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Hyperactive girls escape detection: More
suffer from ADHD than thought, study
finds
Katherine Seligman, San Francisco Chronicle, October 1,
2002
For more articles on disabilities and special ed visit
www.bridges4kids.org.
It's a label usually applied to fidgety, overly aggressive
little boys who can't sit still in class or follow directions.
But attention deficit hyperactivity disorder, or ADHD, may be
much more prevalent in little girls than many parents and
teachers recognize, a new study says.
Girls with the disorder are less likely to act out and never
draw as much attention in the classroom as "hyper boys,"
experts say. But they are just as likely to develop profound
academic and social problems, the study found.
"Girls don't have a pale copy of ADHD," said UC Berkeley
psychology professor Stephen Hinshaw, lead author of the
study, published today in the Journal of Consulting and
Clinical Psychology. "They have significant deficits (from
it). But they may suffer in silence."
The study found that girls with attention deficit
hyperactivity disorder had more trouble focusing and were more
likely to tease peers and act aggressively than other girls.
And many of them -- more than their male counterparts -- were
socially isolated and found it hard to make friends.
The study, one of the largest and longest of preadolescent
girls with the disorder, looked at 228 Bay Area girls, ages 6
to 12, who were recruited to attend a six-week summer camp for
three consecutive years. Unlike most previous studies, it
looked at girls who weren't on medication.
BOYS HAVE BEEN FOCUS
Attention deficit hyperactivity disorder is probably the
most-studied childhood psychiatric ailment, but the vast
majority of studies have focused on boys, who are more likely
to have it by a ratio of 3 to 1.
While "hyper-boys" usually draw more attention, girls usually
have what's called an "inattentive" type, characterized by
disorganization and unfocused behavior, rather than impulsive
outbursts. That makes it harder to spot in a classroom.
But girls with attention deficit hyperactivity disorder are
just as likely to have problems with tasks such as organizing,
planning and setting goals -- all of which lead to trouble
with schoolwork and social relationships, Hinshaw said.
LONG SEARCH FOR ANSWERS
That's what happened to Lori Berry's daughter, who saw at
least three specialists before anyone figured out why she
couldn't concentrate at school. Now 15, she's learned
strategies to help her stay organized, but she still
struggles.
Berry, who lives in the East Bay, said she first noticed
something was wrong when her daughter was in day care. She
never stuck with any activity very long and seemed to be in
perpetual motion.
In elementary school, her daughter's grades slipped to D's and
F's. She fidgeted at her seat, talked during class and
couldn't focus, but she didn't get in trouble or act out. She
wasn't ostracized by other kids, but she felt she was somehow
different. Berry knew her daughter was bright, but no one
could explain the behavior.
"Rather than figuring something was neurologically wrong, the
teachers put it down to behavior," Berry said. "They would say
she's not attending to task, she's not being responsible or
organized. They weren't thinking that maybe she can't settle
down, that she doesn't know how to."
Since the sixth grade, when she was diagnosed after being
referred to the study, Berry's daughter has been treated with
behavioral modification, which she's found most useful, and
medication.
"I wish she'd gotten help earlier," Berry said. "We wouldn't
have done all the shouting, had all the conflict. We just
weren't understanding what was going on."
PROBLEM HARD TO SPOT
Dr. Patricia Quinn, who co-founded an advocacy group called
the National Center for Gender Issues and ADHD, said the study
confirms what doctors have been finding clinically -- that
girls with the disorder get overlooked.
"People think if you're sitting there quietly that you
couldn't possibly have it," said Quinn, a developmental
pediatrician in Washington, D.C., who specializes in treating
girls and women with attention deficit hyperactivity disorder.
"Girls try to compensate. They sit there and look at the
teacher. They try very hard to please and do well."
As a result, she said, girls tend to get diagnosed two to four
years later than boys. Studies have shown that women with the
disorder develop a sense of helplessness and have self-esteem
problems, Quinn said. Many are diagnosed with depression.
Teachers, doctors and psychologists need more training to
identify girls with the disorder, she said. Often they don't
know the signs -- girls who are hyper-talkative and
emotionally hyper-reactive without being rough and aggressive.
And the general public knows even less, Quinn said. In one
recent survey, 97 percent of those who responded said they
knew a male with attention deficit hyperactivity disorder.
Only half knew of a woman who had it. Fifty percent also said
they didn't know it even existed in girls.
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