Behind the diagnosis and the face you might not expect to be struggling is just a little person who doesn’t understand why they feel incompetent.
Facts to chew on:
- Only 5% of ADHD college students graduate
- 35% of teens with ADHD eventually drop out of school.
- young adults between the ages of 23 and 32 are 11 times more likely to be unemployed
- In general, those who are afflicted with ADHD are also less likely to hold undergraduate and graduate degrees than people without the disorder.
- Having ADHD makes you 3 times more likely to be dead by the age of 45
- Only 1 percent of ADHD research is focused on the disorder in females.
- Girls with ADHD have 5.6 times higher rates of bulimia, and 2.7 times higher chances of developing anorexia.
- 40% of children who have ADHD have at least one parent who has ADHD.
- 40% of youth with diagnosable (but not necessarily diagnosed) ADHD symptoms don’t get treatment
- The rate of emotional development for children with ADHD is as much as 30% slower than it is for their children without the condition. For example, a 10 year old with ADHD operates at the maturity level of about a 7 year old; a 16-year-old beginning driver is using the decision-making skills of an 11 or 12 year old.
- On average, every classroom of 30 students has 1 to 3 children with ADHD.
- Three boys are diagnosed for every one girl.
To be completely honest, life as an adult with ADHD is harder than life as an elementary student, middle school student, high schooler, college student etc… There is no safety net anymore. This means early detection for students is crucial. Learning tools and accessing intervention is the best chance students with ADHD have to get as much as possible out of their education. In adulthood, the impact of early ADHD intervention means that people (like me) can utilize tools to live productive and meaningful lives, attain advanced degrees and find a balance. Unfortunately, girls are wildly under-diagnosed with ADHD though they suffer from the hereditary condition almost equally. As put in “How Girls with ADHD are Different,” “We were initially taught that ADHD is boys’ phenomenon,” says Dr. Stephen Hinshaw, chair of the psychology department at UC Berkley. “Three decades later we know this is an equal opportunity condition.”
Girls and women also present the symptoms of ADHD differently. I speak from personal experience. Who are teachers and parents more likely to express concern over, the daydreaming girl staring somewhere else or the hyperactive boy presenting impulsive behavior like falling out of his seat and tapping his feet loudly? As a teacher, I can say I would most likely notice the boy’s behavior first. It’s in-your-face, its screams ‘SOMETHING IS GOING ON AND I’M NOT ATTENDING’. Unfortunately, the girl probably isn’t either and will internalize her shame and confusion at being different, not being able to complete simple tasks and her inattentive mind that she knows is not like her friends’. But she’s not being disruptive and she isn’t the most pressing concern in the classroom: so she is overlooked and she keeps drowning in school until someone finally puts a name on the debilitating condition, and gives her avenues to help.
Why do I write this? Becuase regardless of peoples’ personal views on ADHD, awareness about how to identify struggling female students’ issues like ADHD is only recently being given attention. It IS important for educators to understand that girls and women present the condition differently.
“This made sense but… at the same time it didn’t. When we, your teachers and all of these people looked at you we all thought ‘She’s smart. She’s not bouncing off the walls. She’s well spoken. So what’s the issue? She isn’t an ADHD kid. She’s just not trying… right?”
-My parents on making sense of possible answers for a smart but struggling child. Had ADHD in girls been a discussed topic, maybe it would have seemed more plausible that this diagnosis held the answers for us.
Regardless of whether ADHD is over-diagnosed, suspected cases and attention to symptoms is part of our duty as a teacher. Leave the diagnosis up to the medical professionals.
ADHD is not some new phenomena. It did not appear with the millennial generation. It has always been around, but it has been undiagnosed and untreated.
So yes, older generations did experience ADHD. It was not “created” in the 1990s. It may even help explain why there were such high drop-out rates in schools. Conditions like ADHD left untreated prevent people from reaching their full potential. It is a good thing that people are on the look-out for the symptoms, and while it is important to not misdiagnose, it is equally important to not ignore it and leave students to cope on their own. Treatment should be advised by medical professionals but there are things we can do in the classroom to make sure neither girls nor boys slip through the cracks.
As a girl who was diagnosed with ADHD in fifth grade, my issues did not suddenly disappear when I received treatment. My parents somewhat reluctantly tried medication for me, and it was not a cure-all, but it was what I needed to show my potential. Combined with assistance in school like how to: organize, plan, receive one-on-one instruction and pay attention to details, I finally felt a little less shame, a little less frustration, a little more hope. I wasn’t going to have an easy time in school but I could finally utilize tools to help me succeed. So many things made more sense.
“She’s bright and hard-working, but learning something new is a constant battle. Once she gets it, she gets it, but the amount of work that goes in and the frustration is overwhelming”
-My parents on early symptoms
I did not present the same symptoms as my three brothers, all definitively diagnosed with undisputable ADHD at young ages. They were the poster-boys for the condition: bright, unfocused, hyperactive, loud, and lacked emotional and physical regulations to allow them to attend to school matters.
Like many girls who fall under the radar, I worked three times harder to learn and complete things, internalized my frustration and felt lower self-esteem. Girls with ADHD are more likely to feel anxiety, depression, increased ‘perfectionist’ qualities and social stigma as well as eating disorders. Not only are girls with ADHD overlooked, they punish themselves for what they judge to be personal failings. In sixth grade, I needed a teacher to remind me to turn the page over on a test for the whole year. I would constantly do well on what I answered but fail assignments and tests until I received repeated and concise instructions. If a sixth grader is consistently failing things because they do not turn the page over it’s probably not because they are lazy, there is probably something else going on.
According to Dr. Quinn in “Late Diagnosis, Little Treatment: What ADHD looks like in Girls and Women” “girls with ADHD tend to have more mood disorders, anxiety, and self-esteem problems than non-ADHD girls. “They might get an A on a report, but because they had to work three times as hard to get it, they see themselves as not being as smart as other people,” she says.”
When you have a female student who:
- loses her train of thought
- is hyper-talkative
- emotionally unbalanced
- anxious about school
- anxious and self-deprecating about abilities
- difficulty remembering things
- difficulty understanding concepts on a consistent basis
- slow to learn
- struggles with basic concepts (time management, budget, rules, expectations)
- easily overwhelmed
- easily frustrated
- eating disorders
- socially awkward
She may be struggling with ADHD. A student might present one, a few or even all of these and still not have the condition. It is better to check in about concerns than not to.
In my case, by the time I received intervention for my ADHD I had already developed anxiety, low self-esteem and was on the path to developing an eating disorder (as a means to control what I felt was an out of control world around me) and depression. All of these are noted side-effects of ADHD in girls. Fortunately, although I reached life-threatening levels of anorexia, I received help and healed. The co-occurrence of other conditions stemming from ADHD is very high. Intervention helps girls with ADHD to live better lives, and most importantly, to live.
School only gets harder as students get older, the social pressure only increases and expectations placed on students to perform a certain way in life only becomes further cemented.
Adulthood with ADHD means there is no more pull-out session during the school day and less structure. There are no more safety nets. It means that constantly forgetting keys, birthdays, bills, being late, being rigid in scheduling and compulsively making to-do lists feel a little heavier on someone’s shoulders. I learned to be a fierce advocate for myself. I constantly check in with professors, I manage work and graduate school like a train timetable and I understand I have a responsibility to utilize the methods I learned to put my best foot forward. I learned not to compare myself with my friends who worked hard, but who did not share the same struggle I did. I learned not to think of myself as a fraud, earning good grades I don’t deserve- I work my tail off for every A I get and I do not view my condition with ADHD as something that separates me from my very smart friends. I now recognize I am smart too, but I had to learn differently and put in far more effort mentally to reach the same goals.
Thanks to the intervention and help I received in school, I was able to show my potential, understand that my struggle in school did not reflect my intelligence and I was able to self-advocate. I am organized and plan things to a T, not because it is natural to me, but because I must. In order to live in a world that overwhelms me on a daily basis, I have to take things as they come and take advantage of my treatment options. If you were deaf and were given a hearing aid that helped you, should someone deny you the option to decide if it was best for you?
“I see that you have it in you, I see that you work hard, I see that you are overwhelmed and I see that you can do this. Let’s meet every week for just a few minutes and make sure you know whats expected, you’re on-task and you are on the right path. I think we can make sure you shine”
-One of my incredible teachers who helped me harness my potential
As teachers, we simply must remain unbiased towards highly controversial topics like ADHD. Diagnosing and judging is not our job. Our job is to give students the tools to move forward. Teach them the tools now so that they are prepared for harder school environments and adulthood, where there are no more teachers to help them.
Recognize the quietly struggling student and help them. You may change their life as my teachers changed mine and as I can do going forward.
*While ADHD does not go away, it does become more manageable with intervention. Every day my life is a constant battle between my ADHD and my goals and my potential but I have an upper hand because I received the assistance I needed. Please keep this in mind and realize that what you do with students now stays with them in adulthood.
For further reading:
On ADHD and eating disorder co-occurrence:
On helping students with ADHD: