1

Victoria Sabo

Young

English 111

13 December 2020

Take This Pink Ribbon Off My Eyes: The Presentation of ADHD in Girls and Its Widely

Unexplored Nature

Citation:

Babinski, DaraE., et al. "The Effects of Single versus Mixed Gender Treatment
for Adolescent Girls with ADHD." Journal of Clinical Child & Adolescent
Psychology, vol. 42, no. 2, Mar. 2013, pp. 243-50. Psychology and
Behavioral Sciences Collection, doi:10.1080/15374416.2012.756814.

Summary:

In this article, the author details a study done into the differences between single and
mixed gender environments when it comes to addressing and treating ADHD in adolescents. The
study was done on 10 girls and 11 boys, all with ADHD, and followed them and their behavior in
varying recreational activities. These activities included single and mixed gender basketball
games and single and mixed Ultimate Frisbee games. After athletic skill and social bias were
eliminated from the influencing variables, the counselors overseeing the activities and
conducting pre- and post-activity discussions rated the participants on their social skills, in
categories including prosocial peer interactions, assertiveness, self management and compliance,
as well as physical and relational aggression. The study found that adolescent girls benefited
most from single gender environments compared to mixed, showing more assertiveness, self
management, and compliance, though changes in positive peer interaction, physical and
relational aggression were unrelated to setting. On the other hand, adolescent boys showed better
social behavior in mixed gender settings, with better self management and compliance, as well as
lower levels of physical and relational aggression. The findings of this study are consistent with
previous findings that girls do better in single gender classrooms and are more likely to engage in
delinquent behavior in the presence of boys. Single gendered environments could provide many
advantages to the treatment of girls with ADHD, as the higher levels of self management,
prosocial behavior, and assertiveness are beneficial when treating and managing ADHD in
young girls. Better self management helps to combat the poor emotional regulation commonly
found in girls with ADHD and higher levels of assertiveness lowers the risk of negative
outcomes that are also common among those with ADHD. The author then goes on to detail how
 2

the study brought about the conclusion that boys perform better socially in mixed gendered
environments. Overall, this study and article show that gender should be considered when
treating and managing ADHD, and that consideration could bring about advantages for the
treatment groups.

Evaluation:

This article is peer reviewed and published in a respected academic journal, as well as
having a long list of references stated at the end of the article and referred to throughout the
paper. This author works in the Department of Clinical Health and Psychology at the University
of Florida, making her a reputable source on the subject.
Reflection:

This article proves that while gender is rarely taken into account when dealing with
ADHD in adolescents, it could be a valuable asset when treating ADHD in adolescent girls. This
furthers my point and is relevant to my subject.

Citation:

McCabe, Jessica. "This is what its really like to live with ADHD." July 2017.
Ted.com, July 2017, www.ted.com/talks/
jessica_mccabe_this_is_what_it_s_really_like_to_live_with_adhd_jan_2017.
Accessed 13 Dec. 2020. Lecture.

Summary:

In this presentation, McCabe describes her personal experience with living with ADHD.
McCabe starts by talking about her childhood, full of potential that was partially inaccessible
because of her ADHD. She describes how taking her medication for the first time allowed her to
perform better in school, better socially, even publish her first poem. But eventually, her ADHD
symptoms were no longer being fully treated by her medication, and it brought her life crashing
down. She comments on what little resources she could find were targeted at adults around those
with ADHD and parents of ADHD children, not made for the people with ADHD. She goes on
to detail what she did learn from her research, which includes that there are measurable
differences in the brain of someone with ADHD, and that anyone can have ADHD: Girls, adults,
gifted students, of any race and any nationality. McCabe says that what came out of this
research, and what really helped her reach her potential, was simply knowing more about her
own brain. By having the information, she was better able to understand why and how her brain
worked the way it did. It also gave her strategies to better cope with what she dealt with on a
daily basis because of her ADHD. She also learned not to compare herself to those with
 3

neurotypical brains, as she puts it, “If you judge a fish by its ability to climb a tree, it will live its
whole life believing it is stupid,”. She ends the presentation by stating what ADHD really is, its
not just lazy kids and people constantly fidgeting, its a unique set of challenges that anyone can
be handed, and once they recognize those unique challenges, they can find their unique solutions.

Evaluation:

The publisher of this presentation is a well known and extremely reputable source. The
presenter is speaking from her own personal experience, making her the well versed source on
the matter.

Reflection:

This presentation shows the importance of simply knowing about what someone is facing
and the power behind well done and applicable research. Though McCabe was fortunate enough
to receive the correct diagnosis, she was still not well educated on her ADHD until her early
30’s. Research into how ADHD presents itself in girls is important for the girls facing it in real
time, and this talk showcases that, making it relevant to my subject.

Citation:

Quinn, Patricia O. "Treating Adolescent Girls and Women with ADHD:

Gender-Specific Issues." Journal of Clinical Psychology, vol. 61, no. 5,
May 2005, pp. 579-87. Psychology and Behavioral Sciences Collection,
doi:10.1002/jclp.20121.

Summary:

In this article, the author remarks on the gender-sensitive approach that is required when
diagnosing and treating girls and women with ADHD, as it often presents differently and
requires different treatment. Girls and women with ADHD are more likely to have internalized
symptoms, such as forgetfulness, disorganization, and low self esteem, which often get
overlooked, unlike the disruptive behavior more common in boys with ADHD. Girls with
ADHD in their adolescence are more likely to engage in at risk behaviors and more likely to
withdraw socially, as they face the shame of being unable to meet standards, whether they be
gender roles or expectations from teachers/parents. ADHD often goes undiagnosed in girls
because they will exert significant effort to suppress and hide their symptoms, usually at a great
personal cost. Girls with ADHD will likely show no history of academic impairment, as they
spend the time and effort to meet their teachers and parents expectations, though it gets
increasingly harder to maintain as they move into higher education. Inattentive symptoms are
 4

particularly hard to identify and diagnose and often do not appear until the onset of puberty and
the entrance into middle school add extra pressure.
ADHD is an incredibly treatable condition, between therapy, medication, and behavioral
adaptations, though the presentation of ADHD must be taken into account for the treatment.
ADHD, more often than not, occurs alongside other disorders such as anxiety, depression,
obsessive- compulsive disorder, and Tourette’s syndrome. Since girls’ inattentive symptoms of
ADHD go largely unrecognized, they are often sent to a clinician and treated for the secondary
condition, leaving the underlying ADHD untreated. Without treating the ADHD, their condition
rarely improves when attempting to treat the comorbid disorder. Clinicians often misdiagnose
women and girls who have ADHD with a different disorder because the patient does not come in
with the history of poor academic performance and disruptive behavior that they expect, rather
they are socially withdrawn with internalized symptoms, leading them to believe it is along the
lines of depression, anxiety, bipolar, etc.
Adolescent girls with ADHD are more likely to report distress, anxiety, and depressive
episodes in relation to their ADHD symptoms than their male counterparts. Girls with ADHD are
more likely to be overlooked in the classroom and not receive a proper diagnosis as teachers can
more easily recognize a male student acting out and being disruptive than a female student
putting much more effort in than her peers to simply appear normal. Girls are more likely than
boys to be treated for depression before ADHD is even considered by doctors.
Women with ADHD most commonly reported struggling with dysphoria and, when given
a self evaluation as part of a study, showed lower self esteem than the male participants. Women
whose ADHD goes undiagnosed are at a higher risk for life mismanagement, divorce and single
parenthood, as well as diseases connected to chronic stress, such as chronic fatigue syndrome
and fibromyalgia.
If a woman or girl is lucky enough to receive the correct diagnosis, the next step is
treatment, but most that is known about the treatment is formulated around elementary school-
aged boys, meaning most treatment plans do not take into account the differences facing women
with ADHD. The medication used to treat ADHD is affected by the fluctuating hormone levels
that menstruating women face monthly. The few studies done on the subject of hormones
(specifically estrogen and progesterone) affecting ADHD treatment have shown that due to the
fluctuation of these two hormones, menstruating women would required different dosage of
medication throughout the month, as estrogen enhances the effect of the drug while progesterone
dampens the effect.

Evaluation:

This article was written by Dr.Patricia Quinn, who has over 35 years of experience learning,
writing, and working in the field of ADHD, making her a reliable source on the subject matter.
The paper also includes a long list of sources and recommended readings.

Reflection:
 5

This article offers the insight from not only an expert in the field, but some one who struggles
with ADHD herself. It also provides a look into how the internalizing of symptoms affects stress
levels, as well as how fluctuating hormones affects ADHD medication, which is useful to my
subject.

Citation:

Rinsky, JennaR., and StephenP. Hinshaw. "Linkages between Childhood Executive

Functioning and Adolescent Social Functioning and Psychopathology in Girls
with ADHD." Child Neuropsychology, vol. 17, no. 4, July 2011, pp. 368-90.
Psychology and Behavioral Sciences Collection, doi:10.1080/

Summary:

In this article, the author details a study done exploring the possible link between
childhood issues with executive functioning and difficulties functioning in a social environment
in adolescence. The study followed two girls of girls for five years, from middle childhood to
early/ mid adolescence. One group consisted of girls with ADHD, the majority with Combined
subtype and the minority with Inattentive subtype. The comparison group was made up of girls
without ADHD. Participants were evaluated on measures of Executive Functioning, which are
high level cognitive processes essential to complete cognition. The functions tested included
planning, response inhibition and working memory, along with fine motor control as a control
measure. Impairment in executive functioning is common among those with ADHD, though
most commonly seen in the Combined subtype. The study found that regardless of ADHD status,
with or without and throughout both subtypes, childhood Executive Functioning issues predicted
adolescent social functioning. The study also found that poor childhood planning predicted the
presence of internalizing/ externalizing comorbidity, and poor childhood working memory
predicted internalizing disorders. Though there was no statistically significant difference
between ADHD and non ADHD girls, there was a significant difference between the Combined
subtype and Inattentive subtype, with the results favoring the Combined subtype. This study
proved that proper Executive Functioning in childhood is crucial for social interactions into the
future, and that treating ADHD symptoms in children is not enough on its own, Executive
Functioning deficits must be addressed as well. The author then goes on to point out the
discrepancies in studies involving children with ADHD, specifically girls with ADHD. Most
studies are not done in the long term, meaning the results do not take into account the changing
social, emotional, and educational requirements and expectations put on children as they mature.
These studies are also often conducted on male participants only, barely including or completely
excluding females. Girls with ADHD are rarely included in the studies, meaning not much is
known about the differences, and the author calls for future research on the subject.
 6

Evaluation:

This article is written by Rinsky and Henshaw for the Department of Psychology at the
University of California, Berkeley. Additionally it is a peer reviewed paper, both of these factors
making it a reputable and reliable source.

Reflection:

This article offers one of the few studies done in the long term on girls with ADHD, providing an
insight that is hard to find. The author discusses the lack of research in the area, which is
applicable to my subject.

Citation:

Soffer, Stephen L., et al. "Understanding Girls with Attention-deficit/

hyperactivity Disorder (ADHD): Applying Research to Clinical Practice."
International Journal of Behavioral Consultation and Therapy, vol. 4,
no. 1, 2007, pp. 14-29. APA PsycArticles, doi:10.1037/h0100828.

Summary:

In this article, Soffer addresses the discrepancies in research between ADHD presentation in girls
versus the presentation in boys. Though there are few, the authors bring to light studies done on
girls with ADHD, both comparing them with non-ADHD girls and with boys with ADHD. These
studies have all shown that girls are affected by this disorder at a similar rate as boys, though
girls are more likely to exhibit ADHD Predominantly Inattentive type (ADHD/I) and boys more
likely to exhibit ADHD Predominantly Hyperactive/ Impulsive type (ADHD/HI) as well as
ADHD Combined type (ADHD/COM). Girls, both with ADHD/COM and ADHD/I were shown
to have greater difficulties in academic performance and in social interaction, both with family
and with peers, than their non-ADHD comparison girls. They had more trouble making and
keeping friendships than the comparison girls, as girls with ADHD/COM and girls with ADHD/I
show higher levels of relational aggression, which includes gossip and spreading rumors. The
authors then go on to speak on studies done between girls with ADHD and boys with ADHD.
While some earlier studies have shown that boys and girls experience ADHD to a similar extent
with similar symptom profiles, newer studies have been done showing that while they do
experience a similar degree of impairment, boys and girls exhibit different symptoms that fall
within the diagnosis criteria for the disorder. Girls are more likely to be diagnosed with
Inattentive type and show internalizing behaviors, while boys are more likely to have
Hyperactive or Combined type, showing externalizing behaviors, such as aggression and the
 7

inability to sit still. When assessing for ADHD in girls, it is important to take into account how
girls present the disorder differently than boys, and a key to assessing and diagnosing ADHD is
early intervention. The authors emphasize the importance of universal screening, done by
teachers in primary schools, as symptoms are most likely to present themselves in young
children while they are in the classroom. Attention and impulse control problems are signs
teachers can look for when screening their students. Applying gender-specific norms associated
with ADHD can allow teachers to intervene with an at-risk student before the symptoms become
severe.

Evaluation:

All three of the authors have their PhDs and work in the Children’s Hospital of Philadelphia,
making them reputable sources on child psychology. They also cited many sources, both
throughout their writing as well as at the end
Reflection:

This article provides studies disputing the notion that girls do not experience ADHD at the same
rate as boys, as well as showing the difference in presentation between the groups. The studies
given also show the difference between girls with ADHD and their non-ADHD comparison
groups. Both of these points will be useful in my subject, forming a solid basis for further
research.