Epidemiology reports indicate attention-deficit/hyperactivity disorder (ADHD) is a behavioral disorder that is characterized by impulsivity, hyperactivity, and high levels of inattention. The available research showed that ADH affects 3%-5% of the school going kids. The available data indicate the diagnosis and treatment of ADHD are more often in males than in females. The differences in the expression of the disorder among boys and girls are identified as the reason why ADHD may be underdiagnosed or under-identified in girls (Shimko et al. 2019). This research aims at evaluating the differences existing in gender diagnosis and treatment of ADHD in children.
Background information
Research indicates that most kids show signs of ADHD before the age of 7 years. However, lack of sufficient knowledge about the disease it might remain undiagnosed until someone becomes an adult. Significant differences exist in how ADHD signs and symptoms manifest in girls and boys. The variation affects the recognition and diagnosis of the disorder. At a young age, the girls show fewer impulsive and aggressive symptoms and also have lower rates of diseases associated with behaviors compared to the boys, which leads to late diagnosis of the disease. Inattention in girls is linked to daydreaming, while boys show more behavioral and hyperactivity problems in their childhood (ATTENTION-DEFICIT, 2011).
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Early diagnosis and treatment of ADHD are essential, considering that prognosis leads to impairments in different areas such as academics and relations with the other kids (Hosogane et al., 2018). Kids with ADHD exhibit characters such as emotional dysregulation, academic underachievement, and problematic connections with peers. These behaviors evolve with age. By the time the kids are reaching adolescence, and early adulthood behaviors such as drug use, first pregnancies, and problems with the authorities start to show when the disorders are not controlled early. The hormonal make-up of the girls and the existence of disorders such as dysphoria, chronic sleep deprivation, and compulsive overeating affects their moods, which affect the diagnosis of the disorder.
Diagnosis in Children
The complexity of ADHD among the children resulted in to change in the diagnostic age of the disorder was increased from 7 years to 12 years. This was based on the changes done on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The changes done on the age of symptoms onset has led to an increase in prevalence estimates. For the diagnosis of ADHD 18 classic symptoms, which half relate to hyperactivity-impulsivity and the other half pertain to inattention (Leahy, 2018).
Externalized signs such as impulsivity and running are shown by boys with ADHD. School going girls show internalized symptoms, which are characterized by signs such as low self-esteem and inattentiveness (Rosen, & Factor, 2015). While boys tend to be more physically aggressive, the aggressiveness in girls tends to be more verbal. Girls, in most cases, will pose a fewer behavioral problem, which is a major challenge for the physicians because the symptoms are less noticeable, and they might be overlooked. As a result, girls may remain undiagnosed as a physician do not refer them for evaluation or treatment. It can lead to a late diagnosis, which can be problematic to manage.
ADHD In Girls
Research indicates that girls display the inattentive symptoms of ADHD. Hyperactive characteristics are essays to identify for parents at home, teachers in schools, and doctors in health facilities. However, the inattentive behaviors that are most common among girls are subtle, making it hard to be identified in the early stages. Thus the girls are less disruptive in school and at home, making it hard to identify these conditions among the girls. Since the girls with ADHD may not display the symptoms of a kid suffering from the disorder, it is important for the doctors to look out for certain symptoms such as withdrawal, anxiety, low self-esteem, intellectual impairment, verbal aggressiveness, academic difficulties and inattentiveness (Rosen & Factor, 2015).
Unlike boys who show physical aggressiveness, girls will show the signs of withdrawal and low self-esteem, and when engaged, they will show verbal aggression. The girls will seem to keep to themselves while alone or remain silent when with others. However, when engaged, they become aggressive with a word such as name-calling. The inattentiveness in girls is related to daydreaming, which causes trouble with focusing. Girls appear not to listen to what is said to them which in most cases impairs academic achievements. There is a form of intellectual impairment which is caused by anxiety. The girls show anxiety, which affects their behaviors and impairs the kids’ intellectual growth (ATTENTION-DEFICIT, 2011). When a preschooler or a school going girl shows these signs, the physicians are likely to diagnose the patient with ADHD and recommend immediate treatment measures.
ADHD In Boys
Boys with ADHD mainly demonstrate hyperactive characteristics. Naturally, boys are hyperactive compared to girls. It can be a cause of misdiagnosis for ADHD in boys. The available research on ADHD in children indicates that boys suffering from the disorders are more hyperactive and impulsive than the girls. Therefore, physicians lookout for symptoms such as acting out/ impulsivity, hyperactivity, inattentiveness, aggression, talking excessively.
Doctors are likely to diagnose boys with ADHD when they show signs such as lack of focus. Hyperactivity in boys makes them run and hit other people causing disruptions and causing chaos. Boys also have challenges to sit still for long, and most of the time they are playing. Boys suffering from ADHD seem to talk excessively frequently disrupting activities and conversations of other people. Young boys also show impulsiveness, meaning that they act before reflecting or forethought of consequences of the action.
ADHD Treatment
Different treatment strategies are adopted for children with ADHD. In Japan, kids with ADHD are referred to services because of exhibiting behaviors such as difficulties in obeying commands, aggressiveness, and tantrums.
The treatment process of ADHD is the management process to lower the inattentiveness and hyper activeness of the person. The disease can only be managed and not entirely healed. The management approaches used vary greatly depending on the needs of the patient and the age of the patients and not the gender (Villemonteix et al., 2017). ADHD overarching goal is to eliminate behavioral obstacles, enhance function performance, and improve the symptoms of the disease. Thus the standard ADHD care requires multiple models of approach including pharmacological therapy, psychological intervention, and caregiver education (Leahy, 2018).
For children, the treatment approaches are divided based on the stage of growth. Behavior interventions are used as the first line of intervention for preschoolers. According to Leahy (2018), for school-going children, medications, and pharmacotherapy are used. ADHD medications fall under two main categories non-stimulants and stimulants.
Hosogane et al. (2018) note that the recommended treatment guidelines for children with ADHD include psychosocial treatment, environmental adjustments, and psychopharamacotherapy. Physicians recommend that children under the age of 6 should not use psychostimulant medications, which are the first line of treatment. The reason for not using such treatment recommendations for kids below the age of 6 years is the safety and efficacy investigation paucity associated with kids at this age. Available research indicates that parent behavior training (PBT) treatment approaches are more effective for preschoolers with ADHD. PBT intervention focuses on teaching parents behavioral skills to improve the problematic behaviors in kids with ADHD (Hautmann et al., 2018).
Treatment For Girls With ADHD
When girls are diagnosed with ADHD, doctors are likely to prescribe medication. In cases where medications are not effective, doctors recommend using both medication and psychotherapy. Parents and other caregivers are the keys to managing ADHD in girls.
Psychotherapy is a natural alternative for managing ADHD, and it is used together with medication. Cognitive-behavioral therapy (CBT) an approach that is used to change the thinking patterns of a patient to change negative behaviors. The approach focuses on helping the kids change behaviors that are termed destructive while controlling others, such as impulsiveness. Parents can help in seeking professional help, encouraging the kids to sleep and rest, finding a suitable professional or group for behavioral therapy. Parents and caregivers learn more about nutrition and how it affects ADHD and how proper nutrition and eating habits can be used in managing certain symptoms of ADHD. Parents are supposed to support the girls in engaging in outdoor activities, exercises, or playing in groups (Jiang et al., 2018).
As girls grow into an adolescent stage, there is a need for them to be independent and may need support to regulate personal behaviors. Some of the approaches that the girls can use include understanding and accepting the difference existing from other normal kids, focusing on reducing stress to the minimal and simplifying the schedule as much as possible. Adolescent girls with ADHD need to schedule time out, developing healthy self-care habits and going to bed in regular hours to ensure that they get enough sleep (Canela et al. 2017).
ADHD Treatment In Boys
For boys who are less than six years should begin with behavioral therapy. If the patients are not responsive to behavioral therapy by the age of six years, medications may be considered while the symptoms are severe. Behavioral therapies to be considered for treating boys with ADHD include classroom management, parent training, and peer interventions (Canela et al. 2017). Boys portray physical aggressiveness, which can be managed through improved classroom routines to instill positive behaviors and record the daily behaviors for the boys. Parent training involves educating parents to understand the disorder, child development, and behavioral challenges in boys (Jiang et al., 2018). Peer interventions for boys include time-intensive and skills training to improve social behaviors ( Felt et al., 2014) .
Medications are also used to reduce symptoms of the disorder in boys. Common medications include psychostimulant and dextroamphetamine, antidepressants, and mood stabilizers ( Felt et al. 2014) . Each of the drug group affects a given symptom, such as hyperactivity. Mood stabilizers are used in boys who depict aggressive physical behaviors such as running around in the house or in class.
Conclusion
ADHD symptoms, children, are different in boys and girls. While the boys are physically aggressive, the girls tend verbally aggressive. The differences between boys and girls make it difficult for physicians to identify ADHD symptoms (ATTENTION-DEFICIT, 2011). As a result of the differences in the signs and symptoms, the treatment approaches are different. ADHD treatment is specific to the needs of the patient. For young children below the age of six behavioral therapies are adopted, but when the symptoms tend to be severe after six years, therapies are combined with medication ( Felt et al. 2014) .
References
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