Okay, we noticed, we don’t have a “Z” topic.  What is the Z of ADHD?

504 Plan

A plan setting forth services and/or Special Accommodations for a child with a disability, pursuant to Section 504 of the Rehabilitation Act of Counterpart of an Individualized Education Plan (IEP) under the Individuals with Disabilities Education Act (IDEA).

Americans with Disabilities Act (ADA)

A Federal anti-discrimination Statute that can be used to protect students with disabilities from discrimination in pursuit of a major life activity (ie Education). The Act prohibits disability based discrimination by agencies receiving Federal funding.

Assistive Technology

An external device or functionality that seeks to remediate a learning disability, or other disorder, or to provide equal access to educational services to children with disabilities.

Attention Deficit/ Hyperactivity Disorder (AD/HD, ADHD and ADD)

This general term encompasses Attention Deficit Disorder (ADD), hyperactive, inattentive or combined types.

Behavior Intervention Plan (BIP)

A plan of positive behavioral interventions, made a part of the IEP of a child whose behaviors interfere with that child’s learning or their peers.

Code of Federal Regulations (CFR)

Set of administrative regulations established by the United States Department of Education to interpret IDEA.

Committee for Special Education (CSE)

Sometimes referred to as the special education team, that is required by the Individuals with Disabilities Education Act (IDEA) to provide an Individualized Education Program (IEP) to address the needs of children from Kindergarten through High School Graduation, or the age of 21, who qualify for Special Education Services pursuant to the statute.

Committee for Preschool Special Education CPSE

Similar in operation to the Committee for Special Education, but deals with children from two years of age up to Kindergarten.

Co-Morbid Disorder

A disorder, or Specific Learning Disability (SLA) that is present along with another functional disability.

DSM IV

Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) published by the American Psychiatric Association. It is the main diagnostic reference for mental health professionals in the United States.

Due Process Hearing (Impartial Due Process Hearing)

An impartial hearing which commences upon a formal request by either parents or LEA. The hearing is conducted before an Independent Hearing Officer (IHO) or Administrative Law Judge (ALJ) who takes testimony under oath and presides. The hearing is stenographically recorded and a written decision is required to resolve the dispute between the parties. Either party can appeal the decision of an IHO to a State Review Officer (SRO).

Family Educational Rights and Privacy Act (FERPA)

Federal Statute that ensures both the right to privacy and access of a student’s educational records. It is important to note that the protection of this law for children under 18 belongs to the parent and/or legal guardian, while that protection switches to the child at age 18, subject to a few limited exceptions schools and parents must obtain written consent of the student to share educational information.

Free Appropriate Public Education (FAPE)

See IDEA

Independent Hearing Officer (IHO)

An officer appointed by a State Department of Education to hear disputes between parents and school districts at a Due Process Hearing. Depending upon the testimonial record, an IHO has the authority to subpoena documents, and/or order either side to comply with his or her directive.

Individuals with Disabilities Education Act (IDEA)

An Educational Statute enacted by the Federal Government and codified under 20 USC 1400. IDEA governs children up to the age of 21 or up to achieving their high school diploma. The statute, now referred to as the Individuals with Disabilities Education Improvement Act, ensures that children with qualifying disabilities receive a Free Appropriate Public Education (FAPE).

Individual Education Program (IEP)

An education program required by the Individuals with Disabilities Education Improvement Act, to be designed to meet the specific needs of a disabled child who qualifies for Special Education. The IEP must contain annual goals and be reviewed on an annual basis.

Learning Disability (LD) or Specific Learning Disability (SLD)

A disability category under IDEA which includes disorder s that affect the ability to understand and/or use spoken or written language, or which may be manifested by difficulties with listening, thinking, speaking, reading, writing, spelling and/or performing mathematical calculations. LD or SLD also includes minimal brain Dysfunction (AD/HD), dyslexia, dysgraphia developmental aphasia and other disorders.

Least Restrictive Environment (LRO)

A requirement under IDEA, that special education and/or related services be provided in, or as close to a main stream environment as is possible or practicable under the circumstances.

Local Educational Agency (LEA)

The local school district responsible for providing services to a student or group of students.

Mediation

A procedural safeguard under IDEA to resolve disputes between parents and LEA’s. Mediation is a voluntary alternative to a to a due process hearing and may not be used to deny or delay a due process hearing. The medication must be conducted by a qualified and impartial mediator who is trained in effective mediation techniques. The decision of the mediator is non-binding and a disagreement between the parties can still be the basis for a due process hearing.

Obsessive Compulsive Disorder (OCD)

is classified, in DSM IV as an anxiety disorder characterized by distressing intrusive thoughts and/or repetitive actions that interfere with the individual’s daily functioning.

Occupational Therapy (OT)

is a related service used to remediate deficits or developmental problems with sensory integration and fine motor skills.

Oppositional Defiant Disorder (ODD)

refers to a recurrent pattern of negative, defiant, disobedient and hostile behavior toward authority figures lasting aat least six months.

Section 504 of the Rehabilitation Act of 1973 (504)

A Civil rights statute prohibiting recipients of Federal funding from discrimination on the basis of a disability.
Special Education PTA (SEPTA) – Branch of the local Parent Teacher Association specializing in issues concerning children with special needs.

State Review Officer (SRO)

An officer appointed by the State to review the decision, on appeal, of an Independent Hearing Officer (IHO) after a Due Process Hearing.

Traumatic Brain Injury (TBI)

is a disability category under IDEA which includes acquired injury caused by external physical force and open or closed head injuries that result in impairments. It does not include congenital or degenerative brain injuries or injuries caused by birth trauma.

• Under diagnosis due to symptoms that don’t echo the male standard for ADHD
• Hyperactivity presenting as talkativeness and emotional behavior instead of the classic “propelled by a motor.”
• Greater disorganization, depression and anxiety than boys.

This fall Dr. Quinn will publish a new book, 100 Questions and Answers about ADHD in Women and Girls.  We thought this would be a good time to ask her a few questions of our own.

Edge: Is there anything about the challenges ADHD girls and women face that has emerged for you since our last interview?

Dr. Quinn: I think we have seen more in the way of confirming the development of eating disorders in girls with ADHD.

Edge: What, if anything, is unique about diagnosing ADHD girls with eating disorders than is different from other girls?

Dr. Quinn: Well first, the symptom of impulsivity seems to be a significant factor in the development of eating disorders in girls with ADHD. Poor self-esteem may also play a role, but one does not see the impaired body image seen in girls with eating disorders in general.  Girls with ADHD may binge and develop bulimia, but not because of a desire for thinness, but rather because of mindless or impulsive eating. Women with ADHD often report that they eat to feel better or for stimulation.

Edge: What should parents do when they suspect their daughter with ADHD has an eating disorder?

Dr. Quinn: Parents of these girls should pursue a complete assessment with an eating disorder specialist trained to realize that ADHD may be part of the picture. Girls will need to be treated for their ADHD symptoms (inattention and impulsivity) in order to be able to follow a program to address their disordered eating. Stimulants not only treat the symptoms of ADHD, but, according to some experts, may actually decrease the urge to binge.

Edge: Is there anything else you want people to know about girls and ADHD?

Dr. Quinn: Girls tend to suffer silently for many years, and as a result develop poor self-esteem early on. In addition, many develop anxiety because of their untreated ADHD symptoms. Their symptoms seem to sneak up and ambush them and they worry that this will happen again. So, they get anxious or develop compensatory strategies. They may worry and begin checking to see if they have a test they have forgotten about, or a book they forgot to bring home from school.

They can even develop obsessive compulsive personality disorders where they try to control one aspect of their life to the exclusion of others.  I have seen girls with ADHD become perfectionists to compensate for their symptoms. They spend a great amount of time and energy trying to compensate until it all gets too much for them and they get depressed or just give up.  It is, therefore, important to treat ADHD in girls even if they seem to be doing well academically and holding it all together because they may be doing so at a great cost.

I also want to send the overall message that the disorder does not remit but continues to cause significant problems and functional impairments particularly in girls with the inattentive type ADD.

Edge: What would you say, then to parents who are hoping their daughter will just “outgrow it?”

Dr. Quinn: ADHD is a chronic, life-long disorder. Symptoms may be less impairing as we learn to live with them and develop strategies and a life style to better cope. However, girls who demonstrate the most success are those that have adopted a multi-pronged approach to treating the disorder including, medication, therapy and appropriate treatment goals early on. ADHD coaching, like the Edge Foundation offers, can be an important component in learning compensatory strategies and behaviors.  Girls who as adolescents continue to have significant functional impairments are those who are usually not taking medication even though they have briefly made use of other services in and outside of school. These, however, may not be enough.

Edge: What are some of the most common questions you are asked about women and girls who have ADHD?

DR. Quinn: I am constantly asked why girls and women aren’t diagnosed as early as boys. I think this is because girls are not identified by teachers or others. Often teachers are comparing girls’ behaviors to those of boys rather than the performance of other girls. Mothers may be more likely to compare their daughter’s behavior to that of other girls thus may be more reliable at referring their daughters for an evaluation.  Girls are less disruptive and don’t call attention to themselves, so they don’t get referred. In addition girls and women work hard to compensate for their symptoms and to not let others know the problems that they are having.

Edge: Do women’s hormones have any impact on how medication levels need to be prescribed over time? For instance, does going through puberty or menopause mean medication levels need to be adjusted during those periods?

Dr. Quinn: When hormone levels decrease in menopause many women report that their ADHD symptoms increase and that their medications don’t seem to be as effective as previously.  It is often necessary to increase the dose of medications at this time. In addition, I find that during puberty symptoms often worsen in girls with ADHD. A medication dose that worked previously may no longer be effective during this time.

Edge: You’ve been a long-standing champion for women and girls who have ADHD, do you see the rest of the medical profession catching up in awareness or is there still a lot of ground to cover until females with ADHD receive equal medical treatment?

Dr. Quinn: I think that overall the medical profession is doing a better job at recognizing and treating girls with ADHD.  The problem seems to be with educating teachers and school systems about the disorder in females.

Readers:  Do you have a question about ADHD in girls?  Let us know in the comments and we’ll do our best to get you an answer.

504 Plan

A plan setting forth services and/or Special Accommodations for a child with a disability, pursuant to Section 504 of the Rehabilitation Act of Counterpart of an Individualized Education Plan (IEP) under the Individuals with Disabilities Education Act (IDEA).

Americans with Disabilities Act (ADA)

A Federal anti-discrimination Statute that can be used to protect students with disabilities from discrimination in pursuit of a major life activity (ie Education). The Act prohibits disability based discrimination by agencies receiving Federal funding.

Assistive Technology

An external device or functionality that seeks to remediate a learning disability, or other disorder, or to provide equal access to educational services to children with disabilities.

Attention Deficit/ Hyperactivity Disorder (AD/HD, ADHD and ADD)

This general term encompasses Attention Deficit Disorder (ADD), hyperactive, inattentive or combined types.

Behavior Intervention Plan (BIP)

A plan of positive behavioral interventions, made a part of the IEP of a child whose behaviors interfere with that child’s learning or their peers.

Code of Federal Regulations (CFR)

Set of administrative regulations established by the United States Department of Education to interpret IDEA.

Committee for Special Education (CSE)

Sometimes referred to as the special education team, that is required by the Individuals with Disabilities Education Act (IDEA) to provide an Individualized Education Program (IEP) to address the needs of children from Kindergarten through High School Graduation, or the age of 21, who qualify for Special Education Services pursuant to the statute.

Committee for Preschool Special Education CPSE

Similar in operation to the Committee for Special Education, but deals with children from two years of age up to Kindergarten.

Co-Morbid Disorder

A disorder, or Specific Learning Disability (SLA) that is present along with another functional disability.

DSM IV

Diagnostic and Statistical Manual of Mental Disorders (Fourth Addition) published by the American Psychiatric Association. It is the main diagnostic reference for mental health professionals in the United States.

Due Process Hearing (Impartial Due Process Hearing)

An impartial hearing which commences upon a formal request by either parents or LEA. The hearing is conducted before an Independent Hearing Officer (IHO) or Administrative Law Judge (ALJ) who takes testimony under oath and presides. The hearing is stenographically recorded and a written decision is required to resolve the dispute between the parties. Either party can appeal the decision of an IHO to a State Review Officer (SRO).

Family Educational Rights and Privacy Act (FERPA)

Federal Statute that ensures both the right to privacy and access of a student’s educational records. It is important to note that the protection of this law for children under 18 belongs to the parent and/or legal guardian, while that protection switches to the child at age 18, subject to a few limited exceptions schools and parents must obtain written consent of the student to share educational information.

Free Appropriate Public Education (FAPE)

See IDEA

Independent Hearing Officer (IHO)

An officer appointed by a State Department of Education to hear disputes between parents and school districts at a Due Process Hearing. Depending upon the testimonial record, an IHO has the authority to subpoena documents, and/or order either side to comply with his or her directive.

Individuals with Disabilities Education Act (IDEA)

An Educational Statute enacted by the Federal Government and codified under 20 USC 1400. IDEA governs children up to the age of 21 or up to achieving their high school diploma. The statute, now referred to as the Individuals with Disabilities Education Improvement Act, ensures that children with qualifying disabilities receive a Free Appropriate Public Education (FAPE).

Individual Education Program (IEP)

An education program required by the Individuals with Disabilities Education Improvement Act, to be designed to meet the specific needs of a disabled child who qualifies for Special Education. The IEP must contain annual goals and be reviewed on an annual basis.

Learning Disability (LD) or Specific Learning Disability (SLD)

A disability category under IDEA which includes disorder s that affect the ability to understand and/or use spoken or written language, or which may be manifested by difficulties with listening, thinking, speaking, reading, writing, spelling and/or performing mathematical calculations. LD or SLD also includes minimal brain Dysfunction (AD/HD), dyslexia, dysgraphia developmental aphasia and other disorders.

Least Restrictive Environment (LRO)

A requirement under IDEA, that special education and/or related services be provided in, or as close to a main stream environment as is possible or practicable under the circumstances.

Local Educational Agency (LEA)

The local school district responsible for providing services to a student or group of students.

Mediation

A procedural safeguard under IDEA to resolve disputes between parents and LEA’s. Mediation is a voluntary alternative to a to a due process hearing and may not be used to deny or delay a due process hearing. The medication must be conducted by a qualified and impartial mediator who is trained in effective mediation techniques. The decision of the mediator is non-binding and a disagreement between the parties can still be the basis for a due process hearing.

Obsessive Compulsive Disorder (OCD)

is classified, in DSM IV as an anxiety disorder characterized by distressing intrusive thoughts and/or repetitive actions that interfere with the individual’s daily functioning.

Occupational Therapy (OT)

is a related service used to remediate deficits or developmental problems with sensory integration and fine motor skills.

Oppositional Defiant Disorder (ODD)

refers to a recurrent pattern of negative, defiant, disobedient and hostile behavior toward authority figures lasting aat least six months.

Section 504 of the Rehabilitation Act of 1973 (504)

A Civil rights statute prohibiting recipients of Federal funding from discrimination on the basis of a disability.
Special Education PTA (SEPTA) – Branch of the local Parent Teacher Association specializing in issues concerning children with special needs.

State Review Officer (SRO)

An officer appointed by the State to review the decision, on appeal, of an Independent Hearing Officer (IHO) after a Due Process Hearing.

Traumatic Brain Injury (TBI)

is a disability category under IDEA which includes acquired injury caused by external physical force and open or closed head injuries that result in impairments. It does not include congenital or degenerative brain injuries or injuries caused by birth trauma.

Take a look at the 12 rules and you’ll see that much of what he talks about are familiar Edge Foundation topics. Want to get a great preview of what his book covers? Visit Brainrules.net where Medina has free, on-line tutorials covering the important information from each chapter.

We agree that the principals outlined in the book are important insights into living to your full potential with ADHD.  When looking them over, we noticed a few common themes we’ve shared in the posts we have written over the last couple of years.  Here’s our take on each brain rule and how it plays out for ADHD:

Exercise – Rule #1: Exercise boosts brain power.

Treating ADHD with exercise
Spark: Reduce ADHD symptoms with exercise
ADHD and anxiety:  Non drug treatments everyone can try

Survival – Rule #2: The human brain evolved, too.

Wiring – Rule #3: Every brain is wired differently.

Executive function and ADHD success/
Succeeding despite learning disabilities/

Attention – Rule #4: We don’t pay attention to boring things.

Fidgeting helps ADHD people stay focused

Short-Term Memory – Rule #5: Repeat to remember.

Long-Term Memory – Rule #6: Remember to repeat.

Sleep – Rule #7: Sleep well, think well.

ADHD students need to take their sleep seriously
ADHD and sleep
ADHD, anxiety and the sleep connection

Stress – Rule #8: Stressed brains don’t learn the same way.

Improve your focus with water

Sensory Integration – Rule #9: Stimulate more of the senses.

You can do more to manage ADHD
Fidgeting helps ADHD people stay focused

Vision – Rule #10: Vision trumps all other senses.

Gender – Rule #11: Male and female brains are different.

Girls with ADHD face special challenges

Exploration – Rule #12: We are powerful and natural explorers.

Did you read the book or learn anything here you didn’t know about how the brain works?  Let us know in the comments.

• A just-published study by researchers at Columbia University shows that teens who stay up later are more prone to depression and suicidal thoughts.
• People with ADHD have twice the rate of insomnia and sleep disturbances as people who don’t have ADHD.
• Irregular sleep habits can actually increase your anxiety symptoms.
  Sleep deprivation is also linked to memory and concentration problems and can actually exacerbate hyperactivity symptoms.

When you consider that people with ADHD have much higher levels of depression than the general population , and shorting yourself on sleep increases depression, it seems like a no-brainer to practice healthy sleep habits. If going to bed on time every night can help reduce depression, why are you still pulling all nighters?
So while you are busy sticking to all of your New Year’s resolutions, why not add one that can boost the likelihood you’ll be able to keep them? Go to bed on time every night! And don’t forget to turn off your computer and phone so you won’t be tempted to text or surf at night. One quick text or tweet can easily turn into a late night.
If you are having trouble sticking to a regular bedtime, even when you intend to go to bed on time, a talking to an ADHD coach can help you reduce the distractions, obstacles and last minute fire drills that rob you of life-giving sleep.

Next up, our Executive Director, Sarah Wright, will be speaking at the ADD Resources annual conference entitled Acceptance is Empowering and held in the Seattle area on November 14, 2009. Her session, A is for Anxiety, focuses on how to keep anxiety at bay and builds on the material in these Edge blog posts: ADHD and Anxiety Overview, Common Anxiety Disorders and ADHD, and Non Drug Treatments for Anxiety Everyone Can Try.

If you haven’t heard of them before be sure to check out ADD Resources. This non-profit is a great resource for people living with ADHD. They have a large library of podcasts, books and articles that are free to members or offered at a very low price for non-members. Their November conference will offer a wide range of breakout topics aimed at the parent or student who has ADHD. If you are in the Seattle area next week, be sure to consider attending.  If you aren’t able to make it, be sure to check out the wide range of articles we have on file in our blog and watch for our upcoming post about coping with depression.

If you’d like to find out where Edge Foundation board or staff will be appearing and other inside information about Edge, be sure to  sign up for our Newsletter. ,

Earlier this year we did a series on ADHD and anxiety.   You may recall that the rate of anxiety disorders is much higher in folks with ADHD than in the general public.  Are you surprised to hear that there is also a higher rate of depression among people who have ADHD than the general population?   ADHD often comes with a host of other issues such as learning disabilities, anxiety and depression.  Perhaps depression is the most life-threatening condition of all.  This post is the first of a series that explores living with ADHD and depression.

What are the known causes for depression?

There is no single cause of depression.  Depression happens because of a combination of things including:

Genes – some types of depression tend to run in families.  Genes are the “blueprints” for who we are, and we inherit them from our parents.  Scientists are looking for the specific genes that may be involved in depression.

Brain chemistry and structure – when chemicals in the brain are not at the right levels, depression can occur.  These chemicals, called neurotransmitters, help cells in the brain communicate with each other.  By looking at pictures of the brain, scientists can also see that the structure of the brain in people who have depression looks different than in people who do not have depression.  Scientists are working to figure out why these differences occur.

Environmental and psychological factors – trauma, loss of a loved one, a difficult relationship, and other stressors can trigger depression.  Scientists are working to figure out why depression occurs in some people but not in others with the same or similar experiences.  They are also studying why some people recover quickly from depression and others do not.

Why do people with ADHD have depression at higher rates than the general population?

Unfortunately science hasn’t cracked the code of why some people get depressed and others do not.  However, Aaron Beckr (who is known as the father of Cognitive Behavioral Therapy) recently gave us a clue when he said  “brain scans have found that in depressed people the prefrontal cortex, known as the seat of rational thought, tends to be underactive.”  If you’ve read much about ADHD, you’ll know that this  area of the brain that is also underactive in ADHD and executive function disorders.

Research shows that people with ADHD have a higher incidence of depression due to the many obstacles, disappointments, perceived failures, and lack of support and understanding that often comes with living with ADHD.  The typical person with ADHD has an uphill battle facing the many myths and misconceptions surrounding the diagnosis.  The years of hearing “if only you would try harder” can take its toll and low self esteem is common.

All teens — especially those with ADHD — should be tested for depression

Last April the journal of Pediatrics reported that the government-appointed U.S. Preventive Services Task Force recommends that all teens should be tested for depression by their primary care physician.  Nearly 2 million U.S. teens are affected by depression, but most suffer undiagnosed.  When you consider that a higher than average number of those kids have ADHD, it is a compelling reason to be sure your teen is screened for depression at their annual exam.

For more information on depression:

http://www.nimh.nih.gov/health/topics/depression/index.shtml

And watch in coming weeks for Part 2 in the series which will explore types of depression.

Getting accommodations can be helpful, but they don’t address the real issues of ADHD.  Let’s step back a minute and look at what makes a student successful.  Successful students usually have four main qualities that help them achieve their goals:

• Sticking with things even when the going gets tough (a.k.a. perseverance),
• Ability to delay gratification and focus on the big picture,
• Time management and organizational skills, and
• Striking the right balance between fun and work.

These qualities, which are also known as your brain’s executive functions, are actually the hallmarks of ADHD. Students with ADHD can’t depend on these skills because these are exactly the skills they are weakest in.  Getting more time on your tests isn’t going to help you with getting organized. And preferential seating won’t solve impulsivity or time management.

For most with ADHD the problem is not so much in knowing what to do, but in getting it done.  If you have ADHD and are reading this, it’s likely that you’ve already tried countless organizational systems, have been nagged-to-death by caring, but overprotective parents, and feel frustrated with yourself because you know what to do, you just can’t seem to follow through.

ADHD coaching works with your strengths to accommodate your weaknesses

There is growing evidence, both research and anecdotal, that coaching helps students learn to plan, prioritize, and persist (i.e. follow the plan). It helps students develop self determination and self confidence and reduces anxiety and feeling overwhelmed. Through being coached, students learn how to coach themselves, and actually strengthen their executive functioning skills – something that no other intervention does.

It’s not too late to get started with an Edge coach. Because many coaches work on the phone, you can “take your coach with you” wherever you go. Starting early in the school year is smart because it is surprisingly easy for students with ADHD to fall behind without even realizing it. Failing classes is a big waste of money and not a good way to start your college career.

Want to learn more?  Sign up to speak to an Edge coach today and see if you don’t find you are more on top of things than you ever dreamed possible.

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.