Recognizing and Helping Girls with ADHD in the Classroom. Kathleen G. Nadeau, Ph.D.

Transcription

1 Recognizing and Helping Girls with ADHD in the Classroom Kathleen G. Nadeau, Ph.D.

2 What is different about girls? How do we recognize them?

3 What prevents many girls from being diagnosed? Don t fit the stereotype of ADHD that most teachers know Dependent upon others for referral teachers tend to refer the squeaking wheel most girls don t squeak Studies show inattentive type harder to recognize more girls fall into the inattentive type Clinic numbers for women much higher, suggesting that girls are under-diagnosed Have made MUCH progress in identifying girls over the past decade

4 Girls Most Likely to be Overlooked are those that: Have mild symptoms Have Structured home and school environments Have a high SES Don t have ODD or CD patterns Have a high IQ Have anxiety/ocd tendencies Feel social pressure/need for approval

5 What do Inattentive Girls look like? Daydreamers may seem a bit lost in class; often not prepared More passive academically don t raise hand; fear being called on May appear tired, disheveled Shy, timid, easily overwhelmed Tendency to withdraw, not act out May have expressive language difficulties Hypoactive, lethargic, easily discouraged

6 What do Combined Type Girls look like? Hyper-talkative, hyper-social, hyper-reactive Restless and fidgety, chair tipping, forgets to raise hand Some are charismatic, bossy, stubborn May be blunt with little tolerance for girls social dynamics Struggle to manage daily life management and academic demands, Tend to blame others Intolerant of boredom

7 What do Hyperactive/Impulsive Girls look like? Seen as difficult by age 3 or 4 Tantrums, willfulness, emotional intensity Higher percentage of learning problems AD/HD traits of high activity level, competition, dominance, risk-taking More prone to have friends that are boys, more argumentative, attracted to physical activities

8 Why do girls look different than many boys with ADHD? Biological differences girls in general are less active and aggressive; often more verbal than boys Different cultural expectations more pressure on girls to behave, to use self-control; to be organized, considerate and thoughtful Tendency to internalize more prone to anxiety or demoralization rather than to anger or aggression when problems arise Tendency to compensate girls in general try harder to please

9 How are girls impacted by ADHD? Self-blame, self-attribution Low self-esteem, demoralization Which moves into anxiety and depression Social neglect or rejection by peers More likely to feel overwhelmed because they try harder to meet demands May be perfectly behaved at school, but have meltdowns at home due to daily pressures.

10 How are differences manifested in the classroom? Often flustered and unprepared borrows pencils, paper Often asks classmate to explain what teacher has just said Slower processing speed may not finish seat work on time Rarely raises her hand fears being embarrassed in class Significant test anxiety Difficulty with completing long-term projects May appear bright but unmotivated

11 Preschool Issues Not too early to diagnose Look at activity level, aggression Problems with transitions Reactions out of proportion to events Extended terrible two s Withdrawn/ easily overwhelmed Bladder control takes longer

12 Elementary School Girls with AD/HD Symptom patterns less severe than boys More internalized symptoms Less aggression, teacher defiance Strong desire to conform, please teacher May see more problems at home than at school

13 Elementary School Issues Hard to keep own needs and others in mind at same time School anxiety, refusal, even phobia Hyper-focused efforts to comply May experience peer rejection/peer neglect Works harder to please teacher than boys typically do

14 Helping Girls at Elementary School Level Talk with parents to understand issues she hides at school Coordinate efforts at home and school to turn in homework, keep things organized, be aware of dates Pair with a classmate that can help her Be sensitive to slower processing speed Look for ways to reduce anxiety agreement not to call on her Set up classroom with many visual reminders

15 Puberty in Girls with AD/HD Girls symptoms typically increase as hormone levels start to fluctuate Mood swings, emotional reactivity Addictive behaviors a greater risk in girls Increase in anxiety and depression

16 Middle School Girls with AD/HD May seem hyper-reactive rather than hyperactive More peer problems - feels rejected or neglected - different Experience more parent (and teacher?) criticism Start to feel overwhelmed as demands increase and teacher support decreases

17 Middle School Issues Demands for organization and planning overwhelm her Subtle encouragement to be non-assertive, feminine Lags in emotional development ADHD can be mistaken for anxiety or depression

18 Helping Middle School Girls Needs a safe harbor at school Online posting of homework and due dates very helpful Post information in writing in classroom don t expect her to remember verbally presented information May need support outside of classroom tutors, coaches, parental involvement

19 High School Girls with AD/HD Feeling of different-ness at most extreme Pattern of feeling overwhelmed/withdrawn Impulsive acting out leads to shame Risks: pregnancy, STD s, smoking alcohol and drug abuse Anxiety patterns may emerge as she struggles to keep up with increased demands

20 Factors associated with early sexual activity in girls with ADHD low self-esteem poor parental relationships living in a non-intact household higher levels of externalizing behavior low academic achievement parents with low education levels

21 Social Issues More expectation for girls to interact socially Misses cues, especially when feelings are strong Reactions sneak up and ambush them Sense of never belonging Painfully aware of differentness - unlike some boys

22 Educational Issues for Girls Teachers need more training to recognize Abilities dismissed, undervalued Need to learn self-advocacy Late diagnosis more likely Need support/encouragement/safety Social issues need to be addressed at school

23 Take Home Message for Educators Good grades cannot rule out ADHD in girls; Risks of untreated ADHD can seem hidden, but are very significant