Miss Diagnosis
Psychiatrists estimate that one in three children with AD/HD is female. Yet, of every ten children referred for AD/HD diagnosis and treatment, only one is a girl. Clearly some of our daughters are falling through the cracks.

Part of the problem is a lack of research. According to Dr. David Rabiner, a psychologist and researcher who works with children who have AD/HD, "one of the important shortcomings of most of the research based information on AD/HD is that the vast majority of studies have been conducted solely on boys, or, have included very few girls in the sample. As a result, the scientific literature on AD/HD is almost exclusively based on male subjects.

The few studies that have included girls may explain why girls like Barbara are so often undiagnosed. Unlike their hyperactive brothers, girls with AD/HD tend to have AD/HD Without Hyperactivity. They don't fidget or squirm or get up to sharpen their pencil every two minutes. Instead, they just sit at their desk and zone out. These girls have the same AD/HD problems of inattention, distractibility and poor impulse control, but few parents, teachers or clinicians ever suspect these girls have AD/HD because they aren't hyperactive.

Girls with AD/HD are also less likely to exhibit disruptive behavior or conduct disorders. Research led by child and adolescent psychiatrist Joseph Biederman, M.D., of Massachusetts General Hospital found that AD/HD girls are only half as likely as the boys to exhibit aggression, yet diagnostic codes still define this behavior as an integral part of the disorder. Disruptive behavior is often what drives parents to seek a diagnosis. Girls are less likely to present these problems, which may be one reason why they are less likely to be diagnosed.

Girls may have fewer behavior disorders, but that doesn't make them immune from other conditions that may accompany their AD/HD. In fact, according to research conducted at Harvard University, 45 percent of AD/HD girls have another serious condition, such as clinical depression and crippling anxiety. Compared to other girls their age, those with AD/HD score lower on IQ and academic tests and are at greater risk of teen pregnancy. And they’re more likely than even AD/HD boys to have trouble with drugs and alcohol.

Finally, the age of onset criteria for AD/HD, which requires that symptoms must be present before age seven, is based on research in males. But symptoms of AD/HD in females often don't emerge until puberty, a time when most kids have emotional ups and downs. Even experienced clinicians may have difficulty distinguishing AD/HD characteristics from normal developmental woes.
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