The character of ADHD may change as the child reaches adolescence.18 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, students may become overwhelmed and fall significantly behind their peers in core classes. Approximately 45 % of teens with ADHD develop a concomitant Conduct Disorder characterized by starting fights, lying, and running away with little regard for consequences. 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.