A.D.D. is not necessarily milder in girls, but it can be different. Boys with unrecognized and untreated A.D.D., especially if they are impulsive and overactive and also have learning difficulties and family problems, tend to show antisocial behavior and are at risk for later substance abuse. Girls with untreated A.D.D. tend to show more emotional problems, such as anxiety and depression.
- More boys than girls are diagnosed with A.D.H.D. (A.D.D. with the hyperactive component). Some studies quote ratios as high as 6:1. A good estimate is that boys with A.D.H.D. outnumber girls 3:1. But we believe these figures are misleading. A.D.D. traits are often overlooked in many children who are not hyperactive, especially girls.
- Girls with A.D.D. are more eager to please and less likely to be disruptive, so their difficulties may not be so readily noticed. Their A.D.D. problems show themselves as anxiety and learning or cognitive problems. Boys with a high level of activity may sometimes be incorrectly identified as having A.D.D.
- Hyperactivity tends to lessen in the teen years, so the incidence of A.D.H.D. becomes less. In an Ontario, Canada, population survey, about 9 percent of boys and 3 percent of girls between the ages of six to eleven had A.D.H.D., but these rates dropped to about 3 percent of males and 1.5 percent of females in the teen years. The ratio of males to females characterized as having A.D.D. without hyperactivity, in this study, was more even and stayed at about 1.4 percent for children and teens. The rate of diagnosis evens out in adulthood, when the number of males and females with A.D.D. is similar.
- Girls tend to stick with a task longer than boys. Girls show a greater preference for social interaction, whereas boys are more interested in objects and action, such as playing with blocks and trucks. Boys pay more attention to environmental sounds, such as fire engines and loud noises in the hall; girls are more sensitive to verbal sounds of classmates and teachers.
- Boys are likely to act out in school, becoming either the class discipline problem or the class clown. Girls, on the other hand, are less impulsive and more likely to be “spacey” and daydreamers.
- In general, girls adapt more easily to the traditional classroom setting. They find it easier to sit still and listen to a teacher. Boys are generally more distractible, restless, and unable to selectively filter out competing influences in the classroom.
- In some respects, boys enter school with a disadvantage, since the traditional classroom and mode of teaching is usually more geared toward the female gender and is usually run by female teachers. This may partially explain why children with A.D.D. do better when they get a male teacher (male teachers usually talk less). Still, as one wise mother summed it all up, “I’m not going to let him grow up being rowdy and disruptive just because of his gender.”
- Fathers tend to be more tolerant of their child’s hyperactive behavior. Perhaps this is because the father can see himself more easily in his child. Fathers, especially those who do not spend a lot of time with their child (and when they do it’s all fun and games), tend to overlook the annoying parts of the child’s personality.
- Mothers are more likely to seek treatment and persevere with it. Fathers are more likely to reject drug treatment and discount the value and necessity of other management techniques. In some ways the parents’ different gender perspectives on A.D.D. are helpful and lead to a balance; you do not want to make the child a behavioral and educational project, but you do want to get him the help he needs.
A.D.D. management is a family enterprise, and it succeeds best when mother, father, and child all work together as a team.