ADHD and ADD in Girls

ADHD occurs up to four times more in boys than girls but there is an increasing concern that the condition is picked up so much later in the female population.

ADHD in girls – is it different?

ADHD and ADD involve difficulties with inattention, self-regulation and hyperactivity. There is also a link to anxiety and sleep difficulties. However, not all these symptoms occur in every case and many children present without the hyperactive element and receive an ADD diagnosis, often these will be girls. They may seem unusually distracted, untidy, or late with assignments.  Girls with ADD may have difficulty sustaining attention on a single task, so it appears boring, and wish to change activity quickly. However, there is a big question over the lack of diagnosis for the condition in girls, and when it does happen, why it is occurring so late with the average age for boys receiving a diagnosis at seven years, while for girls it is twelve.

Perhaps the answer lies in the presentation, some studies have shown that hyperactive and combination types of ADHD seem to be more frequent in boys, and is often spotted when they are starting school as they disrupt class, while the inattentive ADD type symptoms present more in girls. Worryingly, it appears both teachers and parents are more likely to spot the behaviours in boys than girls, although presentations are similar. However, others studies dispute there is a difference in ADHD between the genders and claim the symptoms are the same for both, but the combination of inattention and hyperactivity changes over time, as the child matures, with younger children being more noticeably active, while older children and adults struggle with inattentiveness.

Causes

The exact root of ADHD is not known, but it is known to have a genetic component. Other factors include prematurity and low birth weight, and smoking and alcohol during pregnancy. It can occur with any level of IQ but it is more common with children with learning difficulties. Evidence has shown a link between attention control in babies and later diagnosis of ADHD. Treatments involve management by medication and psychological therapies, and can be effective if identified early on.

Signs of ADHD in girls

  • Inner restlessness
  • Need to be on the go
  • Fidgety
  • Distracted easily
  • Forgetful
  • Impatience to move from one task to another
  • Acting without thinking
  • Being unable to take turns

ADD and ADHD change over time, as the child makes gains in concentration, however relative to their peers they continue to struggle with inattention and impulsivity, particularly when the increased organisational demands of secondary school become too much. They may become tired and disheartened by poor school performance.

Social problems and ADHD

Anxiety Disorder and Depression commonly co-occur, causing the child to be worried and nervous, or even have physical symptoms like a rapid heartbeat. Studies show that women with ADHD also have reduced executive function to their peers that is cognitive abilities which affect self-control, memory and flexible thinking.

Girls with ADHD have been shown to have relatively high rates of verbal aggression to other children in a classroom situation, whereas boys may be engaged in more rule-breaking and externalising behaviours. This goes some way to explain why fewer girls are referred to professional help at a young age. However, on many other, more unobtrusive social behaviours, the genders were found to be alike.

Attention difficulties like ADHD can co-exist with other behavioural conditions such as AutismODD or dyspraxia.

How parents can help

  • Identification is the first step in providing the support that is required, so act on your instincts if your child’s functioning is being affected by their attention difficulties, by contacting your GP or Senco.
  • Continue to monitor and re-evaluate their progress with concentration
  • Support, and do not penalise, organisational weaknesses both at school and at home in aspects such as assignment due dates, having PE kit, and planning for tests and exams.
  • Be prepared to support homework requirements.
  • Consider measures that offer options for socialising across a range of ages, eg after-school clubs.
  • Monitor internet use and electronic communication sensitively.
  • Consider counselling if issues of negative moods or anxiety occur, as in some cases they may not want to talk to teachers or parents.
  • Don’t rule out the option of medication to support attention and concentration skills.
  • Prepare the child for changes of routine and transitions.