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Councelling: Girls can be hyper too

Until very recently, attention deficit disorder with hyperactivity (AD/HD) was something we associated only with boys.

Gulf News

Educational Psychologist Dr Onita Nakra has a Ph.D. in Educational Psychology from the University of Minnesota, USA. Her specialisation is in assessment, diagnosis and intervention methods for children with special needs.

Until very recently, attention deficit disorder with hyperactivity (AD/HD) was something we associated only with boys. However, over the past ten years experts have received sufficient evidence from grown women to indicate that girls, too, display hyperactivity.

Unfortunately, very little is known about the symptoms, how it affects young girls or adult women, and what methods work best for them. It is sad but true that girls and women with AD/HD grow up unnoticed and untreated, often developing anxiety, depression and underachieving as professionals.

Kathleen Nadeau in her new book, Understanding Girls with ADHD explodes the myth that boys are more hyperactive than girls. The real truth is we have no diagnostic criteria to assess attention disorders in girls and women.

In fact, it is only now that the first generation of women with attention difficulties has begun to voice and clarify its experiences, thereby enabling experts to collect information and analyse what needs to change in education to support these women.

The first step is to listen to the childhood experiences of these women and use them as a rich resource to develop more appropriate diagnostic criteria. For example, one criterion for AD/HD diagnosis is that the onset of hyperactive behaviour must occur before the age of seven.

However, research has established that many behavioural problems for girls begin only after puberty. This implies that the diagnostic criteria for AD/HD in girls need to be different. One reason why attention difficulties in girls are less understood than in boys is because the symptoms are far more subtle.

Social struggles are an important manifestation of AD/HD issues in girls. This makes sense because social interaction among girls is highly valued. As early as preschool, girls with AD/HD issues are avoided by their friends because they are sensed as lacking in sensitivity, co-operation and verbal skills.

Some girls may be too shy to interact verbally with their peers and this could well result in outright rejection or criticism. They withdraw socially and may have one or two friends outside school. Others may be 'hyper-social', that is, they adopt silly behaviour in an attempt to find social acceptance. Girls in the middle school may engage in risky behaviours and 'show off' to compensate for poor academic achievement and peer rejection.

Not all girls with AD/HD are low achievers, however. Some of them tend to be extremely bright and are driven, over-anxious and over-focused on their studies. They mask their social inadequacies by working very hard and may hit a wall in college or in a professional programme when the intellectual demands peak.

Girls with AD/HD tend to internalise shame and guilt, resulting in depression and anxiety. Society tends to have double standards. The impulsive tendencies of men are looked upon with tolerance and humour but we are much crueller to women. Research, too, has established that mothers, too, tend to be more critical of their daughters than of their sons.

Girls who are argumentative, messy and explosive are less accepted by their families. This is an important finding because without parental support and positive acceptance, girls with AD/HD are likely to grow up with low self-esteem, depression and anxiety.

Hyperactivity in girls takes a different form than in boys. Boys are physically active. Boys are easily noticed because they act out by being impulsive, may disrupt the classroom, and are most often referred for diagnosis and treatment.

Girls tend to be more talkative and emotionally excitable. For teachers and parents, it is difficult to understand behaviours in girls such as social withdrawal, talkativeness, forgetfulness, a tendency to be late, to miss assignments, and so on. Some girls are over-anxious and over-focused on schoolwork. This, too, could be an attempt at masking attention difficulties.