Common ADHD misconceptions and roadblocks to diagnosis
Elementary school girls with ADHD often go undiagnosed. Reasons for overlooking the diagnosis vary, including unexpected presentations, social expectations, and parental hesitations. Regardless, if you suspect your daughter has ADHD, you should screen her as soon as possible. In this blog, we’ll look at some common ADHD misconceptions and barriers to diagnosis. These issues can stand in the way of girls getting an ADHD diagnosis at age 7 or 8 when it would help them most.
ADHD misconceptions about presentation
ADHD misconceptions about presentation are a common reason why girls don’t get a timely diagnosis. ADHD presentations can include any combination of hyperactive, inattentive, and impulsive symptoms. But fewer girls show physical hyperactivity than boys.
Remember the saying, the squeaky wheel gets the grease? That often applies to ADHD children in the classroom. Hyperactive, impulsive boys are more likely to disrupt the class and get referred for an ADHD evaluation. On the other hand, a quiet, daydreaming girl with ADHD may be completely overlooked. But while she isn’t disrupting the class, if those wandering thoughts are disrupting her learning, it can be a sign of ADHD.
Girls can hide their ADHD challenges
ADHD signs in girls, like daydreaming, can be subtle. Unlike boys, girls are supposed to be demure and polite. Boys will be boys, right? But expectations are different for girls, and that can shape their ADHD presentation. Of course, girls can be hyperactive, overly talkative, or highly impulsive. But it’s usually not as clear-cut as it is with boys.
For instance, girls will often disguise their ADHD symptoms and struggles. This is called masking, and girls are experts at it. Because of masking and trying their best to please, girls with ADHD can hide their challenges for a long time. But that doesn’t mean they aren’t struggling.
“Girls mask their ADHD more than boys… It’s much harder to see. The symptoms might be internal, like in her mind, where she has lots of thoughts going on and difficulty organizing tasks.”
What are subtle ADHD symptoms to look for?
Subtle ADHD signs include executive function difficulties and social struggles. Is your daughter highly sensitive? Is she disorganized, forgetful, or distracted? Does she have a hard time following conversations or starting tasks? Is she socially awkward, or does she have difficulty making friends? That can be ADHD. However, ADHD shows up in different ways, and every child is unique.
A fixed idea of what ADHD looks like
What if you are only familiar with one presentation or example of ADHD? If you are only looking for certain signs, you may overlook your daughter’s possible ADHD. Let’s say you have a quiet, distracted daughter and a son who is diagnosed with ADHD. He’s hyperactive. Your daughter is not. But–and this is a key point–she could also have ADHD. But if you only expect to see the same ADHD symptoms you see in your son, you could miss less overt signs in your daughter. Treat your daughter like the individual she is and consider her symptoms as they relate to her. Try not to compare her with outside perceptions or another child’s symptoms.
Something else to remember is that ADHD has a high inheritability rate of 74%. So, if one child is diagnosed, it’s a good idea to screen the entire family for ADHD.
ADHD and self-esteem concerns
Do you worry about how an ADHD label will make your daughter feel? What if it lowers her self-esteem? The fact is, it could. But if your daughter has ADHD, she already recognizes a difference between herself and her classmates. A diagnosis can help her understand that difference and accept herself.
Of course, girls react differently, but her feelings about ADHD will likely mirror yours. So, be open and honest with her. Encourage her to ask questions and reassure her. Don’t dismiss her challenges, but be sure to celebrate her strengths. As you show your daughter that she is capable and worthy of respect, she’ll develop the self-confidence to be her authentic self.
Fear of judgment
While awareness and acceptance have increased, ADHD misconceptions are still widespread. Are you afraid an ADHD label will make your daughter seem less intelligent or capable to others? Or people will think she’s a bad kid? It’s an understandable fear.
But,
“…if you don’t get them help, they’re going to get labeled in other ways, such as unmotivated or lazy.”
Many people still wrongly believe that ADHD is a behavioral problem. But ADHD results from different wiring in the brain. In other words, the disorder has nothing to do with character flaws or lack of effort. Your daughter is likely trying as hard as she can.
But, while ADHD is lifelong, it doesn’t have to be life-limiting. Once she has a diagnosis, information, and tools, she can develop new skills and behaviors. Of course, unfair judgments can and will happen. But they will happen less as more people become aware of the true biological basis of ADHD.
ADHD misconceptions: origin
You may believe that ADHD is caused by bad parenting. It isn’t though; that’s an absolute myth. But if you have this belief, it can be tough to overcome. Misplaced parental guilt and shame can keep you from seeking a diagnosis and help for your child. ADHD isn’t caused by any parenting style. In fact, there is strong evidence that ADHD is hereditary. So, while your genes may be responsible, your parenting skills are not.
Know that if you’re struggling with feelings of parental guilt, you’re not alone. There are available resources to help you, such as online ADHD parental support groups. Attending therapy can also help prepare you for a child’s potential ADHD diagnosis.
Concerns about cost
Initial ADHD testing costs can range from a few hundred dollars to a few thousand dollars. However, the price depends on several factors, including your insurance, location, and provider. Ask about costs upfront, then decide what will work best for your family.
Although an ADHD evaluation and treatment can be expensive, missing it costs even more. A timely diagnosis reduces lifelong ADHD costs. The fact is, the earlier your daughter gets her diagnosis, the better off she’ll be. She’ll have access to more support and resources. For instance, section 504 of the Rehabilitation Act of 973. This law allows ADHD students in federally funded schools to request special accommodations at no cost. Learn more about 504 accommodations here. If your daughter has support from the beginning, the more likely it is that she’ll do well later on.
Concerns about Her Future
Of course, you’ll worry about her future with ADHD. Questions like—how will she do—will she be okay—will a diagnosis limit her—may keep you up at night. That’s understandable, but if she has ADHD, then she has ADHD. And the sooner she has a diagnosis, the better. Without it, her future success and physical well-being are at risk.
For example, undiagnosed ADHD leads to higher rates of accidents, self-harm, and suicide attempts. Other risks include a higher likelihood of dropping out of school, abusing substances, and becoming a victim of domestic violence. Although these outcomes are scary, they are not inevitable. Your daughter needs information about ADHD and support to help her thrive. Giving her those tools as soon as you can will improve her future outlook.
“Early diagnosis is early intervention.”
Treatment Options
Finally, you may have concerns about ADHD treatments. And there could be several. ADHD is treated with medication, therapy, and behavior modification. ADHD coaching is also available. Usually, the most effective treatment is some combination of these. But medication paves the way.
“Medication, sometimes it’s a starting point. It’s definitely not the endpoint, but many of the other interventions hinge on the medication aspect of the treatment.”
ADHD Misconceptions: Medication
Although not the only medication for ADHD, stimulants are the most commonly prescribed. These can be short or long-acting. And what works for one child may not work for another. Be patient. It can take some time to find the right medicine and dosage.
Are stimulant medications safe?
The FDA advises that stimulant medications are generally safe and effective for kids as young as 6 years old. Although stimulants are a controlled substance, there is no evidence that ADHD medications increase the risk of substance abuse. Talk to your child’s doctor about their recommendations and any concerns you have.
When to Consider an ADHD Diagnosis?
So, how do you know when to be concerned about ADHD in your daughter? Look for patterns. If she forgets her homework occasionally, that’s probably just an oversight that every child makes from time to time. But does she forget a lot? Ask her questions about school. Does she like school? Is she interested in what she’s learning? Watch her. Does she often seem distracted? Or is she anxious for no apparent reason? For example, any child may be uneasy about a divorce or a move. But ADHD girls are often perfectionists, which causes anxiety. So, if there’s no outside stressor, question where her worry comes from. Girls with ADHD may be struggling and still perform well or make good grades. In fact, that’s often the case. So look closely.
Remember: If you suspect something is off, it probably is. Trust your gut. Screen her for ADHD.
Summary: Take action despite ADHD misconceptions and barriers
You’re going to have hesitations and doubts along your family’s ADHD journey. But these challenges are faced by countless other parents with ADHD children every day. Lean on them for guidance. Seek information for any ADHD misconceptions or concerns you have. Facts dispel myths, and you need support as well as your daughter.
Just a simple ADHD screening can help protect your daughter from an invisible threat that gnaws away at her resilience and self-esteem. Because once it’s diagnosed, ADHD is no longer a nameless monster; it’s simply something your daughter has. You’ll know what it is, and you can learn to manage it together. So, if you suspect your daughter has ADHD, confront your concerns and protect her future today.
At a loss for how to explain ADHD to your daughter? Check out our blog on explaining ADHD to your daughter.
Co-Authors
Cynthia Hammer, MSW
Cynthia Hammer, MSW is the Executive Director of the Inattentive ADHD Coalition (www.iadhd.org) and the author of Living with Inattentive ADHD
