ADHD Weekly 2017-02-09

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What happens to the hyperactive girl or the inattentive, outwardly calm boy? When ADHD symptoms don’t fit our expectations, how can we spot the child who needs help coping rather than dismiss troublesome behaviors? 

Frequently, girls are described as more likely to have the predominately inattentive presentation of ADHD, which includes difficulty concentrating, disorganization, problems following instructions, forgetting or losing things, and being easily distracted. Boys, on the other hand, tend to have more outwardly noticeable hyperactivity symptoms, such as fidgeting, difficulty remaining seated, blurting out answers, not taking turns, and running around excessively.  

Girls and boys can display ADHD symptoms in ways we might not think of as being typical of the diagnosis. Hyperactive girls and quiet boys can be missed when parents and professionals tend to assign ADHD presentations to boys and girls. 

What can you be on the lookout for when considering ADHD symptoms in girls and boys?

Hyperactivity in girls

Kathleen Nadeau, PhD, author of Understanding Girls with ADHD, provides information that may help you recognize hyperactivity in a girl, who:

• tends to be physically active, drawn to more risk-taking activities such as tree climbing
• may have messy handwriting 
• is often disorganized and may rush out the door for the next activity, leaving her room a huge mess 
• may have trouble falling asleep at night or will wake up early in the morning
• may be hyper-talkative or hyper-verbal, rather than physical
• may be very strong-willed and controlling and have difficulty getting along with her peers

Girls with hyperactivity may be harder to spot in the classroom. From a very young age, girls are taught to sit still in class and told that being overly rambunctious is “unladylike.” Instead, hyperactive symptoms may come out during the unstructured time at recess and before and after school. Girls affected by hyperactivity can also be more talkative than their peers and chatty during situations when they are required to be quiet. 

Although more information on how ADHD affects girls is widely available today, many girls who experience ADHD symptoms nevertheless go unrecognized. A study in Child Care Health Development describes teachers who were presented with descriptions of girls affected by ADHD. The educators in the study recognized the presence of a problem, but did not identify it as potentially ADHD.

“Teachers were able to recognize ADHD-related behaviors and impairments but conceptualized these as reflecting attentional or emotional difficulties rather than as relating to a disorder (ADHD),” the study authors write. “Improving teachers’ knowledge about ADHD, especially the inattentive subtype, could assist in tackling gender-related barriers to care.”

For the girl, hyperactivity may get her into trouble at school for talking to classmates or causing problems in class for speaking out of turn, not raising her hand, or being too aggressive with classmates. Some of her aggressive behaviors may be channeled into sports, such as soccer or basketball, where these behaviors can actually be an asset on the field or court. Away from sports, however, her hyperactivity and impulsive behaviors can make it harder for her to keep friends and so she may spend more time on her own, rather than with other children. 

Inattentiveness in boys

Inattentive boys can be harder to detect because they don’t fit the mold. They tend to fly under the radar and may have their symptoms mistaken for daydreaming, stubbornness, or even willfulness. A boy with inattentive ADHD will exhibit symptoms in which he:

• frequently makes careless mistakes or has trouble paying attention to details 
• may act as if they are daydreaming or mentally wandering off
• may struggle to follow instructions
• does not appear to listen
• has problems organizing, both at school and at home
• avoids or dislikes tasks requiring sustained mental effort 
• loses things
• is easily distracted
• appears forgetful in daily activities 

Boys with inattentive ADHD may be overlooked because their symptoms generally only affect themselves and don’t get in the way of other children’s learning. Their needs could be overlooked because they are not creating obvious behavior problems within the classroom. They may be characterized as daydreamers or may be easily distracted. They may silently end up with poor grades, have fewer friends, and experience depression related to their ADHD symptoms. 

How can you help your child?

If you suspect that your daughter or son has ADHD, talk with the pediatrician and ask for a referral to a specialist in ADHD diagnosis and treatment. 

In addition to seeking treatment for your daughter, consider channeling her hyperactivity constructively. Many girls with hyperactivity can benefit from participating in sports, such as martial arts, soccer, or gymnastics, which not only improves concentration but also provides a physical outlet for their excess energy, with social benefits as well. 

For boys with inattentive ADHD, helping them obtain organizational skills, study strategies, and other educational supports can help them succeed.  Finding treatment specifically designed to help children with inattentive ADHD is crucial. A study of a psychosocial treatment for children with inattentive ADHD yielded some encouraging results. One component, parental training in which parents learned strategies to help their children, proved particularly useful. The training taught the use of rewards and positive consequences and ways to establish daily routines, give effective directions, avoid power struggles, manage stress, ways to organize and structure their home to promote their child’s adaptive functioning, and how to use negative consequences.

Do you or your child march to the beat of a different drummer? Share your experiences with our community.