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ADHD is not created equal



By Heather Berry

John is sent to the principal’s office daily for his defiant behavior in class. He disrupts the teacher’s lectures, refuses to sit down, has lousy grades and frequently “forgets” homework. Sarah is quiet, polite and has “A’s” and “B’s.” The teacher says, “Sarah is a pleasure to have in class.” Which child has AD/HD? Most would answer John, but the truth is they both do.

AD/HD Types

AD/HD has three subtypes including inattentive, hyperactive-impulse and combined. John is the classic example of hyperactive-impulse. He is defiant, hyper, forgetful and impulsive. Most boys with AD/HD fall in this category. Sarah’s symptoms aren’t as obvious. She is a classic example of a girl with the inattentive variety of AD/HD.

Sarah is never a behavior problem, works hard at her grades and looks as if she is listening. Instead, Sarah is daydreaming while she looks straight in her teacher’s eyes. The problem is that Sarah has to work very, VERY hard to focus and achieve those high grades. Sarah’s parents are baffled why their well-behaved student comes home and has frequent crying fits and explosive tantrums. While John is “acting out” his frustrations, Sarah is hiding hers and at a very high cost.

Boys and Girls

According to Kathleen Nadeau, Ph.d, a clinical psychologist who specializes in the gender differences of AD/HD, you can sum up the differences between boy attention problems and girl attention problems in one simple illustration. When a boy has problems in school, says Nadeau, he will come home and gripe about the “lousy teacher.” A girl, however, having the same academic problems, will come home and blame herself. She may even think to herself that the teacher doesn’t like her.

AD/HD is a household term, but less than 50 published research articles exist examining this disability in girls. According to the National Center for Gender Issues and AD/HD, for every girl who is sent for an AD/HD evaluation, four to five boys receive the same. Girls with AD/HD, all types, also appear to be overlooked in the classroom. On study published in the Journal of the American Academy of Child and Adolescent Psychiatry stated teachers were more likely to miss the symptoms of AD/HD in girls even when parents identified AD/HD behavior in the same girls.

Misunderstood Daydreamers

Boys with inattentive AD/HD may also fall under the radar. Children with inattentive AD/HD are often dismissed as spacey. The children showing outward signs of hyperactivity seem to receive the most attention. Kids without hyperactivity, boys and girls, are more difficult to identify. Inattentive boys will be slow to start projects (at school or home), may appear lethargic and even depressed. If a parent suspects a child having AD/HD, inattentive type, a thorough evaluation by a qualified professional is vital.

Not all girls with AD/HD are inattentive daydreamers. Girls with hyperactivity, though, still behave differently. Boys may act physically hyper while girls seem to talk hyperactively and/or exhibit hyper-sensitivity to emotional situations. Other girls may exhibit a combination of inattentive and hyperactive symptoms. Maybe the girl who is vigorously defiant on the soccer field, stares at her math homework in frustration because her brain is so foggy she can’t get started. There’s no single definition of AD/HD, especially in girls.