Girls with ADHD - Not So Different

 

        In her paper, Top-down Attention Modulates Auditory-evoked Neural Responses in Neurotypical, but not ADHD, Young Adults, Jasmine A.C. Kwasa Ph.D. measures both behavioral performance and key neural signatures of attention using electroencephalography (EEG) during an especially demanding listening task for ADHD and neurotypicals. Participants were to focus on a target speech sound while choosing to either ignore or engage with other auditory stimuli functioning as 'interrupters' and 'distractors.' Kwasa and her team's findings expectedly show decreased attentional modulation, demonstrated by neural signatures, for ADHD subjects. However, researchers found no difference between groups in terms of behavioral performance - everyone varied behaviorally in how they attended to a target, no clear behavioral difference for ADHD folks (man or woman). This is relevant for when we think of what ADHD symptoms should look like and for who. 

        According to the Center for Disease Control and Prevention (CDC), boys are more than twice as likely to receive an attention-deficit/hyperactivity disorder (ADHD) diagnosis - 12.9% boys to 5.6% girls. Rae Jacobson from the Child Mind Institute cites co-founder and director of the National Resource Center for Girls and Women with ADHD, Patricia Quinn, MD, and Clinical Psychologist, Stephen Hinshaw, Ph.D., and Clinical Psychologist, Kathleen Nadeau Ph.D. in her article, How Girls With ADHD Are Different. Best put by Dr. Nadeau, “Girls are under a lot more pressure to be socially tuned in and self-controlled.” Dr. Quinn describes an image of little boys with ADHD bouncing off walls, known and accepted well in our hegemonic society. However, when children begin to grapple with their ADHD symptoms, frustrations are natural. What differs is the socially acceptable way of expressing those frustrations. Boys are allowed and expected to do so externally while girls are confined to express their frustrations internally. This can manifest as low self-esteem, lack of self-advocacy in the classroom, and severe impacts on mental health. Dr. Hinshaw's own research finds that girls with ADHD have significantly higher rates of attempted suicide and self-harm than girls without.  

It appears as though, in the controlled environment of the lab, the complex influences of gender roles in our society seem to fall away. It begets the question, that if women and girls were not so constrained to the performance of their gender, would their ADHD symptoms look more like that of boys? Now the fact that behavioral indicators of attention continue to prove non-distinctive between neurotypicals and folks with ADHD, might not make accurately diagnosing girls easier, but it is important science that propels us towards a more equal society. 

“Data and Statistics about ADHD.” Centers for Disease Control and Prevention, U.S. Department of Health & Human Services, 23 Sept. 2021, https://www.cdc.gov/ncbddd/adhd/data.html.

Jacobson, Rae. “How Girls with ADHD Are Different.” Child Mind Institute, 15 Feb. 2022, https://childmind.org/article/how-girls-with-adhd-are-different/.