As a child psychologist, I get asked many questions about Attention Deficit Disorder and recently I received some interesting questions pertaining specifically to girls who have ADHD. I thought I would share some of my answers to this parent:
1. What are the symptoms in girls with ADHD? At what age do they get diagnosed usually?
The incidence of ADHD is 4X more prevalent in boys than girls but we seem to overlook hyperactive boys more readily than hyperactive girls, so these girls are picked up on the school’s radar more quickly than children presenting with only the Inattentive Type of ADHD. Girls who sit quietly and present no trouble or distraction to the teacher, are often overlooked as being inattentive because they appear to be listening.
Most children are diagnosed with ADHD during elementary school when teachers notice they are distracted, restless or underactive, daydreaming, and inattentive. The symptoms for girls do not differ significantly from those observed in boys. Some girls are hardworking and motivated so they are able to compensate until the demands of classes in high school overwhelm their organizational strategies. Also when the content of the class relies more on listening and retaining large volumes of oral or “lecture” material, their attention lags. They often come for testing and diagnosis at that time.
2. Do you think that there is a drop in self-esteem in girls with ADHD as they age and reach the teenage years?
The research is a little alarming for ADHD teenagers. There is a significant increase in co-morbid features such as depression, school failure, social isolation, and acting out. Many teenagers with ADHD engage in risky behavior due to their poor ability to stop and think things through before acting.
Also, for those girls on ADHD medication, they often go through a stage of rebelling against the parents’ decision to give the medicine and sometimes become non-compliant with the regimen. Many girls dislike being “singled out” for special modifications such as extra time on testing, and begin refusing the “help” that the school system has to offer.
3. How will I know if medication could be a help to my child?
We generally feel that for ADHD symptoms which fall only in the mild range, and are thus not interfering with day to day success, no medication is warranted, only behavioral interventions. For symptoms in the moderate range, there are definite indications that the child is not able to achieve to their potential because of their inattention and distractibility. Research says that medication PLUS behavior management is more successful than either alone in these cases. Severe symptoms of ADHD are obvious to even casual observers and are typified by extreme difficulty learning in school and complying with requests or engaging in successful peer relationships. Medication is vital to these children’s success.
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