It’s Monday morning and I am taking my class through planning a story. Ideas are flying and some of the most inventive are coming from Jemma, a little girl at the front.
Jemma is sat with a learning support assistant (LSA) who gives her reminders to refocus and repeats sections of information to prompt her. As a result, Jemma makes excellent contributions to the conversation and her ideas are innovative and often hilarious.
Unfortunately, when I get her work, it does not contain any of the ideas she shared. It has sloppy, inconsistent handwriting with many rubbings out and silly mistakes. Her story is shorter than her peers and she has not completed it in the time.
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Jemma is getting help, but not the help she needs. Because Jemma has yet to get a diagnosis of attention deficit hyperactivity disorder (ADHD).
Missed diagnosis
Girls with ADHD get missed. A lot. ADHD affects 5 per cent of children in the UK and those diagnoses are usually for boys. That’s because, in the UK, ADHD is mainly recognised as a behavioural problem and not an educational difficulty. Hyperactive or impulsive boys are usually spotted, but ADHD has three presentations: inattentive, hyperactive/impulsive and a combination of the two.
Girls are underdiagnosed as they are often not as disruptive, presenting more commonly with inattentive traits that can be misdiagnosed as a learning difficulty. There are several traits you should look for in your students if you suspect inattentive ADHD.
Signs of inattentive ADHD
These are:
- Making careless mistakes in their work.
- Struggling to hold attention during tasks.
- Not following instructions or failing to complete tasks
- Having trouble organising themselves for activities.
- Avoiding tasks that take mental effort - taking the easy option.
- Losing and forgetting things all the time.
- Forgetting daily tasks.
Girls can also present with hyperactive/impulsive ADHD, but the gendering of symptoms sometimes limits diagnosis. Hyperactivity is more commonly accepted in boys, whereas girls who present with these traits can be ostracised.
Although these are outdated perspectives, it means that girls who present as hyperactive can engage in “masking” - stifling behaviours to appear as the world wants them to, by copying.
Different presentations
For example, instead of fidgeting and jumping around, they may twirl their hair. This makes diagnosis more complicated as there are hidden symptoms. Lesser-known symptoms associated with ADHD also provide complications. These include:
- Hyper focus - where children with ADHD can focus on areas of interest for hours. It can be assumed that if they can concentrate sometimes, then at other times they are being lazy.
- Emotional dysregulation - irritability, friendship problems and feelings of rejection and failure, which can be misdiagnosed as other mental health concerns, such as anxiety or bipolar disorder.
If you have concerns about a child, speak to your Sendco and then the child’s parents. A diagnosis of ADHD comes through Camhs, so they must be referred by their GP. When having these conversations, a copy of the traits of ADHD can help - ADDitude has an excellent self-test for girls with suspected ADHD.
In the UK, there are many adult women being diagnosed with ADHD after being missed during education who now have further mental health concerns and, as educators, being more aware of this disparity means it will not continue into the next generation of young women who may have ADHD.
