Counselling: Creating a safe space for ADHD girls

In her book Understanding Girls with AD/HD, Kathleen Nadeau, American child expert and author, writes: "We want not only to treat AD/HD but to treat it in such a way that encourages our girls to develop their gifts, to build a strong self-image and to speak with assured voices."

The goal of intervention is "not to make their lives perfectly organized and trouble-free" but to teach them to value and use their differences, "to empower them rather than pathologize them".

Attention deficit in girls is a new territory for most of us, and requires a great deal of empathy and effort to understand where to start. Here is a guideline to some typical behaviour patterns that arise at each developmental stage and the kind of assistance that may be required.

Lags of maturation
Girls with AD/HD lag behind in maturation. They may not have the age-appropriate skills and may ask "Why is everything so much harder for me than others?". Teachers might use the word immature to describe their classroom behaviour.

A mother may notice that her daughter is quite comfortable playing with younger children. Or, it takes her longer to learn how to tell the time; pack her school bag; and, distinguish right from left.

Instead of being critical, parents must encourage and reassure the child that everyone learns at their own pace, and that time and practice will help her keep up with her friends.

Parents need to be sensitive to the fact that their daughter may not be ready to live independently or leave home for college at 18. She may not be ready to drive at 16 and may find it harder to handle school prom or dates.

Applying learning to new situations
Girls with AD/HD are poor in applying skills to new situations. For example, when Jenny stays overnight at her grandmother's house, she may not be able to organise herself for bedtime.

She may require more adult help and guidance, and someone telling her, "You need to get to bed now or you'll be sleepy tomorrow".

Self monitoring
One of the hardest tasks for girls with AD/HD is setting priorities. In the classroom, they can be distracted by all stimuli and it's challenging to know what to focus on. Often, a girl with AD/HD may choose to focus on something that the teacher considers irrelevant!

"The cognitive struggle then is not about distractibility or a short attention span; it is a struggle to regulate attention" points out Kathleen Nadeau. Parents and teachers have to teach girls with AD/HD how to juggle different tasks. For example, switch the music off when doing homework; don't talk to friends while driving the car, and so on.

Modulating stimulation levels
The struggle to find the right kind of stimulation is an ongoing one for the girl with AD/HD. Brain research has shown that the sensory system demands high stimulation for optimal functioning.

If under-stimulated or bored, she will seek out novelty, noise, colour, excitement. On the other hand, if she is over-stimulated, she may end up hitting, crying, or unable to handle situations. Suddenly, the fun becomes too much fun; the pace too fast; the sounds too loud.

Parents and teachers need to watch out for such situations and act before they reach overload proportions. Girls with AD/HD, and even grown women, may not see the 'crash' coming till they are physically and emotionally exhausted.

Gaining a complete knowledge of ADHD is the single most important factor in its successful management. Parents and teachers have to appreciate the complex issues and arrive at a common consensus.

Girls with attention problems have to be taught that it's not their fault but it is their responsibility to learn strategies to manage AD/HD.

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