ADHD diagnosis and gender-bias

From me to you...online learning has allowed me to spend so much time thinking and writing about contemporary issues in mental health...loving it.

ADHD can appear as early as infancy (Seligman and Rider, 2012) and appears to have neurological foundations resulting in impaired frontal lobes (Seligman et al., 2012). There is some concern that over diagnosing may be occurring; for every two boys diagnosed, one girl is diagnosed (Seligment et al, 2012)—some have wondered what causes the disproportionate number of male diagnoses.

Harrison (2010) suggests that female adolescents with ADHD are an increased risk of “antisocial, addictive, mood, anxiety, and eating disorders” (Harrison, 2010). Harrison’s analysis is particularly relevant because as she points out, the majority of existing research consists of male dominated control groups (Harrison, 2010).  “Despite a possible difference in ADHD symptoms exhibited by boys and girls, our study clearly shows that exactly the same symptom picture is evaluated differently in boys than in girls.” (Bruchmüller, Margraf, Schneider, 2012, p136)

Gender based studies are important for several reasons, mainly because there are such clear behavioural differences between genders, that these variables must be considered in both diagnosing and treating ADHD. ADHD is considered by some to be on the Autism spectrum; females are diagnosed Aspergers far less frequently than males, and it is often attributed to social conventions (that is, it is acceptable for a female to be shy, smart and eccentric). I wonder if this is the case with ADHD; are females better at hiding symptoms, or coping and developing adaptive behaviours to compensate?  There are three times more males diagnosed with ADHD than female and the diagnostic  process is largely heuristic (Bruchmüller et al., 2012) leaving a bit too much grey area.

References

Bruchmüller, K., Margraf, J., & Schneider, S. (2012). Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis. Journal Of Consulting And Clinical Psychology, 80(1), 128-138. doi:10.1037/a0026582

"I do, You do, We do" Direct Instruction...Educational Gold.

Direct Instruction

Social Skill and Making Memories

A bubble machine does wonders for getting a group of kids to focus on the same stimuli, for an extended period of time, in a small physical area. It hits ALL the bases.

Kids that would otherwise find a quiet space away from others to work or play are suddenly heading straight for the fuzzy red carper and participating in sustained joint-attention with their peers. One child says "pretend they are mosquitoes" an instructor follows along and says "catch a mosquito" and shows the other students how...she then instructs each child by name to catch a mosquito "Billy, catch a mosquito like this!" "Alley, catch a mosquito like this!"

In a new group, some kids just won't respond unless addressed  by name. Whatever it takes, right?! And eventually I will shape it and fade it, but for now...it's baby steps. Especially since it's only day 2.
All of the kids were engaged, and performing the same repetitive pretend skill, together. Some were even exclaiming "GOTCHA" to the bubbles/mosquitoes. Ah, success.

I started singing a song about mosquitoes and immediately a child covered his ears in horror. Eek, I should have known. I didn't realize my vocal skills were that bad, but hey I heard him loud and clear. I put on some phonics related songs instead.

Eventually, the bubbles ran out and everyone was feeling happy and satisfied. next we moved into the gym to use our sensory motor toys; I have to say, toys that are designed for two people (see-saw specifically) is ideal for eliciting social skills in a natural way. You literally have to ask someone to play in order for it to be fun. I love that! After some fun in the gym, we washed our hands and headed to class for a much needed drink, and snack.

Snack was yummy as always. We worked on answering what questions; what are you eating? What is Alley eating? What is Billy eating? What did you have for breakfast? We worked on labeling various items and saying them in a sentence "I have a ________" "I am going to have _________" and of course "Can you open this please?!" After snack it was time for musical-circle.

Props made my beach themed musical-circle a of fun. Giving each child a prop or costume item helped remind us that we were learning about the beach! It also helped us practice waiting, and using those important words (let's be honest, some of our kids are working on the ps and qs, but others are working hard to master simple manding and tacting first). Whatever the important words are, our kids were using them.

Adding maracas to the mix gave it the island feel it was missing. We shook our instruments to the beat and practiced following instructions in a group. This was easier for some of our friends than for others. By the time wheels on the bus came around I was feeling like pushing the envelope a bit. They were echoing back to be beautifully for each song, and I really want to see if they could mimic not only the words but the pace. I started going really fast, and sure enough the group did the same; ok not every single person, but it was definitely a success.

A lot of the time I find that the failure to acquire skills is the result of a tendency to avoid and escape demands; compliance, though the word itself seems almost animalistic (not a word according the blogger), is a really important part of learning. Especially when the goal is speech acquisition; without basic willingness to comply, there is a limit to your child's overall success. Once you have a child that is willing to engage and interact freely with you, without any (or at least not any indulged) escape and avoid behaviours, they become much more willing participants in the exchange. Not to mention it becomes much more comfortable and less stressful.

I agree though, it can be hard to get a child to relinquish control, especially when they have language delays and use behaviours as the primary means of communication.

As always pictures from freedigitalsphotos.net