Slowly, ADHD Gender Gap Closes
Focusing on the Female
Unlike boys whose symptoms decrease at puberty, girls' symptoms often increase during this time of hormonal change, Nadeau says. The diagnosing criteria for ADHD, however, require that symptoms begin before age 7, according to the National Institute of Mental Health.
"We need better criteria," Jaksa says. "We need more realistic diagnostic [measures] that address what is going on with girls."
Not everyone agrees. Biederman believes that the diagnosing guidelines are appropriate. Better education on how to recognize inattentive ADHD, and get girls referred for diagnosing, would help resolve the gender gap, he says.
"The issue is more emphasis on clinicians and educators not to rely only on aggression to recognize ADHD," Biederman says. "ADHD in girls may not be as commonly described."
Consider, too, that the most common drug treatment for ADHD is methylphenidate (Ritalin), yet much of the research has been conducted in men and boys. One of the most recent studies, published in the Jan. 12, 2001, online issue of the Journal of Neuroscience, used 11 men as its subjects. In the study, researchers from the Brookhaven National Laboratory in Upton, N.Y., and the University of New York at Stony Brook found that Ritalin amplifies dopamine release in the brain and speculated that this would improve attention and decrease distractibility. They noted, however, that their tests were conducted in healthy adult men who were tested in "stress-free" conditions, and said further research was needed.
More studies are under way to further point out the similarities and differences in symptoms between boys and girls. Left untreated, ADHD can lead to depression, lack of self-esteem, and emotional and academic problems -- including drug experimentation and earlier sexual relations for girls, according to Nadeau. Many children with the disorder are physically active and more prone to injury. Once they reach adulthood, undiagnosed ADHD women often struggle with organization and being consistent as parents, just like ADHD men, she says.
"There are a lot of things that happen and they don't have an understanding of why," says Nadeau, who has authored several books, including Understanding Girls with ADHD. "Everyone just blames them. There is tremendous psychological damage."