But if they are "outgrowing" it, doesn't that mean that it's, um...
how to say...
normal, developmentally, for those particular children? See, this is the same thing that I wonder with ASD. What if we're lumping all of these underlying etiologies together on the basis of SYMPTOM similarities? I mean, "shortness of breath" isn't always asthma, right? (In fact, it CAN be completely normal!!)
So what if "inattentiveness" and "poor follow-through" or "impulsivity" isn't dysfunction or at least not the same KIND of dysfunction in everyone, either?
Honestly, THAT is what bothers a lot of neuropharmacology people about pediatric psychopharmacology. There's a lot of tweaking of neurochemistry happening there, and we KNOW that it alters development in some specific ways... but what we DON'T know is what constitutes authentically "dysfunctional" in a mechanistic sense in that population to begin with.
Children are very difficult to study in placebo-controlled groups. The bar for ethics there is (rightly) extraordinarily high. So mostly, nobody knows what happens to the control group-- or to the experimental one-- because it's unclear right away whether or not physicians and parents are selecting different treatment options on the basis of something relevant to a different level of severity, a possible different underlying 'dysfunction' to begin with, etc. Some kids "outgrow" asthma, too, and others worsen-- dramatically-- even WITH treatment. Did they all have the same condition? Probably not.
As others have noted, the FLORID cases of out-there behavior, sure-- everyone can see that those are "non-NT" in some way, even if we don't always have any idea what it means in terms of brain activity or diagnostics.
Where there's no such bright line between yes/no, then maybe it isn't actually "disease" at work so much as some kind of spectrum. Maybe in the case of EF, it's (for the majority) a heritable developmental delay, and not a permanent impairment.
