Girls With ADHD Often Misdiagnosed
Doctors More Likely To Look For Problems In Boys

POSTED: 1:46 p.m. EDT April 24, 2003
CLEVELAND -- Attention deficit hyperactive disorder is often thought of as a problem that affects teen boys, and for the most part, it is.

But researchers said there are tens of thousands of other ADHD children who never get any help, according to NewsChannel5's Tonya Strong.

Brianna Cabano, 17, has had all the classic symptoms of ADHD since she was 10 years old -- hyperactivity, trouble concentrating in class and difficulty making close friends.

"From about fourth grade to right now -- I'm a senior in high school -- I had problems with my grades, and I knew I was smart," she said.

But all through the years, teachers said her problems were her fault.

"And they told me that I was extremely smart but I just didn't apply myself and I was lazy," she said.

"She had some pretty low moments," said Patti Cabano, Brianna's mother.

Dr. Steve Hinshaw, a professor of psychology, has written two studies about girls with attention disorders. He said Brianna's case is typical.

"There may be a significant number of girls -- up to one-third or more of girls -- who actually have ADHD who never really get detected as having a clinically serious problem," he said.

Girls' cases don't get detected as often because the experts are looking for boys, not girls. It is true that boys are three times more likely to have ADHD than girls.

"However, if we look at clinics where kids get referred for treatment, it may be 10 to one boys to girls," Hinshaw said.

Another reason for the low detection is that girls usually don't act out the way boys do.

Doctors said thousands of girls with ADHD are not getting diagnosed or treated.

They said parents should take note if their daughter has low grades, few friends and trouble concentrating. Getting her tested can make a big difference.

Experts also said parents should always get a second opinion.

Original Story: http://www.newsnet5.com/connectingwithkids/2156440/detail.html

I thought i would bring this thread back via new posting....
I am curious about how many girls and women are out there without diagnosis or with late diagnosis because or the stereotyping of it being mostly diagnosed in young boys..

also if you feel this happened to you or some one in your family or circle of friends how did it impact in general your education,your self esteem, and your ability to function in employment or in your family??

I think us women, imho, are ten times more likely to be diagnosed and labeled with comorbids than actually our predominant diagnosis of adhd or even more likely add- inattentive type?

katts

I am 15, and I wasn't diagnosed until I was 14. I have classic ADHD, but it was always overlooked. My parents thought I had problems making and keeping friends and problems learning because of how much we moved and how much I had to switch schools. When I was 10 or 11, I was a real handful. I have lived with my grandparents most of my life, but when I moved in with my mother for a while last year, she couldn't handle me at all and had me tested for mental disorders. After 4 doctors, I was diagnosed with ADHD twice and placed on stimulant medicine. Yes, I have had self esteem issues. I always felt I wasn't good enough, or why couldn't I be like the other girls, why wasn't I into clothes and magazines instead of toys, why didn't people like me, why was I always in trouble, etc. I almost failed the eighth grade as well. My SPD developed because of my ADHD being untreated, and so did my ODD.

I am 25 and just got diagnosed the end of March. My parents had me tested when I was 8, because I was constantly daydreaming in class and my teachers had labelled me a behavior problem. Yet I was smart so I was getting the grades without having to pay that much attention.

Because the psychiatrist who tested me said I -didn't- have ADD, my parents have had a hard time believing me when later in life I came to believe I did, and finally got the diagnosis.

Last weekend they found a copy of the original report, from when I was 8. As I was reading it over, what the summaries describe seem to be taken right out of the add books I've been reading, yet nothing in there mentions the possibility of ADD.

Here's an example:
"results suggest relatively weak inhibitory controls, and as a result - will have trouble resisting the pull of salient distractors. In general she will tend to be engaged by whatever is most interesting to her, and she is likely to have real difficulty ignoring the pull of environmental distractors or of her own thoughts, particularly when tasks are routine or perceived as 'boring'. By the same token, when immersed in tasks of real interest to her, switching her attention to something that is not may be particularly difficult. It is important to note that -'s attentional focus will tend to be 'captured' by whatever is most salient to her, despite her best efforts to comply with task demands."

Is it that I'm still new to the concept of ADD and don't really know how it works? Or was it that they just didn't really know the definition of ADD back then?

I've had so many people react to my diagnosis with disbelief that I am still struggling now with doubt myself, and I feel constantly pulled back and forth between believing it must be and wondering if it really is.

Feeling a bit lost.

Diagnosed at 15/16, when I first mentioned it my mum always was like 'you don't have that, X (7 year old HD type boy) has that and your nothing like him'

Bit of a blow to the old esteem when my teachers thought I was stupid at first, then realised I was actually quite gifted and put my lack of work down to laziness and my stupid behaviour to attention seeking. Then the mother would tell me how I was making labels for not being *****.

The problem of under diagnosing girls has been known for a long time. One of the problems that often girls present differently in ADHD symptoms than boys. Boys often present as aggressive and cause disruption while girls often present as "Chatty Cathy's" and while troublesome, are not usually seen as disruptive enough for referral.

As I understand the statistics, if you adjust for different presentation of symptoms then girls are ADHD just as often as boys.

In a practice setting one sees many more boys who are referred by the schools. The girls are simply passed by as they do not cause as much trouble and those that are diagnosed are often identified when brought in for something else.

Effort is being made to deal with this. Some ADHD home/school surveys use different norms for boys and girls. The Dupaul Survey is one of these. Barkley recommends its use to help accurately pick up girls who would otherwise be missed if the norms were on boys and girls combined as most of the surveys do.

It is a problem and will continue to be a problem until we can better educate mental health professionals and schools on this.

I consider this a serious problem as so many girls do not get the help they need until later in life if at all.

Kattsqueen, thanks for bringing this up. It needs to be addressed every so often in this forum to keep readers alert to this issue.

Dizfriz

I am 25 and just got diagnosed the end of March. My parents had me tested when I was 8, because I was constantly daydreaming in class and my teachers had labelled me a behavior problem. Yet I was smart so I was getting the grades without having to pay that much attention.

Because the psychiatrist who tested me said I -didn't- have ADD, my parents have had a hard time believing me when later in life I came to believe I did, and finally got the diagnosis.

Last weekend they found a copy of the original report, from when I was 8. As I was reading it over, what the summaries describe seem to be taken right out of the add books I've been reading, yet nothing in there mentions the possibility of ADD.

Here's an example:
"results suggest relatively weak inhibitory controls, and as a result - will have trouble resisting the pull of salient distractors. In general she will tend to be engaged by whatever is most interesting to her, and she is likely to have real difficulty ignoring the pull of environmental distractors or of her own thoughts, particularly when tasks are routine or perceived as 'boring'. By the same token, when immersed in tasks of real interest to her, switching her attention to something that is not may be particularly difficult. It is important to note that -'s attentional focus will tend to be 'captured' by whatever is most salient to her, despite her best efforts to comply with task demands."

Is it that I'm still new to the concept of ADD and don't really know how it works? Or was it that they just didn't really know the definition of ADD back then?

I've had so many people react to my diagnosis with disbelief that I am still struggling now with doubt myself, and I feel constantly pulled back and forth between believing it must be and wondering if it really is.

Feeling a bit lost.

Good post. Have some forgiveness for the doctor. When you were 8 there was not a lot known about ADHD. Russell Barkley published the landmark book ADHD and the nature of self-control I believe in 1997.

Before that we did not have a good theory on ADHD. We went through this with my son over 30 years ago. We were able to get a good diagnoses but no one knew how to handle it except with Ritalin.

Even today, many mental health professionals are not really well educated on the disorder and there have been a lot of posts on the forum relating some of the strange things doctors have said indicating their almost total lack of knowledge of the subject.

If you want to get up to speed on the current thinking on ADHD then I recommend this transcript of a workshop by Russell Barkley. Some, including myself, consider it to be the best write up on ADHD available on the internet. It is dated 2000 but most of the data is still basically pretty good. I do warn however that this is forty pages long and Barkley is information dense. It can be a bit of a struggle to work though and you may have to read through it several times but it is, in my opinion and the opinion of many others, very much worth the effort. I am going to suggest you start with this overview and then download or read the article from there.

http://www.greatschools.net/cgi-bin/showarticle/2054

Anyone who has been diagnosed as ADHD needs to know as much about it as possible. The transcript is the best place I know of to start. Russell Barkley is considered to be the top person on the subject and developed the theory that most in the field work from. You cannot get any better.

Good luck. Keep plugging, it can be handled.

Dizfriz

I know for me personally it never even came up until my teenage son was being evaluated...at the tender age of 43...

why not you ask:
started out slow in reading but caught on and took of by the end of the second grade!!!
I always twiddled with my hands and hair...
forever daydreaming and looking out the window...
Respectfull to adults and teachers and other kids
Could not grasp math for love nor money even though reading on the college level in fifth grade (absolutely loved school) except math and gym and oh yes my hand writing was very bad.....
always kind of shy and reserved....

Even when i was diagnosed in1998 I felt like a bit of a sham because tho I was a nervous nelly with low self esteem how could I be adhd? I am not hyper what so ever slighty impulsive and able to talk and write at the speed of light underpressure.

When i was discontinued from my meds in 1999 due to high blood pressure I hated it but i felt like a sham for taking it in the first place,,,

In 1998 i wasnt even aware there was such a thing as add inattentive...
I kind of felt I too was taking the medication under false pretenses..

Now after ive been coming here for several months and am aware of add inattentive I have no doubt that that is what I am...

I do want to receive treatment to see if the rest of my life may be of better quality for me and others

fire fly from what youve written down from your earlier evaluation I dont feel you should feel guilty about wanting or getting treatment. You too noodalz i think we are finally on the right path to find out what the rest of our lives can bring!!

kattsqueen

I know for me personally it never even came up until my teenage son was being evaluated...at the tender age of 43...

why not you ask:
started out slow in reading but caught on and took of by the end of the second grade!!!
I always twiddled with my hands and hair...
forever daydreaming and looking out the window...
Respectfull to adults and teachers and other kids
Could not grasp math for love nor money even though reading on the college level in fifth grade (absolutely loved school) except math and gym and oh yes my hand writing was very bad.....
always kind of shy and reserved....

Even when i was diagnosed in1998 I felt like a bit of a sham because tho I was a nervous nelly with low self esteem how could I be adhd? I am not hyper what so ever slighty impulsive and able to talk and write at the speed of light underpressure.

kattsqueen

Thank you very much. I honestly feel like crying because this is the first time I've had people respond with honest understanding and accepting. So far it's been skepticism, listing of reasons why I can't possibly have ADD, or exasperated sighs and implications I'm just using it as an excuse or they don't want to hear it. For something that was so monumental and deeply important to me when I first started reading about it, the reactions have been a bit crushing and discouraging.

I'm quoting you also because you sound like me. I have a really hard time sitting still, always tapping, biting my lip/nails, clenching my jaw or grinding my teeth, or playing with my hair. Like a part of my brain needs that part of it occupied while I think about other things. I was always an avid reader to the point I'd sneak books, which was bad since I hyperfocused on books and had a hard time transitioning away from them.

I moved in fifth grade and the social became such a stress that I jumped into academics, since I was smart so good at it. And I could do it on my own without dealing with trying to figure out cues from other people. I say that because my biggest doubt has been my 'success', in grades or otherwise. People say I appear organized (because they haven't seen my room/office/desk) and successful (because they don't see the stress I put myself through to appear so) and I just immediately feel I am not so. Having the possibility of ADD was such a relief, like finding out, wait, there's a word for this whole being different thing? You mean other people are like this too?

I'm very shy and not someone who really is used to fighting for things. But I'm glad I fought for the diagnosis I believed in. Even if so far the results its brought haven't been very uplifting or forgiving.

firefly sounds like we could be two chips off the ole block I just wish I could have found out sooner perhaps and really had a chance at a career or accomplishing a little more in my own life..

I am not taking meds right now due to blood pressure concerns but plan on addressing some issues so I can try again....In the mean time I will keep after my son and daughter to make sure they dont have to go through this without the best chance they can have...IF in the mean time I can help other people out here my education and experiences have not been a waste.... Thanks so much glad to give you some help!!

katts

I moved in the fifth grade my self to a school in the country where all the kids had been in the same class since kindergarten together


I was so glad when I started junior and was bussed into the nearest large town where all friends went to school too...

I didnt have a million friends but It was great to have some again..lol

All the females in my family are undiagnosed...I'm the only diagnosed one in my family.