Over the past 30 years there has been prolific research in the area of ADHD, and we know a great deal about this condition. Despite the available research, many parents, teachers and other professionals are uninformed about ADHD and the significant risk factors for those individuals with ADHD when they are not appropriately diagnosed and treated. So, what should parents do if they are worried about their child—whether it is a male or female?
Treatment of ADHD has four prongs and begins with comprehensive and accurate diagnosis. Without an accurate diagnosis, which includes ruling in or out other co-existing conditions, the underlying cause of difficulties will not be addressed and treated. If there are concerns regarding ADHD, an initial consultation and possible testing with a psychologist will help determine if treatment of ADHD is appropriate.
Once ADHD has been diagnosed, treatment should begin with parent and patient education regarding ADHD. Education of the child or adolescent is also important but should be done at a level appropriate to the age and cognitive capabilities of the child. It is my experience that adolescent girls begin to be able to actually take some proactive steps in addressing ADHD when they are in the early years of high school. Prior to that time, females are able to identify that they can be “hyper” and forget to do things they are supposed to do, but they do not take much ownership of ADHD.
The third part of treatment is consideration of medication. Results of the MTA Study (MTA Cooperative Group, 1999), revealed that intensive medication management alone or intensive medication management in combination with intensive behavioral treatment were superior to intensive behavioral treatment alone or routine community intervention in elementary school children. However, the impact of medication diminishes as individuals with ADHD transition to middle school as they do not have the organizational, time management, planning or study skills necessary to be successful in middles and high school
Thus, the fourth prong of treatment—external supports and psychotherapy to address related issues—becomes more important in adolescence. Medication, educational supports and behavioral strategies at home and school can make a significant impact on behavior and academic functioning in school age children. However, by the time individuals reach middle school there will need to increased support at school and psychotherapy becomes more important to address the social, emotional and behavioral aspects of ADHD and other issues which may be impacting the individual.
This is Part II of Dr. Steck’s article Underdiagnosed and Misunderstood: Girls with ADHD. Click here to read Part I.