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ADHD in Children Health Center

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Slowly, ADHD Gender Gap Closes

Focusing on the Female

WebMD Feature

Feb. 12, 2001 -- Becky Stanford loved gymnastics, but she didn't stick with it because she couldn't wait her turn. She had difficulty following rigid formats like long division and essay outlines. She struggled in school and with friends. Even her Sunday school teachers dreaded having her in class.

"I was much louder, much more energetic than my peers. Sometimes it really overwhelmed people," says Stanford, now 28 and living in Helena, Mont. "You had to really gear up to have me over for the weekend or overnight. At sleepovers, I was the one sent to another room because I was keeping people up."

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At 13, Stanford was diagnosed with attention deficit hyperactivity disorder (ADHD). Her brother was already seeking treatment for the condition, but even with ever-watchful parents, the disorder did not seem apparent in her because she was a girl.

Indeed, four to five times more boys than girls are referred for ADHD evaluations because their symptoms are easier to spot, according to Kathleen G. Nadeau, PhD, director of Chesapeake Psychological Services in Silver Spring, Md. Boys, she says, tend to pose more problems for their teachers and may appear more hyperactive. Girls with ADHD (or ADD, as it is called when there is no hyperactivity issue) are less rebellious and tend to be inattentive. As a result, she says, many girls with undiagnosed ADHD are dismissed as lazy or spacey, when in fact they simply may not be getting the help they need.

"They are so good at hiding it, disguising it, and compensating for it, a lot of parents and teachers don't know what is going on," Nadeau tells WebMD.

The disorder has been considered two to three times more common in boys than girls, but many believe the numbers are skewed. "It's much closer to one to one," says Peter Jaksa, PhD, president of the National Attention Deficit Disorder Association, and a psychologist with a private practice in suburban Chicago. "But girls have always been underdiagnosed because they are harder to spot."

"Girls seem to work the system a little better. They can become the teachers' pets and the teachers don't have the same expectations," agrees Becky's mother, Paula Stanford, LPC, who now runs an Oklahoma City diagnostic and counseling clinic for children and adults with ADHD and learning disabilities. "Girls can be charming or coy or ditzy, and it can still be kind of cute. The cultural way of looking at females has a lot to do with that."

ADHD is the most commonly diagnosed behavioral disorder in childhood, with an estimated 3% to 5% of the general population suffering from it, according to the National Institute of Mental Health. Symptoms can include hyperactivity, a lack of attention span, and impulsive behavior. People with the disorder often are disorganized, cannot complete tasks, and have trouble following more than one instruction at a time. Symptoms can begin as early as age 3 and usually are noticeable by age 7.

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