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Is ADD/ADHD more common in boys than in girls?

It is a common belief that ADD/ADHD is far more prevalent in boys than in girls. Research suggests that 5 to 10 percent of school-aged children in the United States will be diagnosed with ADD/ADHD, and boys are three or four times more likely to be diagnosed than girls. However, recent research indicates that ADD/ADHD is under-diagnosed in girls. Boys are more likely to display the hyperactive/impulsive symptoms of ADD/ADHD, whereas girls are more likely to experience only the inattentive symptoms. Hyperactive and impulsive behaviors (e.g., fidgeting, getting out of their seats in school, blurting out answers) typically make the disorder more noticeable at home and in the classroom and lead to a far greater referral rate for boys. However, the inattentive symptoms (e.g., poor attention to details, forgetfulness, distractibility) can be just as detrimental to educational success, self-esteem, and social relationships. Often ADD/ADHD in females goes unrecognized until school work becomes more difficult (4th grade to middle school).

How do I know my son’s high activity level isn't just "normal" behavior?

One of the ways that psychologists determine if a child’s activity level is “normal” is by giving standardized tests. Standardized tests are those that have been given to a group of hundreds of boys and girls of different ages, grades, socioeconomic backgrounds, and ethnicities. Psychologists then use the group’s results to determine what scores most children get on a particular test. The range of scores that has been obtained by a majority of the children in the group is then considered to be the “normal” or “average” range of scores for a particular test. When evaluating your child’s activity level, your psychologist will give you and your son many standardized tests that measure his activity level, attention, and other attributes. The psychologist will then compare his scores to the average range of scores for that test. From this comparison the psychologist can determine if the scores indicate that your child’s activity level is above that of his peers.

I recently read that most children outgrow ADHD. Is that true and if so, is it possible to determine whether my child will simply grow out of his ADHD?

Recent research by Shaw and colleagues (2007) found that maturation of the cortex was delayed in many children with ADHD compared to those without ADHD. Further, the research indicated that approximately half of children with ADHD had “better” outcomes and their brains eventually matured to a level similar to those without ADHD. In the remaining group of children with ADHD who had poorer outcomes, brain differences (specifically, a thinner cortex in regions important to attention control) were maintained over time.

Unfortunately, it is not yet possible to determine whether an individual child will be in the improved group based on an individual brain scan (as the current research looks at accumulated group differences rather than individual differences). It is encouraging that some children demonstrate significant improvement in their attention functioning over time. Since the brain can grow and change based on experience, it seems likely that children who are identified and treated are more likely to experience changes in their brains than children who continue to struggle and experience frustration as a result of their attention problems. Ultimately, it is important to address each child’s needs in the present, with an emphasis on providing opportunities to learn new skills. For some children, classroom accommodations are sufficient in promoting the adoption of compensatory skills, whereas other children benefit from more intensive cognitive/behavioral training and/or treatment with medication. At the ApaCenter, our psychologists are dedicated to helping determine an individual’s strengths and weaknesses and developing appropriate recommendations for home and school to optimize a child’s opportunities and success.