I have been looking without much success, it seems, for information on ADD/ADHD in girls. My five yo daughter has exhibited signs of ADHD for a long time. She is very active----always on the move, very impulsive---sometimes dangerously so---, doesn't like to listen to me, takes risks, wants to go one step beyond whatever limit I set with her. One friend who has been teaching special ed for a long time told me she is more active than most five yo's.

We are taking her for counseling to deal with the problems her impulsivity has caused. She did well in a half-day preschool last year and is in a half-day kindergarten this year. So far, the teacher says she is doing fine. I know she likes to please. However, with the above-mentioned issues, I am concerned that as the year becomes more academic, that she will have more problems. I called in August with a request to have her tested, but the school is dragging their feet.

Does any of this sound like ADD/ADHD in girls? What's a good resource for me to read? I am frustrated in my search for information. My eyes are fried by looking.

Thanks,
Elaine

I have a son and daughter that are ADHD, but have never looked for information on just girls. I believe I'm ADHD so they must naturally get it from me, and my mom believed she is ADHD too.

So much information is geared towards boys with ADD/ADHD, but as in medicine, I truly believe that girls might exhibit it differently.

Thanks,
Elaine

I envy you for getting good reports from the teachers about your child. I think most of us deal with the opposite; we are getting negative reports from school about our children. She is only five years old and very active. Keep a close eye on her and LOTS of supervision and be HAPPY that she is doing fine in school. Please don't even think about medicating her at age 5.

I don't want to medicate her. Yikes!!!! That's why we're working on the behavior modification, but I do believe she might be oppositional defiant as well. I really want to head things off and make sure she has good experiences in school. I just don't too much about ADHD except what I've been able to find as far as symptoms.

Thanks,
Elaine

My daughter has ADHD and growing up her symptoms are identical to that of a boy with ADHD.

My daughter is 11 and has ADHD, and I believe she has ODD also, but we don't see the neurologist until next month. My daughter was just diagnosed this summer, all through school - 7 teachers at the same school - no one ever suggested that she had ADHD. I took her to see a counselor for other issues, and while I was talking about her childhood, the counselor suggested it. After reading "Taking Charge of ADHD" by Barkley, I was absolutely convinced - it's an excellent book, but not geared specifically at girls. My daughter's teachers always had positive comments, and my daughter has always received mostly As & Bs. Their comments were always that she talked too much in class and needed to stay on task.

She's outgrown most of the hyperactive stuff. She's on Ritalin LA and when it's working, it helps a lot, but it's like a rollercoaster ride - I never know what to expect. We tried Strattera to even out the ride, but that had very negative effects with her ODD, and I can't wait for it to wear off - imagine her worst ODD day, all day every day - doesn't make for a very happy homelife.

I wanted a boy, so when my little monkey was climbing out of her playpen at 8 mos, and scaling the bookshelves at 1 yr, I figured I got a boy with hair. No one ever suggested that her behavior was anything other than active. So if your child is more active than most other girls her age, it's probably not a bad idea to at least consider ADHD. The book I mentioned also talks about parenting and what steps the ADHD parent goes through with discipline - I saw my life for the last 11 yrs in that book. I believe that book also said that it's difficult to get a child tested before they're 6 yo.

Good luck to you!

Just because a child is more active than peers of the same age and sex in NO WAY means that they are ADHD. Every child is different. Some more active, some less active. Some better at school, some better at sports. Being extra active DOES NOT mean that the child is ADHD.

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~*~ Kristy ~*~

Not meaning that hyperactivity isnt a symptoms, Just meaning that if a child is extra active and thats the only problem then they're not ADHD.

Now heres an article I found:

* ADHD IN GIRLS *
by David Rabiner, PhD

One of the important shortcomings of most of the research based information on ADHD is that the vast majority of studies have been conducted solely on boys, or, have included very few girls in the sample. As a result, the scientific literature
on ADHD is almost exclusively based on male subjects.

Recently, a study funded by the National Institute of Mental
Health on a large group of girls both with and without ADHD was published in the Journal of the American Academy of Child and Adolescent Psychiatry (Biederman, J. et al., (1999). Clinical correlates of ADHD in females: Findings from a large group of girls ascertained from pediatric and psychiatric referral sources. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 966-975. In this study, the authors examined the clinical correlates of ADHD in girls so that similarities and differences with what has been found among boys with ADHD could be ascertained. This study represents the largest and most comprehensive study of
girls with ADHD that has been published to date.

Participants in this study were girls between the ages of 6
and 18. There were 140 girls who had been diagnosed with ADHD based on structured psychiatric interviews conducted with the child's parent(s). In addition, 122 girls of similar ages and other backgrounds who did not have ADHD were included as comparison subjects. These two groups of girls were compared on a wide variety of characteristics so that
the researchers could learn about the problems associated with ADHD in females specifically. The major findings are summarized below.

* Among the girls who were diagnosed with ADHD,
59% had the combined type (i.e. both inattentive and hyperactive/impulsive symptoms), 27% had the Predominantly Inattentive type, and only 7% had the Predominantly Hyperactive/Impulsive type.

Overall, a significantly greater proportion of symptoms of
inattention were present according to parents relative to
either hyperactive/impulsive symptoms.

* Girls with ADHD were significantly more likely to be diagnosed with other disorders as well.

Compared to girls without ADHD, girls with ADHD were
more likely to be diagnosed with co-morbid conduct disorder, oppositional defiant disorder, mood disorders, anxiety disorders, and substance use disorders. Tic disorders and enuresis (i.e. bed wetting or day-time wetting) were also
more common in the girls with ADHD.

Overall, 45% of the girls with ADHD were diagnosed with at least one other condition. Only 4% of the girls with ADHD
had more than 2 co-morbid disorders, however.

Although the rate of co-morbid behavior disorders in girls
with ADHD was high, it was still no more than half of the rate that has been previously reported for boys. Because disruptive behavior disorders are one of the main reason that children get identified and referred for treatment, the authors speculate that the lower incidence of these problems in girls with ADHD may partially explain the marked gender differences that are often found in children with ADHD who
are receiving clinical treatment.

The rate of mood and anxiety disorders in girls with ADHD was quite similar to what has been previously found in boys. Contrary to what some have suggested, there was thus no evidence in this sample of children that girls with ADHD are more likely than boys to have problems in these areas. There was, however, an indication that problems with substance
use were more common among girls with ADHD than has been previously found to be true for boys. For example, girls with ADHD were about 4 times as likely to be smokers.


* Cognitive, school, and family functioning

Girls with ADHD had scores on measures of intellectual functioning and academic achievement that were modestly lower than what was found in the non-ADHD girls. They were also about 2.5 more likely to be diagnosed with a learning disability, more than 16 times more likely to have repeated a grade in school, and almost 10 times as likely to have been placed in a special class at school.

It is perplexing why girls with ADHD were so much more
likely to have repeated a grade given that the difference in
the academic achievement test scores were, although lower, not so dramatically different from other girls. I think this may reflect that fact that achievement testing - which is done on
an individual basis - tends to reflect the highest level of work that children are capable of. In many instances, this is quite
a bit higher than the level that a child with ADHD actually performs at on a day to day basis. So, these data may
reflect the debilitating effect that ADHD has on a child's
typical school performance, which can result in grade
retention and special class placement even for children
who are quite bright and capable.

Whatever the explanation, these data underscore how important it is for parents to insure that their daughter's educational needs are being carefully and adequately addressed. Children with ADHD are often legally entitled
to special educational services to help address the unique needs that they have. You can learn about the educational rights for children with ADHD. The parents of girls with ADHD also described their family
life as less cohesive and reported greater amounts of conflict with their daughters.

CLINICAL IMPLICATIONS

The results of this study make clear that ADHD in girls is as
serious a condition and has a comparably large negative impact on children's functioning and adjustment as it does in boys. Overall, the correlates of ADHD in girls were remarkably similar to what is known to be true for boys. Among the few differences found were that girls were less likely to be diagnosed with a co-morbid behavior disorder than boys (i.e. oppositional defiant disorder or conduct disorder) and perhaps more likely to have problems related
to substance use. Rates of mood and anxiety disorders,
and impairment in academic functioning appeared to be
quite comparable.

The lower rates of disruptive behavior problems, along with the preponderance of inattentive symptoms relative to hyperactive/impulsive symptoms, may partially explain why ADHD in girls may often not be recognized. Because rates
of mood and anxiety disorders were similar to what has been found in boys, the authors speculate that in conjunction with the lower levels of disruptive behavior and hyperactive/impulsive symptoms, this may lead clinicians to diagnose girls with the former types of disorders rather than ADHD. As you may recall from a study recently reviewed were significantly more likely to diagnose boys with ADHD than girls, even when the problems described by parents
were quite comparable.

The authors stress that clinicians need to be aware that, despite their lower rates of disruptive disorders, ADHD in girls is a serious condition associated with impairment in multiple areas of children's functioning. Thus, there is no reason to assume that the treatment of girls with ADHD should be any less aggressive or comprehensive than that of boys.

Parents need to be aware that their daughter with ADHD is at
significantly increased risk for a variety of other conditions as
discussed above. In fact, in this study, almost 50% of girls
with ADHD had at least one other diagnosable disorder. It is
thus essential that evaluations of girls for ADHD take a broad
look at their emotional, behavioral, social, and academic
functioning so that a comprehensive treatment plan addressing all areas of important difficulty can be developed and implemented. In particular, given the indication of possible increased risk of substance use in girls with ADHD, this may be an area that is especially important for parents to monitor.


Too often, in my opinion, even if ADHD in females is identified, necessary attention to areas of difficulty apart from core ADHD symptoms may not be targeted in a child's treatment, or may not be addressed in the most helpful way. This is especially likely to be the case when a primary care physician is the sole treatment provider, as physicians are typically less attentive to a child's overall emotional and behavioral functioning in their evaluations, and may tend to rely on medication treatment alone when other interventions may also be needed.

There are several limitations to this study that the authors
acknowledge. First, the girls with ADHD were referred from both psychiatric and pediatric facilities/practitioners, and the
degree to which they are representative of girls with ADHD in
the general community can not be determined with any certainty. Thus, it is quite possible that the girls in this study were more impaired than would be girls with ADHD from the general population.

In addition, it is clear that research on treatment specifically
in girls with ADHD is sorely needed. Currently, most of the
data on both medical and non-medical treatment of ADHD is also based predominantly on boys. To my knowledge, there is currently no clear indication of any known differential effect for various treatments that is specifically related to gender,
but this may be partially because the studies that are required to carefully look at this issue have not really been done. As such studies are published, I will certainly be sure to include them in the newsletter.




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~*~ Kristy ~*~

Another article

Girls and Women are Under Diagnosed
The DSM-IV estimates that the ratio of boys with ADHD to girls was 4:1. For those in actual treatment in clinics, the ratio was 9:1. Clinicians who treat a girls with ADHD feel that many girls have been overlooked. Why is this?

The Squeaky Wheel Gets the Grease

Boys with ADHD are more likely to be disruptive in class and at home. Parents and teachers notice this and refer them for treatment. Girls with ADHD can be physically hyperactive, but are more likely to be quietly inattentive and disorganized. Adults are more likely than children to refer themselves for treatment.

Women Are Often Diagnosed in Adulthood

Sometimes we see a woman who brings her son in for treatment. While evaluating the child we take a thorough family history. As the mother tells her own story, she realizes that some of her difficulties are similar to her son’s. Whether she was hyperactive or just inattentive, the diagnosis was missed.

Signs of ADHD in Girls

Girls can manifest their ADHD in vastly different ways. In Understanding Girls with AD/HD, Nadeau, Littman and Quinn identify types of ADHD girls. Active girls may act like tomboys. They may socialize with boys. They are active, and may engage in impulsive escapades. Another group of girls shows their ADHD by talkativeness and excessive socializing. They too may become involved in risky behavior. Some girls with ADHD seem to fade into the background. They are shy and inattentive. They may have few friends and are more likely to be depressed. The last group is often escapes diagnosis until adolescence or adulthood. These are the very smart girls who have the ability to put in an extraordinary effort to hyperfocus. Adults see them as achievers but are often unaware of the anxiety and extreme effort the such girls use in order to compensate for their inattentiveness. Such girls are often anxious and self-critical.

The Consequences

Girls and women with ADHD (particularly if undiagnosed) are at higher risk for anxiety, depression, drug abuse and unplanned pregnancy. This makes treatment more complicated.

Early Diagnosis Is Important

The unique concerns of ADHD girls and women often respond well to treatment. Understanding one’s own ADHD is therapeutic in itself. Effective treatments include medication, psychotherapy, support groups and coaching.

by Carol Watkins, M.D.


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~*~ Kristy ~*~

I really appreciate all the replies here. I'm not sure what will happen although the school will be following through. I talked to the guidance counselor yesterday about more specific issues.

Tonight was another prime example of her impulsiveness-----she knows not to run in a parking lot, but she almost ran in the front of an oncoming car because she didn't look. She scared the heck out of me. I want her to reach her full potential whatever that will be for her. I know she's smart. :) I'm hoping to keep it from escalating any further.

Elaine

Elaine

mm -
Im sure she is very smart :) Try to get her involved in something she likes. Maybe an art class if she likes art, maybe crafts, sports, anything that can help her realize that she is good at something.

At age 5 many kids run out into the street. Very scary I know. Some kids just take longer to mature than others. (Talking about both ADD and non-ADD kids here)
It takes a while before a child gets to the age and maturity level that they can comprehend that there are consequences for what they do. For every action there is a reaction.

Before I posted some articles but never got around to giving you any information from my personal knowledge.

I'm female - Will be turning 20 ... dang IM OLD!! lol - Diagnosed ADHD&ConductDisorder

Some girls with ADHD show their hyperactive symptoms differently than boys do. Example girls are more likely to talk and giggle, pass notes, etc. during class, while boys are more likely to be squirming around in their seats uncontrollably, leaving class when they shouldnt, generally running wild, sometimes fighting.

In my opinion girls who have ADHD alone are more likely to be the ones that just talk too much and get into some trouble with their friends in class. While girls who have ADHD along with ODD or Conduct Disorder are much more likely to show their hyperactivity in the same way that boys do. Of course just because a little girl is tomboyish it does not mean that they have ODD or conduct disorder.

I always got pretty good grades in school. But I was always getting in trouble for breaking the rules. I was very very hyperactive but many of my teachers were totally awesome and would do things like allow me to run errands for them so I could burn off extra energy and have a break from the classroom.

I think in some ways its harder for girls who are ADHD than it is for boys. I also think that for a girl having inattentive type ADD is more accepted by society. In the eyes of society it is more acceptable for a little boy to be hyperactive, bouncing off the walls..... sometimes people even make comments "He's all boy" "Boys will be boys" But then when a girl is hyperactive its just totally unacceptable.

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~*~ Kristy ~*~

this message is for elaine, my 4 year old daughter was diagnosed with adhd earlier this year. I tried behavioral modification,nutritional modifications,and thearapy. they all seemed to only prolong the inevitable,biochemical treatment. my daughter's nickname among the staff at her preschool is "WILDCHILD" I don't want this type of stigma to follow her thrughout life. I don't mean to deter you from the options you are examining, but don't completely rule out getting her professinal help.If her heart were bad you wouldn't hesitate to get her the proper medical treatment,so don't hesitate because it is her mind. my daughter was recently prescribed strattra, and unfortunately she refuses to even try to swallow her pill. So now I have a new obstacle to overcome.

I hope I was some support and I wish you many blessings.

Akanni

Thanks for sharing Kristy. How my daughter will turn out is a mystery. :) All I want is for her to reach her full potential in a positive way.

Akanni, I really do appreciate what you are saying regarding medication. As far as I am concerned, the mind and body are inseparable. Medication is not my first or even second choice, but if it is what she ends up needing, then we'll go that route.

Elaine

If you think she may have ADD/ADHD then by all means take her to a clinic that tests for ADD/ADHD. The school should not be responsible for the testing nor is it really appropriate for them to even do the testing since I doubt they have been properly trained to do the testing. This needs to be done at a clinic that specifically tests for this kind of thing. Talk to your childs doc and have them refer you to a clinic for testing and get this taken care of. Just because she is impulsive and goes a mile a minute definately does not mean she has it. I have a son who does have ADD and then my daughter that a teacher suspected had ADD. I knew better but had her tested just to satisfy the schools as well to make sure and she does not have ADD but has what is diagnosed as ADD tendencies. Just within the past 2 years the school again tried to say that maybe I should consider medication for Jenny and I firmly reminded them that she does not have ADD and that if they needed to see her test results I would bring my copy in. It is very easy to see why ADD is misdiagnosed when you even have teachers who want to say she has ADD and the parent has to remind them that there is no diagnosis of ADD.

I really appreciate all the feedback I have gotten here. At this point, I have agreed that the plan for school is to do watchful waiting and see how the next month transpires. Her class is quite small, so that may minimize any problems for now. There is lots more opportunity for one-on-one than there would be otherwise.

Thanks :)
Elaine