Research and clinical practices are built around male presentations of ADHD. We are failing girls and women with ADHD. To right these gender wrongs, it’s time to seriously rethink the way ADHD is assessed, diagnosed, and treated. adhd
Probe for and help to develop a patient’s strengths to help promote a real sense of positive self-worth, which may mitigate risk for other impairments.
Ask about sexual behavior and employment history, as appropriate, as these experiences may also uncover impairments.Be on the lookout for compensatory behaviors from patients– e.g., long hours spent on homework, staying late at work, symptoms of anxiety and depression, highly structured environments, high levels of stress, putting on a “brave” face. Even asking, “Are you overwhelmed?” may elicit responses that can indicate underlying ADHD.
Work to understand the near 1:1 sex ratio of ADHD in males and females by adulthood. Boys are more likely than girls to be diagnosed with ADHD, but the ratio nearly evens out in adulthood. Why? Is it possible due to greater persistence of symptoms in girls and women? A greater willingness to disclose and self-report as an adult? Greater ADHD understanding over time?
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