Editor: We are honored to have had Dr. Patricia Quinn involved with the Edge Foundation since our founding. Dr. Quinn is a leading ADHD expert who has worked with, written about and provided training in the field of ADHD for more than 30 years. This month we are pleased to be talking with her about one of her primary concerns: girls with ADHD.
Key ideas:
- Many girls with ADHD are left undiagnosed because their symptoms look different than boys.
- Hyperactivity in girls can appear as being hyper-talkative or hyper-reactive (more emotional).
- ADHD girls have greater problems with disorganization than boys.
- Depression and anxiety are symptoms to watch for in older girls with ADHD.
- ADHD coaching can help girls with ADHD learn what works to be successful in school and in life.
Edge: Thank you for all you’ve done on behalf of people with ADHD over the last 30 years. What are the ADHD projects you are most excited about these days?
Dr. Patricia Quinn: I can honestly say that working with young girls with ADHD, helping them understand the disorder and learn to live happy, productive lives is very close to my heart. My most recent book, Attention, Girls! A Guide to Learn All about Your ADHD, is special because it focuses on the lives of girls ages 7 to 13 years.
I also feel passionately about my work with college students with ADHD most of whom are newly diagnosed and struggling to stay in school. When I get a call from someone who has just earned his law degree, and he says that he couldn’t have done it without my help when he was in college, it makes my day!
Edge: Girls have had a history of being under-diagnosed with ADHD in part because their symptoms can look very different from boys who have ADHD. Can you speak to that a little bit?
Dr. Patricia Quinn: Boys with ADHD 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 ADHD emphasize items that describe these boys, items about hyperactivity, impulsivity and defiant behavior.
- Only those few girls who are like these boys with ADHD are sent for assessment.
- The ratio of children referred to clinics for ADHD evaluations continues to be about four or five boys for each girl.
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, and 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 with ADHD 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 and suffering silently.
Edge: So you are saying girls have the same symptoms as boys, they are just less rebellious?
Dr. Patricia Quinn: Basically there are core symptoms of ADHD that are critical to the diagnosis. These include problems with attention and hyperactivity/impulsivity. In general, girls usually have more problems with attention. However, girls can also have hyperactivity, but it manifests in different ways. For example, girls with ADHD can be hyper-reactive rather than hyperactive. They are more emotionally labile with tantrums, slamming doors, etc. Instead, of running around and being motorically hyperactive and disruptive like boys with ADHD, they can be hyper-talkative. In addition to problems with attention, girls have problems with disorganization and, after puberty, have greater incidence of coexisting depression and anxiety.
Edge: Is there any advice you can offer to high school or college age young women to help them work with their ADHD to be successful?
Dr. Patricia Quinn: To successfully deal with and manage both ADHD symptoms and their lives, girls with ADHD must accurately assess their strengths, as well as weaknesses, and develop a plan for going forward. For many girls, this means facing and shouting down the shame, low self-regard and those self-defeating scripts they have in their heads that tell them how terrible they are. In addition, they need to develop a plan, building on their strengths, to deal with time management, disorganization and the other issues that get in the way of their success.
High school is the perfect time to begin developing strategies to deal with their ADHD symptoms. However, teens do not need to face these challenges alone. Family members, teachers, therapists and ADHD coaches are there to help. By enrolling the aid of a coach early on, the girl with ADHD can learn what works for her and what she needs to do to be successful in college and life beyond.
6/2010 Editor’s Note: For more about ADHD and Girls, check out the latest interview with Dr. Quinn.
Laura F. responded on 13 Jan 2010 at 5:50 pm #
I have a daughter in her 3rd year at a JC who is barely hanging on to last thread of giving up. She believes she is a loser not worthy… I know she has ADD or learning disability that has sabotaged her everything the last 5 years, through HS and into a junior college. She is extremely talented, coaches say a division 1 college player, an Olympic player came to film her but she cannot get her life together as far as grades, follow through, maturity, learning, her self esteem, depression, and all the things that I contribute to ADD. Coaches come and call from all around and want her but don’t understand what’s wrong with her?? Her personality hid the problem for years until HS. Everyone loved her sunny disposition, sense of humor, sharp wit, huge heart and common sense. I have watched opportunity after opportunity pass her by because she cannot get herself together. With each failure and lost opportunity she has become more and more rebellious, angry, depressed, and she doesn’t know why.
No matter how much she wants it and how much she tries it always fails. She now just doesn’t believe in herself and I know she has the terrible self talk. Her issues do not stand out like a cut so she doesn’t understand what is not working. She only believes she can’t do it. She is frozen in fear….and anger! She has had so many failure in school she shuts down, and stays because the failure. It’s so terrible because it is (so suttble and her personality so strong no one, including herself thinks it’s ADD. She appears lazy and shuts down, she has no motivation or inspiration, if I could describe her it looks like she is bobbing in a stream waiting for a current to take her… she doesn’t swim. She tends to gravitate towards troubled kids beneath her level and class pulling herself down. I doesn’t perform administrative life tasks and skills.
Girls with ADHD 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 and suffering silently.
Peggy -- Edge Foundation blogger responded on 26 Jan 2010 at 12:06 pm #
Thanks for sharing your story, Laura. Just know you are not alone and a coach can help. Following up via email. Good luck!
Brain rules for ADHD | Edge Foundation responded on 29 Mar 2010 at 6:45 am #
[...] Girls with ADHD face special challenges [...]
Phyllis responded on 02 Jul 2010 at 10:04 am #
I have 11-year-old boy/girl twins. My son obviously has ADHD and is on medication to help him focus. He is very active, smart, impulsive and can’t focus to save his life. I have been thinking for a while that my daughter is just as hyper and impulsive as my son, except that she cares about pleasing people and works hard to make others be proud of her. She struggles achademically but works hard to get good grades. My son is very smart and doesn’t have to work as hard as she does to get work done. I have thought about talking to the doctor about ADHD medication for her, but I am afraid that the doctor will just look at the fact that she is overweight and not believe that she can possibly have ADHD. Any suggestions?
Peggy -- Edge blogger responded on 07 Jul 2010 at 7:54 pm #
Phylis — Before any doctor hands out a prescription for ADHD medication, they should conduct a thorough assessment which often includes an evaluation that both you and your child’s teacher(s) fill out. Talk to your pediatrician about their experience with diagnosing ADHD in girls. You may want to get a referral to a physician or psychiatrist who is experienced with ADHD in girls.
Amy responded on 18 Jul 2010 at 9:15 pm #
FYI Phylis- Being overweight is actually a hallmark of AD/HD. It makes sense if you think about impulsivity and the common need to self soothe or escape from feelings of boredom etc. Also just because someone is “hyperactive” doesn’t mean that they will be able to burn off the necessary calories with their hyperactivity to stay slim. Good luck!
Amy (my two kids, my husband and I all have ADD/HD in one form or another, so I totally sympathize)
Peggy -- Edge Foundation blogger responded on 19 Jul 2010 at 9:14 am #
Amy, thanks for your personal insight into impulsivity and overeating. Most of the time we hear about ADHD medication keeping children too thin. So it’s a new idea to many people that ADHD people often have weight issues!