By Kathleen G. Nadeau, Ph.D.
Most parents today have heard a great deal about Attention Deficit Disorder. When they hear that term, it's likely that a hyperactive little boy comes to mind. Boys with ADD, are easy to spot in the classroom, and are much more likely to be referred for an evaluation. Most questionnaires used to screen children for ADD emphasize items which describe these boys, items about hyperactivity, impulsivity and defiant behavior. Only those few girls who are like these boys with ADD are sent for assessment. The ratio of children referred to clinics for ADD evaluations continues to be about four or five boys for each girl. "Tomboys" with ADD
What we are beginning to realize is that there are many girls left undiagnosed because their symptoms look different. One big difference is that girls are less rebellious, less defiant, generally less "difficult" than boys. Sadly, they lose out due to their good behavior. It's the squeaky wheel that gets oiled. When a boy is causing frequent discipline problems, either at home or in the classroom, he will quickly be referred for treatment. Parents and teachers alike want quick relief from their constant challenges. Girls are more compliant, and are not as easy to spot. Often they are left to drift along from one school year to the next, never working up to their potential. Girls with ADD are not all alike. As we mentioned earlier, there are a few girls whose behavior closely resembles the behavior of boys with ADD. But what about those who don't?
Hyperactive girls are often "tomboys." They are physically active, drawn to more risk-taking activities such as tree climbing, exploring and playing with their brothers or other boys in the neighborhood. They may like soccer, swimming or horseback riding, but are less attracted to more girlish activities. But unlike many boys with ADD, these girls are often more cooperative at home, and may work harder to please their teacher at school. Their handwriting may be messy, they are often disorganized, and they may rush out the door for their next activity leaving their room a huge mess. Rather than suspecting ADD, parents and teachers of these girls may see them as undisciplined and just not academically inclined.
"Daydreamers" with ADD
Girls of the inattentive variety are often shy daydreamers. Their inattention in class may be overlooked because they try hard not to draw attention to themselves. Many quiet girls with ADD seem to be listening to their teachers, while their minds are a thousand miles away. These girls often seem anxious about school. They are forgetful and disorganized in completing their school work and become very worried as assignments come due. When sent to their room to complete homework they may quietly daydream at their desk unless they are kept on track by a parent sitting beside them. They may seem easily overwhelmed and operate at a slower pace than other girls. Some of these girls are anxious or depressed, and are often mistakenly seen as less bright than they actually are.
"Chatty Kathy" with ADD
A third type of girl with ADD is a combination of hyperactive and inattentive. While they have a much higher activity level than the daydreamers, they are not necessarily "tomboys." Often these girls are hyper-talkative rather than hyperactive. They are "silly", excitable and overemotional. They chatter constantly in class and have trouble staying quiet even when they are disciplined for talking. They interrupt others frequently and jump from topic to topic in conversation. These girls may have trouble explaining a story line or movie plot - frequently interrupting themselves to say "wait a minute, I forgot to tell you..." Or they tell the story in a very confused manner because they have trouble organizing their thoughts before they start talking. These girls may be social leaders. They are active, talkative and are exciting to be around. Their friendships may be more dramatic, filled with overreactions and arguments.. These girls may adopt a "silly" personality to mask their disorganization and forgetfulness. During their teen years these girls may compensate for poor academics by becoming hyper-social and taking risks such as smoking, drinking and becoming sexually active at an early age.
Gifted girls with ADD
Highly intelligent girls with ADD can be the most difficult to spot. The brighter your daughter with ADD is, the later her school problems tend to emerge. Many girls with above average IQ can keep it together academically until they hit middle school, or even high school. As their school life becomes more demanding and complicated in the upper grades, their problems with concentration, organization and follow-through are more likely to reveal themselves.
The high price of going undiagnosed
Girls with undiagnosed ADD often pay the price of being seen as ditzy, spacey or nonacademic. Due to internal disorganization and distractibility many of these girls pick up, but soon drop many hobbies and interests. Activities such as learning to play a musical instrument, which require discipline and perseverance, are rarely continued. Not only do they fall behind academically, but they also come to think of themselves as "quitters" with few talents. Parents and teachers may dismiss these girls as undisciplined, and sadly, they come to deny their own abilities.
Paula and Becky Stanford, a mother and daughter, both now diagnosed with ADD, have made a very touching video called Dismissed and Undiagnosed Dreamers, describing the experiences Becky encountered as a girl, and later a teen, with undiagnosed ADD. Following her diagnosis and treatment for ADD, Becky went on to earn a master's degree in social work and has made it one of her life's missions to educate parents, teachers and professionals about girls with ADD so that other girls will not suffer through the same experiences.
A checklist if you think your daughter may have ADD
__ I have trouble finishing my assignments in class.
__ I daydream in class.
__ Even when I try to listen, my thoughts wander.
__ I forget to bring papers and permission slips from home.
__ I have trouble following the teacher's directions.
__ My mind wanders when I read.
__ Projects and papers are hard for me to finish.
__ I often do my work at the last minute and turn things in late.
__ I forget to bring the right books home from school.
__ I get upset more easily than my friends.
__ Sometimes it feels like I'm not good at anything.
__ I am frequently late.
__ It's hard for me to concentrate when their are people around me.
__ My parents and teachers tell me I don't try hard enough.
__ Other kids tease me about being spacey.
__ I feel different from other girls.
__ I lose track of time.
__ have a messy book bag.
__ My room at home is a disaster.
What should you do if you suspect that your daughter may have ADD?
Look carefully in your community for professionals who have experience in diagnosing and treating girls. CH.A.D.D. (Children and Adults with Attention Deficit Disorder) is a national organization with local chapters in many cities and towns across the country. You can contact the CH.A.D.D. national office to find the CH.A.D.D. chapter nearest you. (301-306-7070). Monthly CH.A.D.D. meetings are free and are a good place to network with other parents to find the best professionals in your area. If you feel that your daughter is not working up to her potential, or if she seems to fit some of the patterns described here, trust your instincts and seek an evaluation. Your daughter's teacher may disagree with an ADD diagnosis because he or she is only trained to recognize male-pattern ADD behaviors. Teacher education is badly needed to help them recognize the different ADD patterns seen in girls.
You can advocate even more actively for your undiagnosed daughter by helping with community education. Check out the ADDvance website on the internet - A Resource For Women and Girls with ADD at www.addvance.com. Try to convince your daughter's school or your local CH.A.D.D. chapter to purchase the video Dismissed and Undiagnosed Dreamers as a community education tool.
The sooner that your daughter is diagnosed, treated, supported and encouraged the better off she will be. Make sure that your daughter has a chance to develop her potential, to recognize her talents, and to feel good about herself. We've let far too many girls grow up, never taken seriously. Don't let your daughter be one of them!
* Re-posted with permission from www.addvance.com, a site dedicated to women and girls with ADHD.