July 22, 2025 • 18 mins
In this episode, Dr. Fallucco dives into the nuances of ADHD in girls, explaining why it is so important to recognize girls with ADHD, how girls with ADHD present with different symptoms than boys, and why girls often go undiagnosed.
She highlights the importance of early recognition and treatment to reduce risks like suicide, drug abuse, accidents, and social struggles. Dr. Fallucco also discusses the subtle inattentive symptoms in girls, genetic risk factors, and ADHD 'superpowers' such as hyperfocus and creativity.
Tune in to learn why it's crucial for clinicians to identify and treat ADHD early, especially in girls, to help them thrive academically, socially, and in life.
00:00 Introduction to ADHD in Girls
00:49 Why ADHD in Girls Matters
02:35 Challenges in Diagnosing Girls
03:19 Importance of Treatment
04:31 Recognizing ADHD in Girls
04:39 ADHD Subtypes and Gender Differences
04:54 Subtle Symptoms in Girls
06:25 Hyperactivity and Impulsivity in Girls vs. Boys
08:38 Which KIDS you should worry about who may have unrecognized ADHD
13:27 ADHD Superpowers
15:58 Final Thoughts and Pearls
17:17 Conclusion and Contact Information
Check out our website PsychEd4Peds.com for more resources.
Follow us on Instagram @psyched4peds
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Elise Fallucco (00:00):
Welcome back to Child Mental Health for
Pediatric clinicians, thepodcast formerly known as
Psyched for peds.
I'm your host, Dr.
Elise Fallucco, childpsychiatrist, and mom.
Today I'm really excited to talkabout.
All of the things you shouldknow about A DHD in girls.
(00:20):
First we're gonna talk about whythis is important, and second,
we'll talk about how girls withA DHD look differently than boys
with A DHD, and also how whythat makes it so hard to be able
to detect them.
Then we'll talk about which kidsyou should worry about in your
practice, who might haveundiagnosed A DHD.
(00:41):
And finally, I'm gonna share alittle bit about A DHD
superpowers.
So let's get started.
First, let's talk about why youshould care about A DHD in
girls.
As you may already know, A DHDis the most common
neurodevelopmental disorder.
Affecting youth.
About one in nine kids, agesthree to 17 have A DHD.
(01:07):
And the prevalence of A DHD hasbeen rising over the past
decade, which you could probablytell from your own practice.
And at one point in time, reallydecades ago, A DHD was thought
to be a disorder almostexclusively affecting boys.
With 25 times as many boysdiagnosed with A DHD as girls.
(01:27):
And over time, this gender ratiohas significantly narrowed to
the point that now we think it'sabout twice as many boys have a
DHD as girls.
And then when you get intoadulthood, this ratio narrows
even further where you see thatThere are almost as many women
with diagnosis of A DHD as thereare men, so it makes you wonder
(01:49):
what is going on here with thischange in the ratio.
Of males to females with a DHDover time., Is it a boys are
really that much more likely tohave a D, H, D than girls?
B.
Girls just present with symptomsof A D, H, D later in life.
C.
(02:10):
We're just really not good atdetecting symptoms of A DHD in
girls compared to boys, andthat's why we don't see as many
girls with a DHD in childhood.
Or is it D?
All of the above.
And just as a side note, thestudies I'm gonna refer to in
this episode talk about boys andgirls from a biological sex
perspective.
(02:30):
So lots of questions, but thebottom line is that as far as
what we know now, Girls are muchless likely to be diagnosed than
boys with a DHD, even at thesame levels of impairment.
And oftentimes girls who have aDHD symptoms are under
recognized.
And even when girls arediagnosed, these diagnoses are
(02:52):
made often, much later in theirlives compared to boys.
On top of that, even when girlsare diagnosed with A DHD,
they're less likely to beprescribed medication than boys,
even when you control forsymptom severity.
So that means even when a givengirl and a boy both have
symptoms that are causing thesame amount of impact and
(03:13):
problem on their functioning atschool or at home or with
friends.
Girls are less likely to begiven treatment but treatment is
so important for so manyreasons.
Treatment with A DHD meds can behighly effective.
Helping kids with A DHD do theirbest, perform at their highest
level at school.
Or ultimately in work as theyage.
(03:35):
But the biggest, most importantthing that I hope you'll
remember as a take home fromthis is that treatment for A DHD
reduces the risk of some of theleading causes of death in
teens, which includes suicide,drug abuse, accidents, and
injuries related to accidents.
So this is really why you shouldcare, because.
(03:56):
So many girls with A DHD aregoing without a diagnosis or are
not being treated, and that inturn increases their risk for
all of these bad outcomes.
So the bottom line is it'sreally important to be able to
recognize all kids with A DHD,but particularly girls who tend
to be underdiagnosed and underrecognized.
(04:17):
And when you recognize thosesymptoms, it is really important
to have discussions abouttreatment.
We've talked about why it'simportant to recognize A DHD in
girls, and now we're gonna talkabout how to do that.
So.
What does A DHD look like ingirls?
And why are girls with a DHD sochallenging to detect and so
(04:38):
easy to miss?
So the first thing that we needto know about girls with A DHD
is they're more likely topresent with the subtle
inattentive symptoms as opposedto the boys who are more likely
to present with the hyperactiveimpulsive symptoms or the
combined hyperactive impulsiveplus inattentive symptoms.
So think about it this way, thestereotypical girl with A DHD is
much more likely to showinattentive symptoms and less
(05:01):
likely to have the obvioushyperactivity and impulsivity.
These girls may have troublestaying focused when they're
asked to listen to long lecturesin class, or they're asked to
read a long passage or even whenthey're engaged in a longer
conversation with their friendsor family, Girls with a DHD.
With this inattentive subtypeoften start projects or start
(05:23):
tasks, but then they easily losefocus and they're quickly
sidetracked and wanna dosomething else that's a little
bit more interesting orexciting.
Sometimes these girls with theinattentive subtype don't seem
to be paying attention whenyou're talking to them, and you
often have to repeat yourself toget a response from them.
So they sometimes seem to be alittle spaced out.
(05:45):
So that's the stereotypical formof predominantly inattentive
subtype.
And you can see when you've gotthese subtle symptoms, you're
much less likely to drawattention from teachers or
parents.
Yeah, because these are thingsthat the girls are experiencing
in their head, in their minds,and it's really hard to tell
that from the outside.
Whereas the boys with A DHD aremore likely to present with the
(06:08):
mainly hyperactive, impulsivesubtype or the combined subtype
they're very hyper.
They're climbing on thefurniture in the office.
They're spinning around on yourchair.
They're physically busy, evenmore so than you would expect
for a neurotypical boy.
Of the same age or the samedevelopmental level So the
second thing to know about girlswith A DHD is Girls express
(06:31):
their hyperactivity or expresstheir impulsivity in a way
that's different compared toboys.
So boys with A DHD are morelikely to have very physical
hyperactivity and impulsivity.
For example.
Boys are more likely to havetrouble sitting still to often
leave their seat in theclassroom.
(06:51):
They're more likely to befidgeting with their hands or
feet or to run around or climbexcessively, which is one of the
criteria for A DHD climbexcessively.
So, in other words, boys with aDHD really like to move their
body.
They're showing physicalimpulsivity, manifesting it
through their body, which againmakes it easier for us to detect
from the outside.
(07:11):
Whereas girls with a DHD expresstheir hyperactivity and
impulsivity in more of a verbalway than in a physical way.
So girls are more likely.
To be called the chatty Cathys,they talk excessively.
They're more likely tointerrupt, and even when you've
got girls and boys with the samelevel of hyperactivity and
(07:34):
impulsivity, the girls are morelikely to endorse these verbal
symptoms, whereas the boys aremore likely to show physical
hyperactivity and impulsivity.
And let's say even if girls areinterrupting in class or maybe
you're talking a lot in class,that's certainly less disruptive
than having a stereotypical boywho is popping out of his seat
(07:58):
or hitting another child near orrunning around the classroom or
climbing excessively.
That's my favorite symptom.
It makes, helps us understandwhy girls are less likely to be
recognized than boys becausesome of their symptoms are less
disruptive to a classroomsetting, to a family, et cetera,
than girls' symptoms are.
(08:28):
So now that we've talked aboutthe differences between boys and
girls with a DHD, now let's talkabout which kids you should
worry about who may haveunrecognized A-D-H-D-I.
So we'll start with the morestraightforward things First,
you wanna look out for obviousacademic problems in school
where their grades are slippingor they're spending an
(08:48):
inordinate amount of time onschoolwork, or the opposite,
they're totally avoiding it orrushing through it.
And then of course you wannalook out for social problems
because kids with A DHD, whotend to be more impulsive.
May show this when they'rehaving conversations with their
friends by interrupting orblurting things out, or even may
exhibit these symptoms in class,and then they'll be flagged as
(09:11):
unusual.
There's also a particulardevelopmental stage where we
tend to see a second wave ofkids with a DH d in our office,
and that would be the transitionto middle school.
Now developmentally, this is atime where the academic load
massively increases compared toelementary school and also the
social demands are much higher.
(09:32):
And so kids who maybe have beenable to skirt along through
elementary school just fine,begin to have problems in middle
school with their gradesdropping or having more obvious
social impairment.
As developmentally at this time,girls tend to connect with one
another verbally and throughconversation.
So if you're a girl with a lotof a DHD related impulsivity and
(09:54):
you're interruptingconversations or talking nonstop
or blurting out answers, you mayhave trouble seamlessly
connecting with other girls.
So we've talked about some signsthat somebody could be
struggling with a DHD, and thoseare namely having academic
problems, having socialproblems, or somebody who's
struggling through thetransition from elementary
(10:14):
school to middle school.
Now, let's shift gears and talka little bit about genetic risk
factors and other clinicalfactors that could indicate
somebody maybe at high risk forA DHD.
The first types of kids who arehigh risk are kids whose parent
has a DHD.
We know that A DHD runs infamilies.
(10:36):
It's highly heritable, so it'spassed down from parents to
kids, just like hair color andeye color, and some other
traits.
So when I make a new diagnosisof A DHD, I often ask the
family, which parent does thechild seem to take after in this
respect?
And almost always universally,one parent will either name
(10:57):
themselves or their partner andsay, oh my gosh, my child is
just like their father or theirmother So we look out for kids
if we have a known diagnosis ofa parent with A DHD.
So this would be great andreally helpful, except for the
fact that there are a ton ofparents running around who also
(11:19):
have undiagnosed A DHD.
And so we can't always rely onthe parents having gone through
the process of being diagnosedand and treated and being able
to recognize symptoms inthemselves and therefore be able
to see and recognize thesymptoms in their child.
So the other type of kids wewanna look out for are kids
(11:40):
whose siblings have a DHD.
Again, because it's highlygenetic and highly heritable,
just having a sibling with A DHDincreases your risk.
And in fact, one large studypublished in JAMA Peds found
that kids whose sibling had ADHD were 13 times more likely to
be diagnosed with A DHD thankids who didn't have a sibling
(12:04):
with a DHD.
And in the same study, theyestimated that if a child has a
sibling with A DHD, they haveabout a one in two or a one in
four chance of being diagnosedwith A DHD themselves.
So the bottom line is we need tolook out for siblings of kids
who already have a DHD.
And since we know that boys aremore likely to be diagnosed with
(12:25):
A DHD, I would say.
If you have a child in youroffice whose brother has a DHD,
you need to be thinking about ADHD in them.
Okay?
Third, potential clue that thischild's at higher risk for A DH.
D would be a child that alreadyhas a diagnosis of anxiety or
some type of learningdifference, or even a mood
(12:46):
disorder.
Because we know that kids with ADHD are at high risk of having
comorbid anxiety, mooddisorders, learning challenges,
and also substance use, uh,later in life.
And there's this concept with areally beautiful name called
diagnostic overshadowing, whichbasically means that.
When somebody has more than onemental health diagnosis,
(13:10):
oftentimes one of the diagnosesis more obvious to us as
clinicians, and so we're morelikely to diagnose them with
that and then potentially missthis other diagnosis that they
may have.
So something to think about Andthen finally, another clue that
(13:31):
you may be working with a kidwho has undiagnosed A DHD would
be the presence of A DHDsuperpowers.
And I wanna let you know beforeI tell you about these
superpowers that a lot of thisis based on clinical and
anecdotal evidence.
But we don't have a ton ofsystematic studies that are
looking at this.
So just as a disclaimer, butsome of the A DHD superpowers
(13:55):
are the ability to hyperfocus.
So these would be kids who canpay attention to some task or
activity, whatever it is that'sreally interesting to them.
Maybe it's Minecraft, maybe it'svideo games, or maybe it's even
a sport that they're really,really interested in and they
can.
Pay attention for a really longperiod of time and be incredibly
(14:18):
successful in this area.
And unfortunately, thissuperpower that we see in a lot
of kids with A DHD, this abilityto hyperfocus is one of the
parts that makes it really hardto diagnose them, because as a
parent or even as a clinician,you see, oh, well look, they can
pay attention to this for areally long period of time.
And so they can't have problemswith their attention and
(14:39):
concentration.
But again, their ability tohyperfocus is based on their
high motivation.
So for all of us, when we'remotivated or really excited
about something, we can zoom inor.
Super focus because ourmotivation is kind of helping
us.
The difference is that inneurodivergent kids who have a
DHD.
(14:59):
When they don't have thatmotivation, when something's not
as interesting, that's when yousee the differences and where
it's much more difficult forthem to sustain attention
because it's boring and theylike things that are very
exciting and how can you blamethem?
The other superpower with A DHDyou sometimes see is high
degrees of creativity orartistic ability.
(15:22):
Neurodivergent people with A DHDhave incredible ways of solving
problems, at looking at theworld, at being able to build
and create things.
And have incredible imaginationsbecause they're not necessarily
constrained to linearstep-by-step processes in their
thinking.
Another superpower with A DHD ishigh amounts of energy.
(15:44):
It takes a lot for them to beworn out, and often they have
trouble falling asleep becausethey are just so busy and they
wanna be on the go again.
This is kind of an amazingsuperpower, but sometimes makes
it hard when you're the parentof a child with lots of energy.
So to recap, we've talked aboutwhy it is so critically
important to recognize kids withA DHD, particularly those with
(16:06):
the inattentive subtype, and toget them treatment promptly to
decrease the risk of negativeoutcomes and help them to be
their best at school and inlife.
We've also talked about how boysand girls differ in terms of
their A DHD, with girlspresenting with more inattentive
symptoms and girls alsopresenting with more verbal
impulsivity as opposed to boyswho present with more physical
(16:29):
impulsivity as well ashyperactivity.
We've talked about which kidsyou should worry about, and
briefly to recap those withacademic problems, social
challenges, Or kids withrecognized learning differences,
anxiety or mood disorder.
Also be on the lookout for thosekids with a first degree
relative with A DHD, usually aparent or a sibling.
(16:52):
And of course, we wanna have oureyes wide open for all of our
patients during the transitionof middle school.
'cause this is often when webegin to see a second wave of
unrecognized A DHD.
And finally have a high degreeof suspicion among kids with
some of the A DHD superpowerslike the ability to hyperfocus
(17:13):
high amounts of energy, and lotsof creativity.
Thank you so much for takingthis time to listen.
I really appreciate it.
If you have any questions or anyideas or mystery cases of your
own, please feel free to reachout to me at Instagram at
psyched the number four peds, oron our website at psyched the
(17:36):
number four peds.com.
Thanks so much.
See you next time.
Welcome back to Child Mental Health for
Pediatric clinicians, thepodcast formerly known as
Psyched for peds.
I'm your host, Dr.
Elise Fallucco, childpsychiatrist, and mom.
Today I'm really excited to talkabout.
All of the things you shouldknow about A DHD in girls.
(00:20):
First we're gonna talk about whythis is important, and second,
we'll talk about how girls withA DHD look differently than boys
with A DHD, and also how whythat makes it so hard to be able
to detect them.
Then we'll talk about which kidsyou should worry about in your
practice, who might haveundiagnosed A DHD.
(00:41):
And finally, I'm gonna share alittle bit about A DHD
superpowers.
So let's get started.
First, let's talk about why youshould care about A DHD in
girls.
As you may already know, A DHDis the most common
neurodevelopmental disorder.
Affecting youth.
About one in nine kids, agesthree to 17 have A DHD.
(01:07):
And the prevalence of A DHD hasbeen rising over the past
decade, which you could probablytell from your own practice.
And at one point in time, reallydecades ago, A DHD was thought
to be a disorder almostexclusively affecting boys.
With 25 times as many boysdiagnosed with A DHD as girls.
(01:27):
And over time, this gender ratiohas significantly narrowed to
the point that now we think it'sabout twice as many boys have a
DHD as girls.
And then when you get intoadulthood, this ratio narrows
even further where you see thatThere are almost as many women
with diagnosis of A DHD as thereare men, so it makes you wonder
(01:49):
what is going on here with thischange in the ratio.
Of males to females with a DHDover time., Is it a boys are
really that much more likely tohave a D, H, D than girls?
B.
Girls just present with symptomsof A D, H, D later in life.
C.
(02:10):
We're just really not good atdetecting symptoms of A DHD in
girls compared to boys, andthat's why we don't see as many
girls with a DHD in childhood.
Or is it D?
All of the above.
And just as a side note, thestudies I'm gonna refer to in
this episode talk about boys andgirls from a biological sex
perspective.
(02:30):
So lots of questions, but thebottom line is that as far as
what we know now, Girls are muchless likely to be diagnosed than
boys with a DHD, even at thesame levels of impairment.
And oftentimes girls who have aDHD symptoms are under
recognized.
And even when girls arediagnosed, these diagnoses are
(02:52):
made often, much later in theirlives compared to boys.
On top of that, even when girlsare diagnosed with A DHD,
they're less likely to beprescribed medication than boys,
even when you control forsymptom severity.
So that means even when a givengirl and a boy both have
symptoms that are causing thesame amount of impact and
(03:13):
problem on their functioning atschool or at home or with
friends.
Girls are less likely to begiven treatment but treatment is
so important for so manyreasons.
Treatment with A DHD meds can behighly effective.
Helping kids with A DHD do theirbest, perform at their highest
level at school.
Or ultimately in work as theyage.
(03:35):
But the biggest, most importantthing that I hope you'll
remember as a take home fromthis is that treatment for A DHD
reduces the risk of some of theleading causes of death in
teens, which includes suicide,drug abuse, accidents, and
injuries related to accidents.
So this is really why you shouldcare, because.
(03:56):
So many girls with A DHD aregoing without a diagnosis or are
not being treated, and that inturn increases their risk for
all of these bad outcomes.
So the bottom line is it'sreally important to be able to
recognize all kids with A DHD,but particularly girls who tend
to be underdiagnosed and underrecognized.
(04:17):
And when you recognize thosesymptoms, it is really important
to have discussions abouttreatment.
We've talked about why it'simportant to recognize A DHD in
girls, and now we're gonna talkabout how to do that.
So.
What does A DHD look like ingirls?
And why are girls with a DHD sochallenging to detect and so
(04:38):
easy to miss?
So the first thing that we needto know about girls with A DHD
is they're more likely topresent with the subtle
inattentive symptoms as opposedto the boys who are more likely
to present with the hyperactiveimpulsive symptoms or the
combined hyperactive impulsiveplus inattentive symptoms.
So think about it this way, thestereotypical girl with A DHD is
much more likely to showinattentive symptoms and less
(05:01):
likely to have the obvioushyperactivity and impulsivity.
These girls may have troublestaying focused when they're
asked to listen to long lecturesin class, or they're asked to
read a long passage or even whenthey're engaged in a longer
conversation with their friendsor family, Girls with a DHD.
With this inattentive subtypeoften start projects or start
(05:23):
tasks, but then they easily losefocus and they're quickly
sidetracked and wanna dosomething else that's a little
bit more interesting orexciting.
Sometimes these girls with theinattentive subtype don't seem
to be paying attention whenyou're talking to them, and you
often have to repeat yourself toget a response from them.
So they sometimes seem to be alittle spaced out.
(05:45):
So that's the stereotypical formof predominantly inattentive
subtype.
And you can see when you've gotthese subtle symptoms, you're
much less likely to drawattention from teachers or
parents.
Yeah, because these are thingsthat the girls are experiencing
in their head, in their minds,and it's really hard to tell
that from the outside.
Whereas the boys with A DHD aremore likely to present with the
(06:08):
mainly hyperactive, impulsivesubtype or the combined subtype
they're very hyper.
They're climbing on thefurniture in the office.
They're spinning around on yourchair.
They're physically busy, evenmore so than you would expect
for a neurotypical boy.
Of the same age or the samedevelopmental level So the
second thing to know about girlswith A DHD is Girls express
(06:31):
their hyperactivity or expresstheir impulsivity in a way
that's different compared toboys.
So boys with A DHD are morelikely to have very physical
hyperactivity and impulsivity.
For example.
Boys are more likely to havetrouble sitting still to often
leave their seat in theclassroom.
(06:51):
They're more likely to befidgeting with their hands or
feet or to run around or climbexcessively, which is one of the
criteria for A DHD climbexcessively.
So, in other words, boys with aDHD really like to move their
body.
They're showing physicalimpulsivity, manifesting it
through their body, which againmakes it easier for us to detect
from the outside.
(07:11):
Whereas girls with a DHD expresstheir hyperactivity and
impulsivity in more of a verbalway than in a physical way.
So girls are more likely.
To be called the chatty Cathys,they talk excessively.
They're more likely tointerrupt, and even when you've
got girls and boys with the samelevel of hyperactivity and
(07:34):
impulsivity, the girls are morelikely to endorse these verbal
symptoms, whereas the boys aremore likely to show physical
hyperactivity and impulsivity.
And let's say even if girls areinterrupting in class or maybe
you're talking a lot in class,that's certainly less disruptive
than having a stereotypical boywho is popping out of his seat
(07:58):
or hitting another child near orrunning around the classroom or
climbing excessively.
That's my favorite symptom.
It makes, helps us understandwhy girls are less likely to be
recognized than boys becausesome of their symptoms are less
disruptive to a classroomsetting, to a family, et cetera,
than girls' symptoms are.
(08:28):
So now that we've talked aboutthe differences between boys and
girls with a DHD, now let's talkabout which kids you should
worry about who may haveunrecognized A-D-H-D-I.
So we'll start with the morestraightforward things First,
you wanna look out for obviousacademic problems in school
where their grades are slippingor they're spending an
(08:48):
inordinate amount of time onschoolwork, or the opposite,
they're totally avoiding it orrushing through it.
And then of course you wannalook out for social problems
because kids with A DHD, whotend to be more impulsive.
May show this when they'rehaving conversations with their
friends by interrupting orblurting things out, or even may
exhibit these symptoms in class,and then they'll be flagged as
(09:11):
unusual.
There's also a particulardevelopmental stage where we
tend to see a second wave ofkids with a DH d in our office,
and that would be the transitionto middle school.
Now developmentally, this is atime where the academic load
massively increases compared toelementary school and also the
social demands are much higher.
(09:32):
And so kids who maybe have beenable to skirt along through
elementary school just fine,begin to have problems in middle
school with their gradesdropping or having more obvious
social impairment.
As developmentally at this time,girls tend to connect with one
another verbally and throughconversation.
So if you're a girl with a lotof a DHD related impulsivity and
(09:54):
you're interruptingconversations or talking nonstop
or blurting out answers, you mayhave trouble seamlessly
connecting with other girls.
So we've talked about some signsthat somebody could be
struggling with a DHD, and thoseare namely having academic
problems, having socialproblems, or somebody who's
struggling through thetransition from elementary
(10:14):
school to middle school.
Now, let's shift gears and talka little bit about genetic risk
factors and other clinicalfactors that could indicate
somebody maybe at high risk forA DHD.
The first types of kids who arehigh risk are kids whose parent
has a DHD.
We know that A DHD runs infamilies.
(10:36):
It's highly heritable, so it'spassed down from parents to
kids, just like hair color andeye color, and some other
traits.
So when I make a new diagnosisof A DHD, I often ask the
family, which parent does thechild seem to take after in this
respect?
And almost always universally,one parent will either name
(10:57):
themselves or their partner andsay, oh my gosh, my child is
just like their father or theirmother So we look out for kids
if we have a known diagnosis ofa parent with A DHD.
So this would be great andreally helpful, except for the
fact that there are a ton ofparents running around who also
(11:19):
have undiagnosed A DHD.
And so we can't always rely onthe parents having gone through
the process of being diagnosedand and treated and being able
to recognize symptoms inthemselves and therefore be able
to see and recognize thesymptoms in their child.
So the other type of kids wewanna look out for are kids
(11:40):
whose siblings have a DHD.
Again, because it's highlygenetic and highly heritable,
just having a sibling with A DHDincreases your risk.
And in fact, one large studypublished in JAMA Peds found
that kids whose sibling had ADHD were 13 times more likely to
be diagnosed with A DHD thankids who didn't have a sibling
(12:04):
with a DHD.
And in the same study, theyestimated that if a child has a
sibling with A DHD, they haveabout a one in two or a one in
four chance of being diagnosedwith A DHD themselves.
So the bottom line is we need tolook out for siblings of kids
who already have a DHD.
And since we know that boys aremore likely to be diagnosed with
(12:25):
A DHD, I would say.
If you have a child in youroffice whose brother has a DHD,
you need to be thinking about ADHD in them.
Okay?
Third, potential clue that thischild's at higher risk for A DH.
D would be a child that alreadyhas a diagnosis of anxiety or
some type of learningdifference, or even a mood
(12:46):
disorder.
Because we know that kids with ADHD are at high risk of having
comorbid anxiety, mooddisorders, learning challenges,
and also substance use, uh,later in life.
And there's this concept with areally beautiful name called
diagnostic overshadowing, whichbasically means that.
When somebody has more than onemental health diagnosis,
(13:10):
oftentimes one of the diagnosesis more obvious to us as
clinicians, and so we're morelikely to diagnose them with
that and then potentially missthis other diagnosis that they
may have.
So something to think about Andthen finally, another clue that
(13:31):
you may be working with a kidwho has undiagnosed A DHD would
be the presence of A DHDsuperpowers.
And I wanna let you know beforeI tell you about these
superpowers that a lot of thisis based on clinical and
anecdotal evidence.
But we don't have a ton ofsystematic studies that are
looking at this.
So just as a disclaimer, butsome of the A DHD superpowers
(13:55):
are the ability to hyperfocus.
So these would be kids who canpay attention to some task or
activity, whatever it is that'sreally interesting to them.
Maybe it's Minecraft, maybe it'svideo games, or maybe it's even
a sport that they're really,really interested in and they
can.
Pay attention for a really longperiod of time and be incredibly
(14:18):
successful in this area.
And unfortunately, thissuperpower that we see in a lot
of kids with A DHD, this abilityto hyperfocus is one of the
parts that makes it really hardto diagnose them, because as a
parent or even as a clinician,you see, oh, well look, they can
pay attention to this for areally long period of time.
And so they can't have problemswith their attention and
(14:39):
concentration.
But again, their ability tohyperfocus is based on their
high motivation.
So for all of us, when we'remotivated or really excited
about something, we can zoom inor.
Super focus because ourmotivation is kind of helping
us.
The difference is that inneurodivergent kids who have a
DHD.
(14:59):
When they don't have thatmotivation, when something's not
as interesting, that's when yousee the differences and where
it's much more difficult forthem to sustain attention
because it's boring and theylike things that are very
exciting and how can you blamethem?
The other superpower with A DHDyou sometimes see is high
degrees of creativity orartistic ability.
(15:22):
Neurodivergent people with A DHDhave incredible ways of solving
problems, at looking at theworld, at being able to build
and create things.
And have incredible imaginationsbecause they're not necessarily
constrained to linearstep-by-step processes in their
thinking.
Another superpower with A DHD ishigh amounts of energy.
(15:44):
It takes a lot for them to beworn out, and often they have
trouble falling asleep becausethey are just so busy and they
wanna be on the go again.
This is kind of an amazingsuperpower, but sometimes makes
it hard when you're the parentof a child with lots of energy.
So to recap, we've talked aboutwhy it is so critically
important to recognize kids withA DHD, particularly those with
(16:06):
the inattentive subtype, and toget them treatment promptly to
decrease the risk of negativeoutcomes and help them to be
their best at school and inlife.
We've also talked about how boysand girls differ in terms of
their A DHD, with girlspresenting with more inattentive
symptoms and girls alsopresenting with more verbal
impulsivity as opposed to boyswho present with more physical
(16:29):
impulsivity as well ashyperactivity.
We've talked about which kidsyou should worry about, and
briefly to recap those withacademic problems, social
challenges, Or kids withrecognized learning differences,
anxiety or mood disorder.
Also be on the lookout for thosekids with a first degree
relative with A DHD, usually aparent or a sibling.
(16:52):
And of course, we wanna have oureyes wide open for all of our
patients during the transitionof middle school.
'cause this is often when webegin to see a second wave of
unrecognized A DHD.
And finally have a high degreeof suspicion among kids with
some of the A DHD superpowerslike the ability to hyperfocus
(17:13):
high amounts of energy, and lotsof creativity.
Thank you so much for takingthis time to listen.
I really appreciate it.
If you have any questions or anyideas or mystery cases of your
own, please feel free to reachout to me at Instagram at
psyched the number four peds, oron our website at psyched the
(17:36):
number four peds.com.
Thanks so much.
See you next time.
Popular Podcasts
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
The Clay Travis and Buck Sexton Show
The Clay Travis and Buck Sexton Show. Clay Travis and Buck Sexton tackle the biggest stories in news, politics and current events with intelligence and humor. From the border crisis, to the madness of cancel culture and far-left missteps, Clay and Buck guide listeners through the latest headlines and hot topics with fun and entertaining conversations and opinions.