Girl, Get Your Head Out of the Clouds

“Different Thinkers: ADHD” by Dr. Katia Fredriksen, Ph.D. | Courtesy of Boys Town Press

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders.

However, all kids are different, so ADHD can affect kids differently. We spoke with Dr. Katia Fredriksen, a pediatric neuropsychologist who practices in Silver Spring, Maryland, to learn more about the varying presentations of ADHD and how they can affect boys and girls differently.

According to Fredriksen, the three subtypes of ADHD are inattentive-disorganized, hyperactive-impulsive and daydreamy-inattentive. The most common presentation of ADHD is characterized by impulsive and hyperactive behavior, as well as inattention and distractibility.

Why are boys statistically twice as likely as girls are to be diagnosed with ADHD?
Like many things, a lot of the early research on ADHD was done on boys and men. Different sorts of conditions can vary in presentation based on gender. Boys, in general—not always—are more likely to have overt symptoms consistent with early versions of the diagnosis. Girls are more likely to have a daydreamy presentation. Those things are less noticeable.

With ADHD, many people think of a fidgety, restless boy but aren’t necessarily as aware that a girl is presenting much more quietly and subtly but is experiencing just as much difficulty. They may be a quieter student who is more zoned out during lessons and missing things. In a busy classroom setting, it’ll be harder for teachers to notice.

Dr. Katia Frederiksen, PhD | Provided Photo

Why do girls get diagnosed with ADHD later than boys?

Many girls are able to compensate or get by in elementary school, but as academic demands increase, those girls run into some sort of wall. This results in anxiety for the child.

I work with the pediatric population, but sometimes the parents of the kids I see don’t get diagnosed until their 40s. Even diagnosed at that age, there are treatments that can really help.

Is ADHD over-diagnosed?

That’s a question that comes up for a lot of diagnoses. My understanding is that a couple of things are going on. We’ve become more comfortable talking about these things—
the stigma has decreased. This means families are more likely to get help. With the destigmatization, there’s much more info out there that we can access. People are more
open about their diagnoses and there’s more representation, so we’re better at catching other presentations.

What’s one myth about ADHD that you’re always running into?

One is the idea that because a child can focus on an activity that they enjoy that they don’t have ADHD because they don’t have an attention “deficit.”

The “D” in ADHD throws people off. Dysregulation of attention is what we’re talking about.
I talk to parents about this every time I make a diagnosis of ADHD. They can sit for hours playing games or reading books because those activities are preferred and stimulating but may struggle with boring, challenging or stressful activities.

How can parents of kids with ADHD help their child recognize their strengths?

One way is to find ADHD around you. Consider, does anyone in the family have ADHD? Who are some famous people with ADHD?

Humans have a rather negative bias. We focus harshly on what’s hard for us, not what we do well. By getting to know themselves through other people’s eyes, kids may see many strengths in [themselves] that they were not aware of.

Fredriksen and her colleague, Dr. Yael Rothman, recently wrote a children’s book about the different presentations of ADHD. The book, “Different Thinkers: ADHD,” explores the three subtypes of ADHD through vignettes following three kids with ADHD. The book is available online via and other online book retailers.


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