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.
- 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.