or inattentive symptoms that were significant enough to have caused impairment before age seven.  In addition, an adult diagnosed with ADHD must have impairment over two or more settings (i.e., school, work, and at home), and there must be clear evidence of clinically significant impairment in social, academic, and occupational functioning.  Finally, the symptoms cannot be accounted for by another mental disorder. Only recently are researchers beginning to give up the belief that ADHD ceases with maturation.  Jackson and Farrugia (1997)  indicate that "recent longitudinal studies, however, have provided ample evidence that ADHD may be a chronically disabling condition, and researchers have unanimously reported findings of continued and augmented impairment as children diagnosed with ADHD age into adulthood" (p. 312).

Research History and Statistics
 In the past few years, the field of learning disabilities has begun to direct more of its attention to adults as increasing numbers of students exit mandated school-age programs.  Upon leaving school, students become adults with the learning disabilities, entering a stage of their lives that necessitates not only new accommodations and services, but also, and more importantly, new ways of thinking about their disability.  Jackson and Farrugia (1997) estimate that between 30% and 50% of children diagnosed with ADHD will continue to exhibit disruptive symptoms throughout their adult lives.   However, despite the demographic shift cited by Gerber (1994), there has been comparatively little research and writing about adults.  This trend is even more amazing since adulthood is unique compared to other stages of  human development because of its age range upward to 60 years, based on U.S. longevity estimates.  By contrast, school-age years typically span twelve or thirteen years, and research often is further broken into childhood versus adolescence or an elementary- versus secondary-school dichotomy.

 Even though the bulk of the research focuses on children,  Newsweekâs recent (January, 1998) "Special Report" on the brain claims that "the fastest-growing category of disability is Îlearning disability,â especially the variants of attention-deficit disorder" (p. 56).  Even as long ago as 1975, Wender noted that "problems characterized as attention disorders and hyperactivity have long constituted the most chronic childhood disorders and the largest sources of referral to child mental health centers"  (p. 45).  Craig (1996) suggests adults with ADD and ADHD are a new phenomenon to many health care providers and suggests that many children with these classifications have persistent problems into adulthood.  Craig confesses, however, that the significance and management of these disorders for adults are poorly understood in the medical world.

 Even though there is a growing awareness of the "aging" ADD population, the majority of articles continue to focus on children.  Last July,  for example,  American Family Physician (1997) featured an article titled "ADHD:  The Role of the Family Physician."  While the title implies a look at the disorder for the whole family,  the editorial begins with the familiar statistic that "50 to 60 percent of cases continue into adolescence and at least 30 percent continue into adulthood" (p. 42).  But then the article only addresses children.  In spite of this narrower focus in the research literature, the number of students with learning disabilities entering postsecondary institutions has grown faster than any other classification (American Council on Education, 1992).  In fact, according to Jarrow (1987), executive director of the Association of Higher Education & Disability (AHEAD),  students with learning disabilities are the "single largest contingent of students with disabilities being served on American campuses" (p. 46).

Characteristics and Effects of ADHD
Jackson and Farrugia (1997) give the most concise and thorough explanations of primary and secondary adult ADHD characteristics of the articles this author reviewed.  The three primary characteristics mentioned earlier (inattention, overactivity, and impulsivity) are frequently expressed differently by adults.  One can more easily detect these symptoms in a child than in an adult,  for children continually have teachers and parents watching over them.  To recognize ADHD symptoms in adults, counselors must know what to look for and where to look.

Note that by definition ADHD explicitly incorporates  "clinically significant impairment over two or more settings."  Gerber et al.(1990) assert that persisting problems in adulthood tend to become worse or are exacerbated as the years unfold.  Let us explore how the three primary characteristics might typically affect adult development.

Effects of Inattention
For ADHD adults, the inattention factor can bring on a cascade of difficulties in life (Nadeau, 1995).  For example, when these adults inconsistently sustain attention on a job, they may have difficulties retaining employment (Weiss & Hechtman, 1993).  Inattention to rules and regulations may habitually get them into trouble with the law because they "forgot" about the notice that came in the mail to have their car inspected and then "misplaced" the ticket they received for not having it done.  The adult may develop and continue negative attitudes because they perceive that nobody understands how difficult it is for them to work steadily, become organized, keep friends, and set goals for themselves. (Gittelman et al., 1985).

Jackson and Farrugia (1997) cite several studies (Mannuzza et al., 1993; Weiss & Hechtman, 1993; Nadeau, 1995),  suggesting somewhat more optimistic outcomes that ADHD adults generally become economically self-sufficient but may have a poorer work record than their normal counterparts.  They change jobs and are laid off more often and have lower occupational aspirations, and employers rate them as inferior to other workers.  However, they rarely fail because of incompetence or poor ability.  In fact, most have great strengths and high potential if they find the right job.  Many do best at jobs that do not require close supervision, have duties that vary and change often, and incorporate stimulating opportunities that interest them.  Margaret speaks of her own strengths in these words:  "One of my strongest points is that I can take any idea, no matter how unrelated it may seem to others, and find a way to have it support my own÷I find connecting threads to pull ideas together so that they become similar" (Stolowitz, 1995, p. 6).

Effects of Impulsivity
 Adults with impulsivity commonly will have difficulties with delayed gratification  (Barkley, 1990). Interrupting conversations of others, wanting things immediately, not thinking about behavioral consequences creates difficulties with having strong social relationships.  They tend to disregard othersâ feelings, thoughts, and actions.  They may seek the thrills of dangerous activities (Carlton & Manowitz, 1994).  Their often impaired judgment and poor decision-making abilities lead to less stable lives (Jackson and Farrugia, 1997).  Their decreased impulse control, restlessness, and decreased concern for consequences leads them to frequently acting out aggressively (Hechtman & Weiss, 1983).

Research regarding ADHD adults and criminality reveals conflicting reports or prevalence.  Some have found that criminal behaviors were not significantly greater (Hechtman & Weiss, 1983), whereas others have reported that 5% to 25% of adult ADHD participants are incarcerated (Mannuzza et al., 1993).   A recent FBI Law Enforcement Bulletin (1997) cites studies (Barkley et al., 1992) suggesting that this group of adults is likely to cause and experience more auto accidents, sustain more bodily injuries associated with accidents, and receive traffic citations, particularly for speeding.  The Bulletin, however, adds that ADHD adults are not "criminals waiting to happen"  (p. 15).  The best causal connection between the two appears to be the development of antisocial problems in adolescence.  To date, research has yielded very limited hard data on the relationship between ADHD and criminality.

Effects of Overactivity
 Wender (1987) describes ADHD adults as "often Îon the go,â seem to never Îrun out of fuel,â and are consistently trying out new hobbies and exploring new areas of interest" (p. 60).  They are unable to concentrate because of nervousness, anxiousness, and restlessness.  They may be seen fidgeting, moving in their seat frequently, bobbing legs, and tapping pencils.  Pent-up and sometimes violent energy can lead to frustration, anger, and explosive personalities.  Their overactivity becomes more noticeable when required to sit for a sustained period of time.

Margaret (Stolowitz, 1995) writes:  "I remember trying to hold my body together long enough not to get into trouble,  not to break something, not to touch what I shouldnât, and not to say things that were wrong÷an awful chore" (p. 5)!

Secondary Characteristics
One can imagine how the impact of accumulated failures might lead to a constellation of difficulties associated with an unfolding adult life.  Jackson and Farrugia (1997) cite studies (Javorsky & Gussin, 1994; Leimkuhler, 1995) pointing to low self-concept as a common secondary characteristics of adults with ADHD because many have problematic educational experiences and more personal problems that lead to feelings of incompetence, insecurity, and ineffectiveness.  Nadeau  (1995) commented that many are plagued with a chronic inner sense of underachievement and intense frustration.  Many have repeatedly heard negative messages about themselves, both directly and indirectly from teachers, parents, spouses, friends, and/or employers who highlight their shortcomings.  Margaret speaks of her frustrations with these words:  "I know when I have forgotten to take the Ritalin÷the frustrations come out of no place with the power of a furious wind, I am again at the control of my moods, unable to control my responses to them, and sometimes they take me on terrible roller-coaster rides" (Stolowitz, 1995,  p. 6).  One can only imagine how these uncertainties and self-doubts could leave unsettling effects on the psyche of the "mature adult" who is groping to lead a "normal life."

Where Do We Go From Here?
Margaret Stolowitz (1995) concludes her article by saying, "Words are cheap÷action is what counts" (p. 6)!  It would seem that any ADHD research  is needed as our understanding of it and its effects on adults is so paltry and undocumented that virtually any studies would be welcome.
 It is generally accepted that learning disabilities and ADHD can be lifelong problems that accompany each other.  Many mental health professionals assessing adults have difficulties deciphering which disability came first.  Was the initial problem  the learning disability that caused the child to behave poorly, or did the ADHD combination of inattention, overactivity, and impulsivity disable children throughout their educational experiences, which then effect long-range problems into adult development (Jackson & Farrugia, 1997)?  Further research to document the overlap of these two disorders might help answer the "chicken or the egg" issue.

 Gerber (1994) points out that current research and writing in the field of learning disabilities has not broken from a mind-set of studying it during the school-age years, when development is reactively rapid and temporally compact.  He urges the use of research on adults with meaningful developmental markers.  Cronin, Patton, and Polloway ( as cited in Gerber, 1994, p. 7) suggest research and writings be presented in adult contexts that group major life demands into six arbitrary domains:  employment-education, home and family, leisure pursuits, community involvement, emotional and physical health, and personal responsibility and relationships.  Results in these areas might assist one with more prescriptive coping strategies, particularly as a preventive measure.

The author of this paper drew on such limited research that it is not fair to generalize from these findings alone.  However, Gerber (1994) wrote a comprehensive article on research articles of adults with learning disabilities found in the Journal of Learning Disabilities over  the last ten years.  He noted that the majority of studies were on college-age students.  Therefore the age ranges dealt primarily with the younger adult, ages 20-30.  Even the high school follow-up studies focus on adults in their early twenties;  rarely do studies involve adults older than 40.  Since it takes time for an adult to be identified as "successful," one must include older adults when studying "successful adults," and this rarely happens.  Adults need to be chosen or delimited consistent with the age-span phases described by the theorists on adult development. In most cases, then, it seems that access and access alone to adult subjects of whatever age determines the age range of subjects to be studied.

There seemed to be little effort÷if any÷to cluster subjects in accordance with conceptualizations of adult development.We do not have the luxury of time for this long and complex stage of development.  As the field moves forward in its thinking about adults with learning disabilities, the research that is generated must take on an integrated life-span approach, so that what we learn will be meaningful to the profession and specific to the populations we serve (p. 8).  A greater effort should be made to tap a broader, more appropriate adult population for research studies.

Conclusion
 This author hopes that ADHD research focusing on adult developmental stages will forge ahead with vigor.  It appears that ADHD adults have for too long had to defend their misunderstood personalities and psyches.  Their own lack of knowledge about how this neurobiologically based disorder has shaped them holds for many their self-concept in bondage. They need empowerment! They need coping strategies.  New research that aids their self-understanding will empower!

 How does ADHD affect adult development?  Listen one last time to Margaretâs assertion:  "There will be a time in the future when I will challenge the academic system, because it is very destructive to those people who do not fit into little premade boxes, much to the discomfort of the established and outdated system" (Stolowitz, 1995, p. 6).  Research must make a difference·not just for the Margarets but also for society at large,  which can play a supporting  role in hindering or enhancing adult development over the life span.

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