Category: School & Learning

We know that ADHD affects both the person who has it and their family. Over six million children and adolescents in the United States have been diagnosed with ADHD. While most ADHD profiles are not gender-specific, there are a few key differences between ADHD in girls and ADHD in boys when it comes to diagnosis and developing routines or treatment.

What is unique about ADHD in boys?

As you wash the dishes, you look out the back window and smile at your kids playing in the dirt. Your young son, Damon, is singing and running in circles with that contagious, boundless energy that makes you smile. Your daughter is writing with chalk on the patio while the sun sets. Later, the kids come inside screaming. It turns out Damon has been “annoying” his sister. He has been having issues sharing their outdoor toys and even damaged one. Your son has been having small, fiery outbursts at his sister. They don’t last very long and he is otherwise a well-behaved kid. While you explain to both of  them why sharing is important, you notice his eyes look out the window, his foot starts tapping and then he bends down to playing with his shoelace. Because boys are more likely than girls to be hyperactive, ADHD in boys is often displayed earlier and often. The current ratio of boys to girls with ADHD is 3:1, with some studies suggesting 4:1. Noticing that your son is unusually energetic, impetuous or spacey can lead you down the path towards an accurate diagnosis. Hyperactivity, impulsive behavior, and inattention are all attributed to boys with ADHD. These are also common traits in younger children and preschoolers, who naturally experience difficulty paying attention and following directions. If your child is still in early developmental stages, keep an eye on these behaviors and seek out patterns if there is cause for concern.  Regardless of how ADHD manifests itself in your son, there are ways to reduce symptom flare-ups and actively help him succeed. Here are a few tips to help encourage your growth together.

4 Ways to Support Your Neurodiverse Son during Childhood and Adolescence

1. Boot the stereotypes.

“Boys will be boys” though, right? Not so much, actually. Learned behavior and stereotype indicators can lend to biases, conscious or otherwise. Yes, historically, boys are more aggressive. ADHD in boys often shows up as more oppositional than their female counterparts. However, this isn’t the case for every male child or adolescent. All small children start out with open hearts and minds, and some mischief in their eyes. Believing boys are more aggressive or shrugging off any signs of aggressive behavior can both enable negative patterns and drive you further from diagnosing anything behavioral-related. Now is also a good time to address any biases you may have developed on your own over time. Books, peers, and outside sources can really help. But it’s most helpful to make yourself fully aware of the lens through which you are viewing your child. 

2. Meet them where they are at.

Aside from unconscious bias, it can often be difficult to approach a child with ADHD during a fallout or in the midst of chaos. It is important – especially in stressful spaces – that you choose mindfulness. Choosing mindfulness in every situation will improve your communication skills with everyone around you, especially a child who may be struggling. This begins with allowing your child space when they need to calm down. If you are mindful of their emotions at the moment, then they will be more open to responding instead of reacting. The ramifications of ADHD in boys can be excruciating. Even early on, they can be excluded because of increased aggression, or the aforementioned gender bias. They may thrive with attention and want to hold the spotlight a bit more than usual, resolving in aggression from other students and children. However, receiving negative feedback in these instances can be earth-shattering for your son, especially early on in development. Just imagining how this much critical  feedback will probably increase your stress levels. Approaching them with compassion can do wonders for their self-esteem. 

3. Teach effective coping strategies.

Boys with ADHD often struggle with managing their emotions and can misinterpret social situations or miss social cues. Because of this, they are more likely to resort to humor as a way to deflect their issue or cope with discomfort. Peers may find this annoying. And this is just one key example of acting out. As much as – or even more so than – girls, they need to be taught effective coping strategies for managing limited verbal impulse control and emotion dysregulation.  One of the biggest things to keep in mind is that boys tend to experience fewer problems in an activity-oriented social world. In these spaces, common traits for ADHD in boys such as risk-taking and aggression can be viewed in a positive manner. Finding them a group hobby, like improvisational theater, a team sport or another extra-curricular will encourage social interaction and help with symptom management. Mindfulness is also a highly effective coping strategy for people with ADHD. Research has largely supported the fact that meditation for mindfulness can expand the brain’s capacity to hold attention. This is absolutely amazing, and something I think all parents can approach at a reasonable pace for both themselves and their children.  Starting with just one minute a day of stillness or silence in gratitude is a great place to start. If your child requires a little more interaction with their senses, try playing a tranquil piece of music that calms them. Of course, like girls, they also benefit from direct instruction about organizing, planning, prioritizing, flexibility, and time management. 

4. Set goals in line with their ideas.

Building awareness of themselves is key as boys in general mature more slowly than girls. Working together with that awareness can help to empower your ADHD son in navigating his every day. Ask questions that bring focus to how, when, and what more than why. Learning about their likes and dislikes together will help them not only to connect with you but for you to better identify triggers and their ideas of success. Here’s an easy, useful activity for self-discovery. In a quiet moment, explore these questions with your son:

• • What type of learner am I? 
  • What am I good at, and how am I good at it? 
  • Which tasks are most challenging for me?
  • When am I able to focus best?

These questions will help them to start verbalizing their thoughts and examine themselves–building the foundation for the all-important executive functioning skill of self-evaluation. For school-aged children, the following additional questions are often key to identifying study patterns and habits. They can help you set concrete, achievable goals that will not overwhelm your child. (Or you!)

• • What helps me pay attention in class? 
  • What distracts me during homework or other activities? 
  • When am I planning to do X and how can we assess the time needed for that?  

As always, there are many ways to help your son live with more satisfaction and self-confidence. Check out my 5 C’s of ADHD Parenting for more.

Learn more:

• Dads with ADHD: How to use your unique strengths to assist your kids
• The Truth about ADHD in Girls and 5 Ways You Can Help
• Gender, Sexuality and ADHD: Parenting Children and Youth with ADHD Exploring Their Gender and Sexual Identity
• ADHD, Defiance and COVID: What can you do instead of yelling?

Raquel is a bright, creative girl who likes singing, dancing around the house and riding her bike. She is an eighth grade girl with ADHD and mild dyslexia and receives support services at school through her IEP. She can be articulate, warm and funny. Raquel also has also developed a nice group of friends over the past year. Shana can be easily distracted and inflexible about routines. Her room is very disorganized and meals are difficult since she’s particular about her food and doesn’t like to hear other people chew. Bedtime and morning routines often deteriorate into yelling matches if she’s not getting what she wants immediately. In addition, she procrastinates about cleaning her room for months at a time. Life at home with her parents and two older siblings is marked by tension, arguments and disappointment, which nobody likes. For parents of girls with ADHD, can you relate?

Symptoms of ADHD in girls

Although the basic diagnostic criteria for ADHD are the same for all genders, ADHD often looks different for females than it does for males. While you may see signs of physical and verbal impulsivity and hyperactivity in your daughter, you are just as likely to see silliness or spaciness, shyness, daydreaming, perfectionism, anxiety, forgetfulness, emotional dysregulation, trouble making and keeping friends and picking at themselves.

These signs can be overlooked in favor of boys who demonstrate more externalizing symptoms of ADHD and draw more attention from the teacher in class. For every girl who is diagnosed with ADHD, there are three boys with the condition.

How the presentation of ADHD in girls impacts a diagnosis

Girls with ADHD are diagnosed on average up to five years later than boys. Boys are diagnosed more often with hyperactivity/impulsivity, usually exhibiting inappropriate, aggressive or impulsive behaviors. Girls tend to have the inattentive type of ADHD, with more internal traits. This explains why we miss diagnosing ADHD in girls so much of the time. Both boys and girls with ADHD have brains that mature more slowly than neurotypical kids, with a lag of to three years. Higher rates of anxiety and depression often accompany ADHD in girls or may well overshadow or mask it altogether.

Unique challenges for girls with ADHD

While girls with ADHD can pay attention and focus well on things that interest or come easily to them, it’s their difficulties with uninteresting, unpleasant tasks where their ADHD brains struggle. Some deficits may be more obvious than others. Kendra gets to school on time but can’t keep your bedroom organized or meet deadlines for assignment. Zara gets her work done but is distracted so easily that it takes her twice as long as it should.

To make things more difficult, many girls with ADHD or LD will deny their executive functioning challenges and academic issues due to embarrassment or low self-worth. 

Ashamed of their difficulties and overwhelmed by frustration or fear about possible negative outcomes, some girls with ADHD will do anything to avoid disappointing friends and family, including themselves. Their challenges with verbal expression, auditory processing or verbal control make it harder for them socially. Girls are often conditioned to believe that they define themselves through their relationships. So when girls with ADHD misread cues or don’t hear what someone is saying because they are distracted or struggle to express themselves, they have a much harder time relating to their peers with the expected verbal connections.

Many girls will suffer silently rather than appear different from friends. Teachers and parents may miss seeing the ADHD that really exists as girls try to fly under the radar. Addressing this shame is a key feature of any therapeutic work for girls with ADHD. Of course, everybody with ADHD has serious executive functioning challenges, but all neurodivergent people have personal strengths.

Here are some ways that you can support girls with ADHD in your life:

1. Manage your own reactivity:

When you are triggered by your daughter, it’s really difficult to show up as the parent you want to be. Figure out the internal signals that you are being set off and create a plan to calm yourself down.

Take a timed break from each other, go to the bathroom or step outside. Your emotional response will simply activate her even further.

In a calm moment, discuss what’s okay to say and do when she’s upset and what isn’t. Ask her to think of a logical consequence for cursing you out or a way that she can make amends for leaving a sink full of dirty dishes.

2. Set up weekly meetings:

To avoid nagging and arguments, sit down together once or twice a week. Assist them to organize their daily and weekly schedules and set up doable routines. Work with their desire for mastery and independence. Offer girls choices and incorporate their ideas for any programs you create. This will increase their buy-in.

3. Determine their executive functioning age:

Kids develop in uneven ways. They are stronger in some areas than others and this patterned development is especially true for both boys and girls with ADHD. If your daughter is 12, she may act 12 in her self-care (hygiene and ability to take care of the cat). But she may be more like a nine year-old in her organizational, planning and focus skills. Talk with her about her strengths and challenges and pick one skill to improve.

4. Make a study plan:

Figure out together where, when and how homework or hybrid school will occur.

If your daughter gets easily overwhelmed or distracted, help her (or ask the school to) break assignments down into smaller, manageable parts.

Teach her about time: what it feels like and how to work within its limits. This doesn’t come naturally to many kids with ADHD.

5. Offer empathy for their struggles:

Overcoming shame and learning how to advocate for herself are the best things you can teach your daughter to do. Perhaps you’ve had to learn these skills, too. What negative things does she say to herself? How can the two of you reframe these criticisms into something more positive? What tools does she need to talk honestly and non-judgmentally about her executive functioning challenges so she can get the accommodations and support she needs?

Recall times she’s faced her fears or her embarrassment before, and write down these moments of resilience. Hang it up in her room so she can look at the list. It’s too easy to forget the wins!

Read more blog posts:

• Moms with ADHD: Nurturing your power of authenticity
• Recognizing ADHD in Boys and 4 Ways to Help Them Succeed
• Gender, Sexuality and ADHD: Parenting Children and Youth with ADHD Exploring Their Gender and Sexual Identity

Watch on Dr. Saline’s YouTube Channel:

• How Do I Support My Daughter with ADHD? (ADHD Q&A with Dr. Sharon Saline)
• Moms with ADHD: Why YOU Are the Best Mother for Your Child (ADHD Q&A with Dr. Sharon Saline)
• How to Deal with & Educate ADHD Doubters (ADHD Q&A with Dr. Sharon Saline)

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Has your ADHD teen hit a wall with remote learning? Many teens with ADHD in middle and high school are struggling with organization, initiation, time management and a limited capacity for self-evaluation. It’s tough as a parent of a teen to know how much involvement is appropriate and when it’s too much. Independent school work–whether it’s attending remote classes or doing homework–require most, if not all, of kids’ developing executive functioning skills. These skills need to be taught directly, and your teen can’t learn them on their own, despite whatever pushback they show you. Today I’m going to discuss how to strengthen a few of the key executive functioning skills needed for school success.

Collaborate with your ADHD teen about remote learning practices, and make a plan together.

First and foremost, you’ll need to co-create a plan with effective interventions to build these skills with less arguing. The key to creating any programs and having them last is to collaborate with your teen.

1. Set a time for a weekly family meeting.
2. At the meeting, pick ONE skill to address that you both agree on.
3. Then, brainstorm solutions and include at least one of their ideas in your new plan.
4. Prepare to tweak this plan at your weekly chat. As you live with some of these changes, they will likely need to be adjusted.

Finally, remember to validate and acknowledge ANY cooperation and progress towards the goal. When you notice their efforting, kids feel encouraged and will keep trying.

5 tips to help ADHD teens with remote learning challenges:

1. Prepare ADHD teens for the remote learning process

While you’re probably not trained as a teacher, and you may not understand the algebra that your teen is learning, you can still set up the home as a meaningful learning environment. Take some time to understand the online school platform. Make sure your teen does, too. They are agile with the internet, but not perhaps with the intricacies of this site.

Tip: Establish appropriate expectations.

Most teachers are very good at letting their students know what they anticipate from them. You must do the same thing.

If your teen has trouble with completing and submitting their work, set up a routine with the expectation that, at the end of doing homework, you see their finished work and confirm that it’s been uploaded correctly. Provide regular check-ins: ask if they are stuck on something and, if you can’t help them, brainstorm who can.

2. Organization:

Everything needs a place and that includes online materials. When a student attends school in-person, they have materials such as pencils or pens, notebooks, workbooks and textbooks. They store papers and worksheets for classes in folders or files. These materials may be messy or neat, but there’s usually some type of system.

Tip: Manage digital information in a systematic way.

Teens with ADHD need a similar storage system for remote learning: files and folders that are clearly marked and accessible for class materials, separate browsers for school and fun stuff and calendars for what’s due when.

These calendars can be digital or paper or both. A weekly online calendar with color blocks of what’s happening when, a whiteboard that changes weekly or a paper calendar with Post-Its of tasks will provide a map for your teen of what to do. Give extra time for organizing materials and work with what systems make sense to your teen (by color, subject, numerical, etc.)

3.  Initiation:

Many teens with ADHD struggle with initiation and are excellent procrastinators. They simply can’t start with unpleasant or intimidating tasks, either because of the quantity of the task or its content. If something seems too overwhelming and unpleasant, they can’t get started due to three different types of procrastination:

• • Perfectionism (“It’s got to be just so”)
  • Avoidance (“I hate this”)
  • Productive (“I’ll do something I like that I have to do instead of the important thing”).

Tip: Help ADHD teens with remote learning assignments by breaking them down and using incentives.

The greatest barrier to initiation is someone’s perception of the task. Most teens with ADHD can see the value of completing tasks, but they may well lack the interest, skill or focus to do it. Make tasks small enough that beginning them is within your teen’s reach. Instead of doing five math problems, start with one.

If your teen doesn’t understand the remote learning material, arrange regular help sessions with the teacher.

To promote follow through, set up timed work periods based on how long your teen can focus before distraction impacts their productivity. For example, maybe they work for 15 minutes, take a planned 5 minute break and work for another study period with another short break, and a final push before a bigger incentive/reward for their efforts. 

3.  Time management:

It’s very common for people with ADHD to experience time-blindness. They wrestle with how to feel and understand time. This challenge makes it harder for kids to estimate how long something will take and what they can do in a certain amount of time. This misunderstanding of time affects their capacity for organization and motivation. Luckily, time responds very well to direct instruction. 

Tip: Make time physical, and use external alerts.

Use analogue clocks or timers to show kids how time moves. Instead of guessing about time, collect information by putting on your scientist’s cap. Post a simple chart of a few dreaded tasks, a guess about how long they will take and then a measurement of the amount of time it actually took. For three days, ask your teen (or work with them) to keep track of these, Then review your findings and adjust your weekly/daily calendar accordingly.

4. Self-evaluation:

Self-evaluation, also known as metacognitive awareness, is the last executive functioning skill to coalesce. Often, this happens in the mid-to-late twenties for people with ADHD. The term self-evaluation refers to the abilities for self-understanding, judgment and decision-making. It’s critical to develop this capacity for self-reflection as children mature. Teens who are naturally more self-focused are primed for this process. Better self-awareness fosters the academic and social competence they’ll need for adulthood. When kids understand what kinds of learners they are, they are more likely to feel more confident in their abilities and solve problems more effectively. This is important for adapting to new situations, such as teens with ADHD adjusting to remote learning.

Tip: Ask open-ended questions to guide self-reflection.

Instead of telling your teen what they’re not aware of, or how they could do something differently, ask them questions such as:

• • • “What’s helped you before that you could apply to this situation?”
    • “What are some other choices you could make in the future in a similar experience?”
    • “When facing something that you dislike, what’s one strategy that works to get you started?”

Share some of your observations if they are stuck.

Read more blog posts:

• At-Home Learning with ADHD: Creating an ADHD-friendly learning environment
• Feeling overwhelmed by something? Break it down!
• Return to School with ADHD: Tips on Helping Anxious Kids Transition Smoothly

Watch on Dr. Saline’s YouTube Channel:

• How to Help Your Children Transition Back to School Smoothly (WWLP 22 News Mass Appeal interviews Dr. Saline)
• ADHD Students: Tips for Transitioning Back to In-person Learning (ADDitude ADHD Parenting Q&A with Dr. Saline)
• Help Your Kid Overcome School Anxiety (Operation Parent Webinar with Dr. Saline)

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