to that seen in ADHD. Children with language
disorders who have difficulty understanding and/or
expressing themselves can appear inattentive. Their experience may be similar to listening to a foreign language
in which words are picked up only here and there.
Because they do not always understand what a teacher
is saying, such children lose their focus. Consequently,
deciding whether a child with language problems also
has ADHD can sometimes be difficult. Some children
with specific medical problems may also appear to be
inattentive. For example, thyroid problems can cause
attention difficulties. On the one hand, too little thyroid
hormone may cause a child to become inattentive; on
the other, too much thyroid hormone may cause hyperactivity.
Children with seizures may appear inattentive,
but this usually occurs irregularly and only when the
seizures are occurring. Children with sleep problems
may also appear inattentive because they are so tired
during the day. A child with any one of a variety of
emotional difficulties may also appear unable to concentrate
or may become hyperactive. Children with
anxiety or depression sometimes appear preoccupied or
distracted. In addition, unlike adults, depressed children
may become quite agitated or restless, which can be
mistaken for hyperactivity.
As a rule, children with ADHD tend to be distracted
by outside stimuli. In contrast, a child with obsessivecompulsive
disorder or a psychotic illness, for example,
may be distracted by internal events, recurring thoughts,
and excessive worry. However, a casual observer cannot
always tell the difference by the child’s behavior, so it is
difficult to correctly identify the source of the problem
without careful assessment.
Inattentiveness and hyperactivity also can be side effects
of medications. This is particularly common with some
of the medications used for treating asthma, particularly
theophylline and steroids. Antiseizure medicines can
also interfere with attention.
In short, attention problems and hyperactivity are not
automatically signs of ADHD, so you should not assume
your child has ADHD because you see these behaviors.
The child should be assessed by a professional trained to
recognize the origins of behavioral problems so that the
real cause or causes can be determined.
Does gender have an effect on ADHD in children?
Most studies indicate that more boys than girls have
ADHD. The ratio is probably 2–3:1 in school-age children.
One study that researched the frequency of ADHD
in school-aged children in the United States found the
rate in boys was 9% compared to a rate of 3% in girls.
Age seems to have an effect on the gender ratio. The
male:female ratio drops in adolescence toward 1:1. In
fact, some adult studies even suggest that women have
ADHD more often than men. As hyperactivity lessens,
the inattentive form of ADHD more commonly seen
in girls may persist and equalize the ratio.
Bear in mind, however, that these study results are
determined by the detection of ADHD. Gender ratios
may be affected by referral practices. Among children
referred to child psychiatrists or psychologists, the
boy–girl ratio varies from 3:1 to 9:1, whereas in community
surveys of school-age children, it is closer to
2:1. More severely or obviously affected children are
probably referred to a specialist and are usually boys.
It is possible, however, that ADHD goes undetected in
girls more often than it does in boys. In this regard, it
is important to note that boys and girls tend to have
different types of ADHD. Boys more often have the
hyperactive–impulsive type or the combined type,
whereas girls more often have the inattentive type. Some
people suggest that this difference affects the frequency
with which ADHD is picked up. In other words, boys
could receive diagnoses more often because they are
more vocal, their problematic behavior is more obvious,
and they are more troublesome for their teachers and
families. Although girls tend to be affected less often
than are their male peers, some studies suggest that
those with diagnosed ADHD tend to be less bright
and have more academic difficulties than do boys with
ADHD. It is possible that very bright girls simply
compensate better and their ADHD goes undetected.
Read More: Does everyone with attention problems or hyperactivity have ADHD?
