Edge Foundation Blog

Last August, Edge interviewed Dr. Patricia Quinn regarding her work with girls and ADHD.  Dr. Quinn, an Edge Foundation board member, has published four books about the special ADHD challenges that women and girls face that are different men and boys.  Some of those challenges include:

• Under diagnosis due to symptoms that don’t echo the male standard for ADHD
• Hyperactivity presenting as talkativeness and emotional behavior instead of the classic “propelled by a motor.”
• Greater disorganization, depression and anxiety than boys.

This fall Dr. Quinn will publish a new book, 100 Questions and Answers about ADHD in Women and Girls.  We thought this would be a good time to ask her a few questions of our own.

Edge: Is there anything about the challenges ADHD girls and women face that has emerged for you since our last interview?

Dr. Quinn: I think we have seen more in the way of confirming the development of eating disorders in girls with ADHD.

Edge: What, if anything, is unique about diagnosing ADHD girls with eating disorders than is different from other girls?

Dr. Quinn: Well first, the symptom of impulsivity seems to be a significant factor in the development of eating disorders in girls with ADHD. Poor self-esteem may also play a role, but one does not see the impaired body image seen in girls with eating disorders in general.  Girls with ADHD may binge and develop bulimia, but not because of a desire for thinness, but rather because of mindless or impulsive eating. Women with ADHD often report that they eat to feel better or for stimulation.

Edge: What should parents do when they suspect their daughter with ADHD has an eating disorder?

Dr. Quinn: Parents of these girls should pursue a complete assessment with an eating disorder specialist trained to realize that ADHD may be part of the picture. Girls will need to be treated for their ADHD symptoms (inattention and impulsivity) in order to be able to follow a program to address their disordered eating. Stimulants not only treat the symptoms of ADHD, but, according to some experts, may actually decrease the urge to binge.

Edge: Is there anything else you want people to know about girls and ADHD?

Dr. Quinn: Girls tend to suffer silently for many years, and as a result develop poor self-esteem early on. In addition, many develop anxiety because of their untreated ADHD symptoms. Their symptoms seem to sneak up and ambush them and they worry that this will happen again. So, they get anxious or develop compensatory strategies. They may worry and begin checking to see if they have a test they have forgotten about, or a book they forgot to bring home from school.

They can even develop obsessive compulsive personality disorders where they try to control one aspect of their life to the exclusion of others.  I have seen girls with ADHD become perfectionists to compensate for their symptoms. They spend a great amount of time and energy trying to compensate until it all gets too much for them and they get depressed or just give up.  It is, therefore, important to treat ADHD in girls even if they seem to be doing well academically and holding it all together because they may be doing so at a great cost.

I also want to send the overall message that the disorder does not remit but continues to cause significant problems and functional impairments particularly in girls with the inattentive type ADD.

Edge: What would you say, then to parents who are hoping their daughter will just “outgrow it?”

Dr. Quinn: ADHD is a chronic, life-long disorder. Symptoms may be less impairing as we learn to live with them and develop strategies and a life style to better cope. However, girls who demonstrate the most success are those that have adopted a multi-pronged approach to treating the disorder including, medication, therapy and appropriate treatment goals early on. ADHD coaching, like the Edge Foundation offers, can be an important component in learning compensatory strategies and behaviors.  Girls who as adolescents continue to have significant functional impairments are those who are usually not taking medication even though they have briefly made use of other services in and outside of school. These, however, may not be enough.

Edge: What are some of the most common questions you are asked about women and girls who have ADHD?

DR. Quinn: I am constantly asked why girls and women aren’t diagnosed as early as boys. I think this is because girls are not identified by teachers or others. Often teachers are comparing girls’ behaviors to those of boys rather than the performance of other girls. Mothers may be more likely to compare their daughter’s behavior to that of other girls thus may be more reliable at referring their daughters for an evaluation.  Girls are less disruptive and don’t call attention to themselves, so they don’t get referred. In addition girls and women work hard to compensate for their symptoms and to not let others know the problems that they are having.

Edge: Do women’s hormones have any impact on how medication levels need to be prescribed over time? For instance, does going through puberty or menopause mean medication levels need to be adjusted during those periods?

Dr. Quinn: When hormone levels decrease in menopause many women report that their ADHD symptoms increase and that their medications don’t seem to be as effective as previously.  It is often necessary to increase the dose of medications at this time. In addition, I find that during puberty symptoms often worsen in girls with ADHD. A medication dose that worked previously may no longer be effective during this time.

Edge: You’ve been a long-standing champion for women and girls who have ADHD, do you see the rest of the medical profession catching up in awareness or is there still a lot of ground to cover until females with ADHD receive equal medical treatment?

Dr. Quinn: I think that overall the medical profession is doing a better job at recognizing and treating girls with ADHD.  The problem seems to be with educating teachers and school systems about the disorder in females.

Readers:  Do you have a question about ADHD in girls?  Let us know in the comments and we’ll do our best to get you an answer.

Editor’s Note: As you most likely know, Edge Foundation coaches have all completed Edge’s rigorous training for coaches working with students and young adults with ADHD.  We are very proud that Jodi Sleeper-Triplett, adolescent coaching expert, has been instrumental in developing our coach training and mentoring program.  She’s publishing a new book in June, Empowering Youth with ADHD:  Your Guide to Coaching Adolescents and Young Adults for Coaches, Parents and Professionals, and we chatted with her a bit about what you can expect to find inside.

Edge:  You’ve been instrumental at Edge Foundation in designing our ADHD youth coaching training program.  How did training and mentoring the Edge coaches shape your point of view as an author?

Sleeper-Triplett:  My work with the Edge Foundation gave me a fresh perspective on my work and insight into the questions that coaches, clients and parents have about ADHD, the coaching process, and strategies for success.  Each time I was asked a question during my work with Edge, I took notes and used those queries to formulate the information shared in the book.

Edge:  High school and college is a time that most children draw away from their parents or even outright rebel.  How will parents benefit from reading this book?

Sleeper-Triplett:  Parents will learn how a coach can be a great partner for high school and college-aged children.  Coaching allows parents to step back from the day-to-day routine and nagging and allows the young person to be more independent.

Edge:  Over the years were there common questions you’ve fielded from parents about coaching?

Sleeper-Triplett:  Parents need a deeper understanding the coaching process.  They need better insight into what their role is in the coaching process.  They want to explore how boundaries are established within the coaching relationship.  And they want to understand what makes a coach qualified to work with young people with ADHD.

Edge: And how do you respond to parents who are skeptical that coaching won’t make a difference for their students?

Sleeper-Triplett: It’s important for parents to understand that coaching is different from other services, especially therapy.  Many parents have struggled with their ADHD adolescent over time management, organization, and self-advocacy and social skills.  These are all areas addressed in coaching in a non-judgmental manner, allowing young people to feel more confident and ready to stretch themselves to a new level of success.  Not everyone is cut out to benefit from coaching.  So the book also includes a information about how prescreening is used by coaches to ensure a person is ready for coaching before they sign up and invest in the process.

Edge: Writing a book is a huge undertaking of time and energy.  What inspired you?

Sleeper-Triplett:  My clients and coach trainees are my inspiration.  Watching the positive changes that coaching can have on young people and helping coaches to learn new skills is really motivating to me.  I have been encouraged and supported by coaches, therapists, educators and friends to put my work on the page.  Once I committed to doing it there was no turning back for me.

Note:  Empowering Youth with ADHD:  Your Guide to Coaching Adolescents and Young Adults for Coaches, Parents and Professionals will be available in September, however, preordering is now available at Amazon.com.

Click here for more books on ADHD.

Last week we wrote a post about executive function and ADHD inspired by John Medina’s book Brain Rules: 12 Principles for Surviving and Thriving at Work, Home, and School. Each of Medina’s 12 Principals are based on scientifically-proven facts about how our brain works.

Take a look at the 12 rules and you’ll see that much of what he talks about are familiar Edge Foundation topics. Want to get a great preview of what his book covers? Visit Brainrules.net where Medina has free, on-line tutorials covering the important information from each chapter.

We agree that the principals outlined in the book are important insights into living to your full potential with ADHD.  When looking them over, we noticed a few common themes we’ve shared in the posts we have written over the last couple of years.  Here’s our take on each brain rule and how it plays out for ADHD:

Exercise – Rule #1: Exercise boosts brain power.

Treating ADHD with exercise
Spark: Reduce ADHD symptoms with exercise
ADHD and anxiety:  Non drug treatments everyone can try

Survival – Rule #2: The human brain evolved, too.

Wiring – Rule #3: Every brain is wired differently.

Executive function and ADHD success/
Succeeding despite learning disabilities/

Attention – Rule #4: We don’t pay attention to boring things.

Fidgeting helps ADHD people stay focused

Short-Term Memory – Rule #5: Repeat to remember.

Long-Term Memory – Rule #6: Remember to repeat.

Sleep – Rule #7: Sleep well, think well.

ADHD students need to take their sleep seriously
ADHD and sleep
ADHD, anxiety and the sleep connection

Stress – Rule #8: Stressed brains don’t learn the same way.

Improve your focus with water

Sensory Integration – Rule #9: Stimulate more of the senses.

You can do more to manage ADHD
Fidgeting helps ADHD people stay focused

Vision – Rule #10: Vision trumps all other senses.

Gender – Rule #11: Male and female brains are different.

Girls with ADHD face special challenges

Exploration – Rule #12: We are powerful and natural explorers.

Did you read the book or learn anything here you didn’t know about how the brain works?  Let us know in the comments.

You may have noticed that the Edge Foundation has never taken a position about whether or not to use of medication (ex. Ritalin, Adderall etc.) in treating ADHD symptoms. The reason for this is simple: we believe that whether or not you take medication is a personal decision that each family must make after consulting with a qualified doctor. It is not our place, nor the place of people who aren’t living with your ADHD to have any say in the matter.

Yet, there are plenty of vocal opponents to ADHD medication. You don’t have to look far to hear the criticism that we are overmedicating our children in this society. We say to them, walk a mile in ADHD shoes before you start to criticize. Judith Warner has done just that.

Author discovers over medication is a misconception

When best-selling author Judith Warner landed a book deal, she believed that American children were overmedicated. Surprise – turns out she was wrong! What she discovered instead was that this common misconception couldn’t be farther from the truth. “Not only has Warner never met a parent who lunged for the medicine cabinet to dope up their kids, but some fought the medication route as long as they could, to the detriment of their child,” says Kirkus Reviews, Dec 01, 2009.

Warner’s book, We’ve Got Issues: Children and Parents in the Age of Medication, ended up being a thoughtful exploration of how we can help our children live successful lives using all of the tools we have at our disposal – including medication. We hope Warner’s book will help assuage the shame, fear, guilt and embarrassment felt among many people who have decided to use medications as part of their ADHD treatment plan.

Medication doesn’t cure ADHD

And we also want to underline the importance of understanding that medication is not a cure for ADHD. “Medication should be viewed as a useful tool to help individuals with AD/HD make positive changes in their lives as a part of a multi-modal approach which should include positive behavioral management and supports such as ADHD coaching,” says Edge Foundation Executive Director, Robert Tudisco. Tudisco is much more concerned about the diversion of AD/HD medication to individuals who have not been prescribed to use them by a doctor such as sharing them with friends to help them pull an all-nighter, or failing to safeguard prescribed medication that is stolen on campus and either sold or taken by individuals without medical supervision. He is currently working on an article on the subject to be published in Attention Magazine later this year.

The important thing for parents and students alike to know is the best person who can know whether or not medications are for you, is you (along with your physician’s guidance.) And as for those who are misinformed, operating under popular misconceptions, or trying to sell a product, we encourage you to get the facts from a qualified physician and point them in the direction of Warner’s book.

Do you dread January’s New Year’s resolutions? Does it feel like just one more opportunity to let yourself down? This year try something a little different: think small, make only ONE resolution.

The Kaizen Approach to Self Improvement

Unless you work in a manufacturing business, you probably haven’t heard the term kaizen. Kaizen is a Japanese quality management philosophy that directs continual improvement in all aspects of a business – from the CEO to the assembly line.

In his book, One Small Step Can Change Your Life: The Kaizen Way, Robert Maurer takes the kaizen principal and applies it to everyday life. As the title suggests, Maurer recommends focusing your energy on taking small steps towards your goals instead of rushing and attempting to accomplish them in one big bite.

This might seem counterintuitive for the ADHD brain that can find it boring without going “all in” on a New Year’s resolution. But total immersion is hard to sustain and often leads to failure. We’ve all done it. Resolve to exercise 6 days a week. And we do, for the first week or so. But by the end of January, other parts of our lives have gotten in the way, and our “perfect record” is filled with holes. And by February we are discouraged and it’s easier to “forget” our goal than to keep failing at it.

Small Goals: Big Accomplishments

Maurer, a Kaizen expert, suggests setting small goals for yourself. Even large goals, like a doctoral thesis, can be broken down into a series of tiny steps that you take each and every day. Take piano, for example. Instead of trying to learn a whole piece of music on the first sitting, many musicians break down a new composition into a series of measures or bars. They work on these discrete units of music until they nail them. Only then do they move onto putting them all together. If you practice only one measure a day, you can still quickly learn an entire piece. But try to learn the whole thing in the first sitting and you’ll tire, your focus will lag, and discouragement can quickly follow.

Make Only One New Year’s Resolution

So instead of focusing on the big picture, try setting one or two small, achievable goals for yourself each day. Let yourself enjoy how great it feels to get those steps accomplished every day. How would the New Year look different to you if you just made one New Year’s resolution for yourself?

“I commit to doing one thing every day to achieving my intended purpose.”

There’s been so much attention the past few  days about whether Ritalin is effective for treating ADHD, you may have missed the news that fidgeting can help manage ADHD.  That’s right, fidgeting actually helps kids with ADHD stay alert.  Time Magazine reported last week that a new University of Central Florida study shows that ADHD kids move around in order to help them stay focused.  In fact kids with ADHD may actually learn better when they are fidgeting!

Teachers in Minnesota and Wisconsin have been experimenting with flexible desks that allow children the option to either stand or sit at them.  The New York Times reported that researchers from the University of Minnesota have been studying the impact of these flexible desks on the academic outcomes of children using them.

Finally, a study published in the journal of Applied Cognitive Psychology shows that doodling actually improves your ability to remember details, rather than indicating your mind is wandering.

Here at Edge, we know that fidgeting can be used successfully to help manage ADHD symptoms.  In 2005 our Executive Director, Sarah Wright, co-authored, Fidget to Focus:  Outwit Your Boredom: Sensory Strategies for Living with ADD.  Next month we’ll tell you more about this book that started it all! In the meantime, take a look at these reports – perhaps they’ll give you ideas of things to do at school or work to improve your focus.  An ADHD coach can also help you discover which strategies work best for you.

Did you already know that fidgeting was a way that helped you focus?  Tell us about it.  We’d love hearing from you about how you keep your edge!

The statistics on ADHD teens and driving are scary. How do allow our teens to drive, but make it safer for our kids behind the wheel?

AD/HD & Driving – A Guild for parents of Teens with AD/HD, by J. Marlene Snyder  is the first and only book on ADHD, teens, and driving.  It is a must-read for all families who have or are contemplating having a teen with ADHD as a driver in the household.  (Note:  The book is out of print, but you can still find plenty of new and used copies on Amazon.com and other ADHD book selling sites.)

ADHD teens are neurologically more prone to speeding, and accidents.  And it’s critical that parents set clear expectations for ADHD teens when they get behind the wheel.

Chapter titles include:

When you have finished reading the book you will be armed with strategies to use to encourage safe driving behaviors in your teen — observation tools, topics to that require extra emphasis, work sheets and sample contracts.

An ADHD Coach can help your teen be a safer driver

Teaching your ADHD teen these new skills can be challenging.  We interviewed Marlene Snyder about the role of a coach in helping your ADHD teen be a safe driver.  Watch it here.  Next time we’ll outline some other tools that are on the market that can help you be sure your teen is driving safely – even when you aren’t in the car.

What have you done to keep your ADHD teen driver safe?  Here are a few ideas for your teen driver to consider.  Please leave us a comment and share what’s worked for you.

If you’ve recently received an ADHD diagnosis, you’ve probably spent a lot of time looking at web sites, books and videos to learn more about ADHD.   There is a lot of information, and misinformation, about ADHD on the web.  We’d like to help simplify that step in your journey by providing a list of top recommended books and videos in the field.

You may not be aware that the Edge Foundation board and advisory boad has consisted of some of the leading experts on ADHD (ex Nancy Ratey, Dr. Patricia Quinn and Dr. Ned Hallowell).  So you can trust that the resources we list are accurate and based on sound scientific evidence.

ADHD Coach can help sift through it all

One of the things an ADHD coach can help you with is sifting through all of the resources out there.  A good coach has read most of the books, received substantial training and keeps up with the latest therapeutic and scientific studies.    Sign-up today and a coach will contact you within the next business day to get started with your personal action plan.

ADHD Management by Russell Barkley

If you are interested viewing a long, but comprehensive, video about ADHD Management, check out this one.  Dr. Russell Barkley is one of the leading scientists studying ADHD today.  He is Professor of Psychiatry at Medical University of South Carolina and Suny Upstate Medical University and has written numerous books on the topic.

John Ratey’s book Spark: The Revolutionary New Science of Exercise and the Brain is a book everyone should read – whether you have ADHD or not.  And we mean everyone:  you, your spouse, your parents, your kids, their teachers, your doctors. EVERYONE!

You might have seen this book and put off opening it figuring it would be dry and technical, but it’s not at all. Sarah Wright, Edge Foundation Executive Director, reports “It so compelling and easy to read I could hardly put it down.” The evidence in Spark is incontrovertible: aerobic exercise physically transforms our brains for peak performance.

John Ratey is no newcomer to the ADHD community.  He co-authored (with Edward Hallowell) the best selling, Driven To Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood, and is the spouse of ADHD expert and founding Edge Foundation board member, Nancy Ratey.

The book highlights the best findings of hundreds of papers Ratey read in researching this book – most published in the last decade – giving you insight into the latest understanding of how the brain works.

A sampling of John Ratey’s brain research findings

• Exercise is truly the best defense against everything from mood disorders [depressions] to ADD/ADHD to addiction to menopause to Alzheimer’s.
• Getting your heart and lungs pumping can mean the difference between a calm, focused mind and a harried, inattentive self.
• Aerobic exercise has been shown to be as effective as antidepressants in treating anxiety
• The Brain works much as muscles do-growing with use, withering with inactivity.
• Exercise even sparks new brain cell growth!

How to buy Spark!

Of course you know how to order a book on-line, but did you know if you click on the link embedded in this article below, Edge Foundation will receive a small fee for every book you purchase on Amazon.com during that visit?

Click here to buy Spark and support the Edge Foundation today!

And here are a couple of other great books on ADHD:

Fidget to Focus:  Outwit Your Boredom:  Sensory Strategies for Living with ADD — written by Edge Foundation’s Executive Director, Sarah Wright.

Driven To Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood

We’d love to hear what books you’ve found helpful for discovering how to live with ADHD.  Post them in the comments and we will review more books in future months.

Edge Foundation board member, Nancy Ratey, publishes a new book: The Disorganized Mind: Coaching Your ADHD Brain to Take Control of Your Time, Tasks, and Talents (St Martins Press April ‘08)

“This is a book about possibility,” says Ratey “It’s both a practical guide to taking control of the symptoms with which individuals with ADHD struggle, and an inspirational summons to believe that living a rich and balanced life – a life you love – is possible.”

The book addresses the common issues confronted by the ADHD adult:
“Where did the time go?”
“I’ll do it later, I always work better under pressure anyway.”
“I’ll just check my e-mail one more time before the meeting…”
“I’ll pay the bills tomorrow – that will give me time to find them.”

The strategies for managing time, staying on task, and accomplishing your goals are simple, and they work:

• The Parking Lot – Distracted by someting you need to do later?  Get it out of your mind by writing it down on your ‘parking lot’ note pad, where it will be safely stored for later.

• Beat the Clock – Have a deadline on a report? Take your laptop to the park, pop in the battery, and get going. Watch the power drain as your report gets done. Hit save before the battery runs out!

• Appoint a “Watch Dog”—Saying or doing things you regret? Enlist a trusted friend to watch over you and your actions. Give him permission to be very honest and to confront you if you are about to do something you might be sorry for, like calling an old flame or walking off your job.

Nancy A. Ratey, EdM., MCC is a strategic life coach specializing in coaching professionals with ADHD and an internationally recognized expert on the subject of ADHD coaching. Her work has been featured in The NY Times, Newsday, Wired, and Vogue, and has appeared on ABC, CBS and NPR. Click here for more on the book.