ADHD Women 1

Skipton T. Mckenzie

EDU 613

Technology and Women with ADHD

Dr. Miller-Nara

May 12, 2008

America has a history of excluding certain groups of people from important

societal functions. Although many exclusionary practices have been addressed and

improved, such practices continue to shape and influence many important aspects

of American life. Technology is pervasive in our society, yet a digital divide exists

for many groups of people. Women are one of these groups. Within this group are

women with ADHD, who could be considered subject to a “double” digital divide.

This became surprisingly clear when researching articles for this paper. Using the
 ADHD Women 2

key terms, “women/ADHD/technology,” on the ProQuest data base,resulted in no

articles. A similar Google search only provided such results as a blog with

information about women and ADHD, or a video of people talking about women with

ADHD. For this paper, I provide a brief history of ADHD and women with ADHD, a

discussion of the digital divide and women, thedefinition of ADHD, the impact of

ADHD in women, and strategies for managing ADHD in women.

Research and information on adults with ADHD is a more recent topic and

much more limited compared to that of children – particularly boys. Crawford

(2003) reports that only in the past six or seven years has any research focused on

adult ADHD (p. 1). He adds, “And the recognition of females [with the disorder] has

lagged even further behind” (p. 1). Nadeau (1998) explains that girls and women

with ADD have traditionally been ignored because it was considered a male

problem, affecting only a few girls and women (p. 1). Information from the National

Resource Center on AD/HD (WWK19, p.1) indicates that girls with ADHD are often

overlooked, few studies have been conducted on women with ADHD, women are

only recently being diagnosed and treated for ADHD, and much of what we know is

based on clinical experience. Very little research has been published about social

skills in adults with ADHD (WWK15, p. 1). Dlugokinski (2008, p. 2) recognizes the

encouraging efforts of Kathleen Nadeau, PhD, and Patricia Quinn, MD, who founded

the National Center for Gender Issues and ADHD (NCGI), which researches ADHD in

females.

The Mayo Clinic estimates that 7.5% of school-aged children have ADHD

(Matlen, p. 1). Matlen goes on to explain that most of these children grow up to be

adults with ADHD, which means there are 4.5 to 5.5 million women in the United

States with ADHD. Boys are more frequently diagnosed than girls by a ratio of 3:1
 ADHD Women 3

(Manos, 2005, p. 1). Megan Dlugokinski (2008), editor of “Attention Disorder Site,”

believes that because girls tend not to be disruptive and hyperactive, but rather shy

and compliant, they are not identified, which results in them not being identified

until they are maybe in their 30’s or 40’s (p. 1). Adelizzi (cited in Crawford), a

researcher and educational therapist, “. . . theorizes that females with ADHD have

been largely neglected by researchers because hyperactivity is usually missing in

girls, who typically have attention deficit disorder (ADD), the inattentive type of

ADHD” (p. 1).

In their book, “TOWARD DIGITIAL EQUITY: BRIDGING THE DIVIDE IN

EDUCATION, “Solomon et al. (2003) take the position that digital inequities are

extensions of inequities in society (p. xvii). Swain and Pearson (2001, p.10, cited in

Solomon) note, “significant difference in the access to and equity of technology

experience based on categories such as income, race, gender, location, or

education” (p. xvii). Irving (1998, cited in Solomon) reports that, “Today 60 percent

of jobs require skills with technology, and people who use computers on the job

earn 43 percent more than other workers” (p. xvii). Solomon adds that, “. . . today

a high school education and basic technology skills are minimum requirements for

entry into the labor market” (p. xvii).

In Chapter Nine of Solomon’s book, Schrum and Geisler cite some important

data regarding girls and women, and technology. The U.S. Department of Education

(cited in AAUW, 2000) found a downward trend in 1984 of women receiving

undergraduate computer science degrees, and “. . . girls represent only 23 percent

of those students enrolled in computer programming classes in high school, and

only six percent of those students enrolled in Business and Artificial Intelligence” (p.

116). Bernstein (2000, cited in Schrum & Geisler) found that the percentage of
 ADHD Women 4

women in IT occupations in the U.S. declined from 40.2 percent in 1986 to 28.9

percent in 1999 (p. 116). He adds that this is despite an upward trend in needs and

opportunities in the technology field. A study from the National Council for

Research on Women (Thom, 2001, cited in Schrum & Geisler) found that although

women had made significant progress in the sciences, previous gains in computer

science and engineering had stopped or reversed (p. 116). Schrum & Geisler

discuss cultures effect on society and note that, “. . . our society perpetuates

attitudes that suggest that girls cannot become scientists, mathematicians, or

engineers, and that computers are for boys” (p. 116). Studies have shown that girls

are more ambivalent about technology and boys are more positive (Schrum &

Geisler, p. 119), and “Girls, unlike boys, are not expected to know about

technological matters; and are often encouraged to be merely consumers and users

of technology (Berber, 1984; Carter & Kirkup, 1990; Cockburn, 1988)” (cited in

Schrum & Geisler, p.119). Koch (1994, p. 14) found that, “. . . feelings of

incompetence and alienation from technology start or are reinforced in school. How

girls and women relate to technology and the value that they bring to it are often

ignored or devalued in education” (cited in Schrum & Geisler, p. 120). Studies have

found that for women to overcome gender stereotypes and boundaries in careers

they need role models, mentors, and supportive families and friends (Schrum &

Geisler, p. 118-119). To “. . . encourage girls and young women in developing

positive attitudes about the use and possibilities for technology in their lives,”

Schrum and Geisler (p. 127) provide the following suggestions for educators:

technology in context, not just for technology’s sake; technology to solve genuine

problems; information technology for communication not just information; and

technology for design not just consumption. Mumtaz (2001) notes that, “Even after
 ADHD Women 5

controlling for family income and for social and cultural capital, it has been shown

that computer use in the home improves test scores in math and reading” (cited in

Schrum & Geisler, p. 128). Several researchers have demonstrated the positive

effects of home computer use on success in school (Schrum & Geisler, p. 128).

Schrum & Geisler (p. 128) provide the following suggestions to help at home in

providing more equitable perspectives and experiences for girls: raise you own

awareness about inequitable patterns of computer use; encourage exploration of

new computer software on their own; involve girls in software purchases; be a

positive role model; ask your daughter for help; look for activities you can do with

your daughter, for example exploring the World Wide Web; and introduce girls and

women in technical careers (Furger, 1998).

“Attention deficit hyperactivity disorder (ADHD), a neurobiologically based

disorder, is characterized by a symptomatic triad of inattention, impulsivity, and

hyperactivity” (American Psychiatric Association, 1994, cited in Jackson & Farrugia,

p. 312). Mark Atkins, PhD, professor of psychology at the University of Illinois in

Chicago, cites research that shows almost 80% of ADHD is attributable to genetic

factors (cited in Zamora, 2006, p. 2). Professionals have long believed that ADHD

went away with maturation and that such a diagnosis was not applicable to adults

(Wender, 1987, Nadeau, 1995, cited in Jackson, p. 312), however, longitudinal

studies have provided concurrent evidence of continued impairment in adulthood

(Barkley, Fischer, Edelbrock, & Smallish, 1990; Biederman et al., 1993; Herrero,

Hechtman, & Weiss, 1994; Mannuzza, Klein, Bessler, Malloy, & LaPadula, 1993, cited

in Jackson, p. 312). ADHD usually begins before age 7 (DuPaul, 2001, p. 1), and is

frequently associated with conduct problems and academic underachievement

(American Psychiatric Association, 1994, cited in DuPaul, p. 1).

Russell Barkley, PhD, professor of psychiatry at the Medical University of

South Carolina, explains that ADHD has an equally great impact on men and

women, and that both will have problems with memory, driving, school, the

workplace, handling substances, regulating feelings, and managing lifestyle factors

such as weight (cited in Zamora, p. 2). Manos explains that because ADHD is

biogenetic, the symptoms are not different; in other words, brain function is the

same in men and women. The difference occurs in the behavioral expression of

brain function, and these can be very different. He points out that ADHD girls, and

subsequently ADHD women, tend to have an external locus of control, which results

in feeling she is a victim of circumstances, that circumstances control her life, and

her own efforts are ineffective. “Women often get diagnosed after they have

brought in a child for treatment” (Watkins, 2004, p. 2). Information from Women

and ADHD #19 (CHADD) indicates that after learning about her child’s ADHD, a

mother recognizes similarities in herself. Some women may seek treatment

because their life is out of control, whereas other women may successfully hide

their ADHD; however, both describe themselves as feeling overwhelmed and

exhausted. In addition to an external locus of control, women with ADHD are more

likely to have depressive symptoms, lower self-esteem, are more stressed and

anxious, and engage in coping strategies that are more emotion-orientated (use

self-protective measures to reduce stress) than task-orientated (take action to solve

problems). Matlen (p. 2) explains that many women are anxious and/or depressed

because they have struggled many years with undiagnosed ADHD. She also notes

that peri-menopause and menopause can increase ADHD symptoms, especially

memory loss and word retrieval problems.

Patricia Quinn (2004, p. 1-2), MD, explains that estrogen exerts profound

effects on mood, mental status, and memory, and that it improves memory and

cognitive functioning. It enhances or maintains verbal memory, but apparently

does not affect spatial memory. Low levels are associated with PMS, postnatal

depression, and post-menopausal depression. It has been Quinn’s experience that

this critical information is often overlooked in treating women with ADHD. For

example, as they enter perimenopause and “flashes” begin, they experience more

problems with their ADHD symptoms or their stimulant medication does not seem to

work. Coping mechanisms that worked previously for her ADHD may not work as

well when she enters menopause. Zamora (2004, p.2) notes the “emotional

rollercoaster” that often accompanies pregnancy and post-partum depression, and

the drastic changes in hormone levels. Add ADHD to this, and a woman can

become overly stressed. Zamora also mentions iron deficiency during menstruation

and other mental disorders. She notes research that has shown a mild iron

deficiency can affect cognitive skills, and in combination with ADHD can also tax a

woman’s coping mechanisms. Depression and anxiety tend to be more prevalent

in women in general, and they are commonly experienced by people with ADHD.

Kathleen Nadeau (1998), PhD, director of Chesapeake ADHD Center of

Maryland, explains that ADD can be mild, moderate, or severe. Some women cope

until they become mothers, and others collapse when the second baby comes. The

home environment can be very unpredictable and involves many different

tasks/responsibilities. Add to this often the responsibilities of a job or career. She

explains that stress is temporary and can be relieved at the end of the day, with life

returning back to normal. However, for a woman with ADHD, there is no such relief

or returning to normal. Nadeau provides some useful information to help determine

if you might have ADHD: have trouble completing projects and jump from one

activity to another; were told by parents and teachers that you should have tried

harder in school; are frequently forgetful – have trouble remembering to do things

you intended; are frequently rushing, over-committed, often late; make impulsive

purchases, impulsive decisions; feel overwhelmed and disorganized in your daily

life; have a disorderly purse, car, closet, household; are easily distracted from the

task you are doing; go off on tangents in conversations – may tend to interrupt; and

have trouble balancing your checkbook, have difficulty with paperwork.

Nadeau (2000, p. 1) indicates that there are two reasons why women with

ADHD are more challenged in the workplace then men with attentional problems:

”1) Women in the workplace are more likely to be the support system for someone

else rather than to have a support system. 2) Women with ADHD, just as for all

women in the workplace, are expected to work a ‘second shift’ at home, as the

primary homemaker and parent.” She provides a long list of strategies for a woman

to cope with ADHD, The following is an abbreviated list: don’t compare yourself to

others – find an activity level that is comfortable for you and your family; focus on

task that are best suited to you; delegate tasks that are most difficult for you; prior

– don’t keep doing things because you always did them that way; simplify; get the

whole family involved and develop a schedule; give yourself guilt-free down time;

try to make your home and work environment ADHD-friendly; and consider finding a

coach, counselor, or support group to create ADHD-friendly solutions.

Information from the National Resource Center on ADHD (Women and ADHD:

WWK19) indicates that, “There are very few clinicians experienced in treating adult

ADHD, and even fewer who are familiar with the unique issues faced by women with

ADHD” (p. 2). It is recommended that a woman take a multimodal approach that
 ADHD Women 9

includes medication, psychotherapy, stress management, and ADHD coaching

and/or professional organization involvement. “Cognitive behavior therapy focuses

on the psychological issues of ADHD (for example, self-esteem, self-acceptance,

self-blame) while the cognitive rehabilitation approach focuses on life management

skills for improving cognitive functions (remembering, reasoning, understanding,

problem-solving, evaluating, and using judgment), learning compensatory

strategies, and restructuring the environment” (p. 2).

Watkins(2204) explains that stimulants are generally the first ones tried (p.

3). Matlen notes that, “The most common medications used are the stimulants

(Ritalin, Adderall, Dexedrine, and Concerta) and a newer non-stimulant medication,

Straterra” (p. 2).

Information from ADDvance (Special Issues for Women with ADHD, 2004)

explains the importance of an ADHD woman educating her partner so they can help

her create ADD-accommodating and ADD-friendly home. This will also help prevent

any resentment and assumptions that she just does not care. An ADD-friendly

environment is one of acceptance and good humor, which will also reduce tensions.

In cooperation with her partner, she could schedule time periods away from the kids

and related responsibilities, and also use babysitters. Summer camps and visits

with grandparents are also options.

Social skills for women with ADHD can be a very problematic area of their life.

WWK15 from the National Resource Center on ADHD reports that 50% to 60% of

children with ADHD have trouble getting along with other children, and that because

adults with ADHD have not learned these skills they are often lonely and isolated.

They may be lacking such social skills as listening, polite behavior, and following

through on responsibilities. Because ADHD is not a disability others can see, the
 ADHD Women 10

ADHD person’s behavior may be interpreted as rudeness, laziness, irresponsible, or

self-centered. Rejection by others can lead to lowered self-esteem and broken

relationships. The following are some abbreviated strategies for improving social

skills: pay close attention to what others say; be alert to what others are doing –

look for clues about proper behavior; think before you speak; clarify what people

say; set goals one at a time; and use prompts, such as index cards, a vibrating

watch set every four minutes to remind you to be quiet, or a gesture from someone

to remind you to work on a certain skill.

This paper has provided a brief history of ADHD and women with ADHD, a

discussion of the digital divide and women, the definition of ADHD, the impact of

ADHD in women, and strategies for managing ADHD in women. Research has

shown that there are disparities between boys and girls expectations and

interaction with technology. Girls and women are not expected to use technology

for meaningful educational learning and to pursue a career in this field. Women

with ADHD face unique challenges related to this disorder. Although the search for

literature related to women with ADHD and their interaction with technology for this

paper is limited, it is glaringly clear that this is an overlooked area.

References
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Crawford, N. (2003, February). ADHD: a women’s issue. Psychologists are fighting

gender bias in

research on attention-deficit hyperactivity disorder. MONITOR ON

PSYCHOLOGY, 34(2), 28.

Retrieved May 9, 2008, from http://www.apa.org/monitor/feb03/adhd.html

Dlugokinski, M. (2008). Women and ADHD. BellaOnline The Voice of Women:

Attention Deficit Disorder

Site. Retrieved May 9, 2008, from

http://www.bellaonline.com/articles/art27253.asp

DuPaul, G.J., Schaughency, E.A., Weyandt, L.L., Tripp, G., et al. (2001, Jul/Aug). Self-

report of ADHD

symptoms in university students: Cross-gender and cross-national

prevalence. Journal of

Learning Disabilities, 34(4), 370. Retrieved May 10, 2008, from ProQuest

Direct database.

Jackson, B., & Farrugia, D. (1997, March/April). Diagnosis and Treatment of Adults

With Attention

Deficit Hyperactivity Disorder. Journal of Counseling and Development, 75(4),

312.

Retrieved April 25, 2008, from ProQuest Direct database.

Manos, M.J. (2005, October 26). Ask the Experts about ADHD. From Medscape

Psychiatry & Mental

Health. Response to question. Retrieved May 9, 2008, from

http://www.medscape.com/viewarticle/515209
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References

Matlen, T. Attention-Deficit Hyperactivity Disorder Current Trends – Specialized

Treatment for Women.

Social Workers Help starts here. Retrieved May 9, 2008, from

http://www.helpstartshere.org

Nadeau, K.G. (1998). Feeling Overwhelmed, Disorganized, Scattered? Is it just

stress, or could you be a

woman struggling with undiagnosed Attention Deficit Disorder? Attention

Deficit Disorder

Association. Retrieved April 26, 2008, from

http://www.add.org/articles/overwhelmed.html

Nadeau, K.G. (2000). Women with ADHD in the Workplace: Juggling the Dual

Responsibilities of Home

and Work. Attention Deficit Disorder Resources. Retrieved April 26, 2008,

from

http://www.addresources.org/article_adhd_women_workplace_nadeau.php

National Resource Center on ADHD. Interacting with Others: Tips for Adults with

ADHD (WWK15).

Retrieved April 26, 2008, from

http://www.help4adhd.org/en/living/relandsoc/WWK15S

National Resource Center on ADHD. Women and ADHD (WWK19). Retrieved May 9,

2008, from

http://www.help4adhd.org/en/livingwomengirls/WWK19
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Quinn, P.O. (2004). Hormones and ADD(ADHD) in women. ADDvance. Retrieved May

9, 2008, from

http://www.addvance.com/help/women/hormones.html

References

Watkins, C.E. (2004). Treating Girls and Women with Attention Deficit Disorder.

Northern County

Psychiatric Associates. Retrieved May 9, 2008, from

http://www.ncpamd.com/Treatment_of_women_and_girls_with_ADHD.htm

Zamora, D. (2006). Suffering in Silence: Women With Adult ADHD. From WebMD.

Retrieved

May 9, 2008, form

http://www.webmd.com/content/Article/95/103354.htm?printing=true