Is it harder for girls to be diagnosed with ADHD?
CLAIRE SPREADBURY asks the experts about attention deficit hyperactivity disorder
AFTER plucking up the courage to confide in my daughter’s school that I was concerned she may have ADHD, I felt let down by the response.
They seemed adamant there wasn’t the slightest chance my eight-year-old could possibly have it, leaving me in a quandary as to whether I should make a bigger deal of it via the doctor, or park it and hope I’m wrong.
It might well be that she doesn’t have the condition, but it did get me wondering.
My daughter has around half of the symptoms listed on the NHS website, but because she’s not struggling at school and doesn’t have the more disruptive symptoms – which can be more prominent in boys – her fidgety feet, forgetful brain and lack of listening have pretty much been dismissed. So, can it be harder for girls with ADHD to get a diagnosis?
“Girls often show symptoms that are generally less ‘hyperactive’,” says Gabrielle Laycock, who was diagnosed with ADHD as an adult and now works with neurodiverse charities and brands like Equazen, to raise awareness of managing symptoms.
“I think it comes down to the false assumption we have in our society that one size – the male size – often fits all. What is asked in diagnosis sessions in my experience seemed to be centred around more typically male experiences of ADHD.
“I remember being asked if I’d ever fallen asleep whilst working or being in a lesson at school, and answering no, knowing full well I It stands for Attention have come very close, but Deficit Hyperactivity social judgement stopped Disorder, and the core me from actually nodding symptoms are hyperactivity, off every time. impulsivity, and difficulties
“Whereas males are with attention, notes Dr generally judged less for Maite Ferrin, consultant child and this type of behaviour, adolescent psychiatrist at especially in school. Re:Cognition Health (recognitionhealth.com).
“I initially received a
‘mild’ diagnosis of ADHD, “It’s the most common neuropsychiatric even though specialists condition, affecting approximately I’ve seen since have said 5% of children and adolescents, there’s no chance I only have a mild and 4% of the adult population form. worldwide.”
“Would I have received “There are three subtypes that same diagnosis if of ADHD – hyperactive-impulsive, I’d lived a male perspective inattentive, of ADHD? and combined,
“How many women each of which has have completely slightly different symptoms,” slipped through the says Dr Louise net?” Karwowski, head of sci
Gabrielle went undiagnosed ence at Cognassist until 2018, going (cognassist.com). “Those through school, university and her with the hyperactive-impulsive subtype early career years with no support are most likely to fit the stereotype whatsoever. of ADHD (they might move
She only suspected she might have the condition after reading a magazine article on ADHD in girls, and noticing similarities to things she had always struggled with.
WHAT IS ADHD?
around a lot, fidget or struggle with self-control).
“Those with the inattentive subtype often make careless mistakes, and struggle with concentration and organisation. “People with combined-type ADHD have characteristics of both.”
GETTING A DIAGNOSIS
“ADHD is diagnosed three times more often in boys than girls, and boys are usually more frequently referred to child and adolescent mental health services,” Dr Ferrin says.
“This is because symptoms of hyperactivity and impulsivity are more pronounced, and because boys usually present with more externalising symptoms, such as aggression, defiance and conduct problems.
“Girls with ADHD usually present with less aggression and more internalising symptoms, such as anxiety, depression, and increased rates of self-injury and suicidal attempts.”
Dr Karwowski adds: “As girls tend to present in particular with the inattentive type, there can be a delay in diagnosis, as they are thought to be shy, withdrawn or passive, rather than having ADHD. The problem is
made worse by the fact that the bulk of ADHD research has been conducted on boys and men.
“Generally speaking, boys will show symptoms very early in life, and see a decrease in symptoms at puberty.
“The opposite is true for girls, whose symptoms may be exacerbated by increasing levels of oestrogen.
“This means they are less likely to meet the classic diagnostic criteria (which used to specify that symptoms were present by age seven).”
WHAT IS INATTENTIVE ADHD?
The signs of inattentive ADHD in girls (and boys) can be subtle, especially if they’re high-functioning, says
Dr Hayley Van Zwanenberg, consultant child and adolescent psychiatrist at Priory’s Oxford Wellbeing Centre.
“Young people with inattentive ADHD might make more careless mistakes at school than others, as they’re not reading the questions properly.
“They might seem like they’re daydreaming and not listening. They might take longer to complete a piece of work, or forget to hand it in.
“They can be disorganised and not follow a task through, and they can be thought of as quite messy.”
WHAT SHOULD PARENTS WHO ARE WORRIED ABOUT ADHD DO?
All experts strongly advise talking to your child’s school and teachers over any concerns you might have, and if that doesn’t get you anywhere, then go through your GP.
“When it comes to your child’s education and how they will cope in the school environment, it’s crucial that you speak to the school about the worries you have, and the support your child is going to need,” says Dr Karwowski.
“The chances are, your child’s teacher may have already picked up on an issue, however, things can slip through the net, so don’t be afraid to approach the school and discuss your worries with them.
“The best thing you can do is make the school aware of the situation and work with them on a plan to support your child.
“Ensure that you accept your child has a learning difficulty, be supportive and understanding. Be open and encourage conversation around differences in learning and thinking.
“A parent can be a huge support and motivator if they use a positive approach to build the child’s confidence and resilience. It may take a while, but the results can be lifechanging.”