ADHD Inattentive in Girls

While on Spring break I saw a friend that I had not seen in years.  I met her 13 year old daughter as well and we had a great time visiting.  My friend spoke to me about recently realizing that she had the symptoms of inattentive ADHD and concluding, after reading the book Delivered from Distraction, that her daughter had the symptoms of inattentive ADHD as well.

My friend's daughter is in the gifted program at her school.  She was clearly very bright, very secure, quite self aware, and very composed for a 13 year old.When I spoke with her she was clearly concerned about her performance in school and my friend told me that this year, as a seventh grader, she had received some very poor grades and my friend suspected that her daughters inattentiveness symptoms were finally starting to present an impairment.

I spoke to my friend regarding the non-medical interventions that I thought would work best for her daughter but speaking to her reminded me that I have written very little about girls with Inattentive ADHD.  My friend's daughter situation is a pretty classic case presentation of how ADHD is first discovered and diagnosed in girls.

We know from many studies that girls are more likely than boys to go unnoticed and undiagnosed when they have symptoms of ADHD.  They are likely to be more inattentive and not hyperactive.  They are less likely than boys to be impulsive and they are at less risk for co-morbidities such as depression. 

A large study of ADHD done in the U.S. was completed in Massachusetts in 2002.  The lead author of this study, Dr J. Biederman, reported that:  "Girls with ADHD were more likely than boys to have the predominantly inattentive type of ADHD, less likely to have learning disabilities, and less likely to manifest problems in school and in their spare time.  In addition, girls with ADHD were at less risk for comorbid conduct disorders, and oppositional defiant disorder than boys with ADHD."    This same study, however, did find a statistically significant increase in the risk of substance abuse in girls with ADHD symptoms.

From other studies we know that girls respond positively to the same medication and behavioral interventions for ADHD as boys do and we also know that 70% to 80% percent of boys and girls identified with ADHD will continue to have problems into adulthood.  Some research has indicated that girls and boys without disruptive behavioral disorders and learning disabilities respond best to stimulants and behavioral therapies while individuals without learning disabilities and disruptive behavioral disorders do just as well on behavioral therapy alone.

Girls are more likely to have the predominantly inattentive type of ADHD, they are likely to be diagnosed late or not at all, they are less likely have behavioral problems but more likely to have anxiety, depression, and substance abuse problems in adolescents and as adults.  Teachers are less likely to be aware of the symptoms of ADHD in girls.  It is imperative that parents of girls advocate for the treatment that will address the issues of Predominantly Inattentive girls with ADHD.

I will be devoting the next several posts to what more we know about ADHD in girls.