Attention to gender detail

2nd November 2007 at 00:00
Remember that it's not just the noisy boy, but also the girl in a daydream who may need extra help. Fin O'Regan reports on disorder differences?When it comes to special needs, boys make all the noise. Seldom do we come across articles about girls with learning and behavioural difficulties. This is certainly true of Attention Deficit Hyperactivity Disorder (ADHD).

It is estimated that between 3 and 5 per cent of all children have some form of ADHD. Many experts think the disorder occurs in three times as many boys as girls. But rarely are teachers given useful information about how it can affect both girls and women.

ADHD can express itself in three ways: as hyperactiveimpulsive type, as inattentive type, or as a combination of both hyperactive and inattentive symptoms.

Hyperactiveimpulsive type ADHD is characterised by an inability to sit still, a tendency to blurt out in class and poor impulse control that harms relationships at school and home. This type, alone or in combination, is simply impossible to overlook and seems to be much more common in boys. These children often disrupt class or respond impulsively to correction, leading to referrals to professionals.

Although some girls exhibit similar symptoms, they are regarded as less destructive and more dizzy individuals than their male counterparts.

But the symptoms of the inattentive type are seen just as often in girls as in boys - and are much easier to overlook, especially in primary schools. These children may seem unusually distracted, untidy or late with assignments. They are frequently accused of not listening. While this kind of behaviour may cause frustration and tension for the child, it does not usually disrupt the class or prompt parent-teacher conferences.

In girls, the disorganisation and distraction symptoms of ADHD result in lack of activity - they are too confused to get things started. They tend to be daydreamers.

Both sexes have trouble learning the nuances of social interaction but all too often girls end up shy and withdrawn and bullied by other girls, who see them as targets. In the teenage years, this can lead to school failure, social isolation, depression and even self-harm.

Girls with ADHD are likely to be more disorganised than boys: their locker, their bedroom, even their handwriting is often a complete mess. Although both sexes can have problems in this area, girls are expected to be the organisers for themselves while boys are more likely to get this done for them when they can't do it for themselves.

As girls with ADHD hit the teen years, the increased organisational demands of secondary school can become very difficult. They may become tired and disheartened by poor school performance

The girls with hyperactivity may throw themselves into social relationships to compensate. They may be described as "boy-crazy" or "party girls". They may begin to show more risky sexual and other behaviour. They may use drugs or alcohol, both because of growing impulsiveness and to self-medicate. Shoplifting, teen pregnancy and eating disorders are found more often in females with ADHD.

As with boys, having ADHD is not all doom and gloom. Girls and women with the disorder can be highly attractive and creative personalities, larger than life, though somewhat quirky. Think of the character Phoebe from the television programme Friends and you will see what I mean.

But teachers need to remember that it is not just the boys who make the noise, but also the little girl in a daydream who may need extra help.

ADHD is a very real problem for a number of young girls who are currently being overlooked and merely seen as withdrawn, flighty or space cadets. We ignore the reality of the situation at their peril

Fin O'Regan was head of the Centre Academy School in Clapham, south London, a specialist school for children with ADHD, and is the education director of ADDISS (Attention Deficit Disorder Information and Support Service)

As an initial screening device when assessing a girl for ADHD. While children who do not have ADHD can demonstrate some of these symptoms, children with ADHD exhibit them chronically and across multiple settings.

- I have trouble remembering and following my teacher's directions.

- I lose track of things like my house key or my jacket.

- I often forget to bring things to school that I need (lunch money, permission slips).

- I have difficulty completing school projects and writing assignments.

- At home, I get into a lot of arguments and upsets.

- Sometimes it feels as if I am not good at anything.

- I have trouble being on time.

- It's hard for me to concentrate when other things are going on around me.

- My parents and teachers tell me I need to try harder.

- Other kids tease me about being "spacey".

- I feel different from most other girls.

- My room at home is usually very messy.

- I talk a lot, even in class when I'm supposed to be quiet.

More information about girls with ADHD, including separate age-appropriate checklists from pre-school through secondary school, can be found in www.addvance.combookstoreparents.html

Understanding Girls with ADHD by Kathleen Nadeau, Ph.D., Ellen Littman, Ph.D. and Patricia Quinn, M.D. (Advantage Books, 1999).

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