One of the benefactors for the Duke Center for Girls & Women with ADHD and his wife recognized their child faced behavioral struggles from an early age. In preschool, moving between activities triggered disruptive tantrums. And in elementary school, she struggled with friendships and in the classroom.
Eventually, their daughter was diagnosed at age 8 with attention-deficient/hyperactivity disorder (ADHD). But despite their best efforts, her parents couldn’t find help they wanted for their daughter.
“We searched the internet and went to different doctors. It was obvious to me that there was a gap of information to help parents or other directly affected people understand how ADHD affects girls,” he said. “There was very little by way of community awareness, school information or different techniques to help young girls or women.”
That’s when he decided to take action. He donated $1 million in 2021 to launch the Duke Center for Girls & Women with ADHD as part of Duke’s existing ADHD program.
“I wanted to fill this void and close the gap. People who are directly impacted by ADHD need a place to go for information. At Duke, I found people who understood and shared this vision. They demonstrated the passion and drive to create a sustainable center.”
— Donor
“I wanted to fill this void and close the gap. People who are directly impacted by ADHD need a place to go for information,” he reflected. “At Duke, I found people who understood and shared this vision. They demonstrated the passion and drive to create a sustainable center.”
The ADHD Problem with Girls & Women
ADHD is one of the most common neurodevelopmental conditions. But most research has focused on male patients, so healthcare providers understand ADHD in boys and men better than in girls and women. Consequently, boys with ADHD are more readily diagnosed in childhood.
Boys are roughly three times more likely to be diagnosed with ADHD than girls.
In fact, boys are roughly three times more likely to be diagnosed with ADHD than girls, according to Julia Schechter, PhD, an assistant professor in psychiatry and behavioral sciences who co-directs the center with adjunct professor Scott Kollins, PhD.
It typically takes three or four years longer to diagnose female patients with ADHD. A big part of the problem is that ADHD symptoms appear differently in males and females. Boys with ADHD are usually hyperactive and impulsive. Girls, on the other hand, may be more likely to daydream and have difficulty focusing. They can also be disorganized, forgetful, inattentive and make careless mistakes.
Recognizing the condition later creates more obstacles, Schechter said.
“One of the challenges of having these delayed diagnoses is that young girls are much more likely to have picked up other diagnoses before their ADHD is identified,” she said. “They’re more likely to have anxiety and depression that can increase their stress levels and affect their self-esteem.”
Creating a Supportive Resource for Girls & Women
Because diagnosis is more difficult, girls and women are less likely to get the support they need, Schechter noted. Thanks to the donor’s generous support and financial backing, the center is unique. It is the nation’s only center based in an academic medical institution that researches how ADHD affects females while engaging in education and outreach efforts to address the needs of this population. A multidisciplinary team that includes clinical psychologists, a developmental psychologist, public health experts, and an executive functioning coach work together to create valuable resources for patients and their families.
“The ultimate mission and goal of the Duke center is to support the unique needs of girls and women with ADHD—to really allow them to thrive and to support their families and their communities.”
— Julia Schechter, PhD
“The ultimate mission and goal of the Duke center is to support the unique needs of girls and women with ADHD—to really allow them to thrive and to support their families and their communities,” Schechter said. “Our pillars are focused on education, outreach and research. Through these avenues, we are dedicated to connecting patients, their parents or support networks, and community organizations to help these girls and women reach their full potential.”
Center Projects & Initiatives
The bulk of the center’s work is rooted in the need for more information about the impact of ADHD on girls and women. With additional funding from the Patient Centered Outcomes Research Institute (PCORI), Schechter and her colleagues recently surveyed more than 1,300 girls and women with ADHD and members of their communities about the ADHD issues that mattered most to them.
“We analyzed the themes pulled from those discussions, and now we have a really robust research agenda that’s prioritized by girls and women,” she said. “This is research that did not exist before. Not only will it bring the community together, but it will also lead to research that is informed by the needs of the community.”
Based on the survey results, center investigators plan to launch several projects. In one proposal, researchers plan to investigate how the female biological system impacts ADHD symptoms. The center plans to seek funding for additional proposals that will focus on executive functioning strategies that can support girls with ADHD at school, as well as a separate project focused on the impact of menopause on ADHD symptoms.
Another project proposal focuses on how ADHD impacts females as they transition to pregnancy and parenting—an underexplored topic that warrants further examination. Center investigators recently partnered with NC Maternal Mental Health MATTERS at the University of North Carolina at Chapel Hill School of Medicine to develop a toolkit to help providers care for women with ADHD during the perinatal period.
In addition to research, the center has also created multiple resources to support girls and women with ADHD:
- School infographic: School-age girls with ADHD frequently need specific accommodations to succeed in school, such as 504 plans or an individualized education program (IEP). To help parents know which accommodations to request, center faculty and staff members created an infographic that outlines which accommodations best address specific ADHD symptoms.
- Provider infographic: Choosing a provider who can diagnose and treat ADHD can be confusing. This infographic explains what a psychologist, neuropsychologist, and psychiatrist can diagnose and what ADHD treatments they can provide.
- Research Spotlights: On a regular basis, faculty publish “Research Spotlights” on the center’s website and promoted on its social media accounts. This digest makes complex ADHD studies more easily understandable for patients and their families.
Ultimately, Schechter said, the center has had a significant impact on how well patients, families, and the public understand the impact ADHD has on girls and women. But there’s still more work to be done. That’s why continued philanthropic support is vital.
“Philanthropy is critical to our existence and our success. We need philanthropy to keep the doors open,” she said. “We want to grow and continue to be the home of resources that meet the needs of girls and women across their lifespan.”
“Philanthropy is critical to our existence and our success. We need philanthropy to keep the doors open. We want to grow and continue to be the home of resources that meet the needs of girls and women across their lifespan.”
— Julia Schechter, PhD