Technology And Women With Adhd

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).

ADHD Women 6 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.

ADHD Women 7 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

ADHD Women 8 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

ADHD Women 11 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). Selfreport 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

ADHD Women 13 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