The results of this study make clear that AD/HD in girls is as serious a condition and has a comparably large negative impact on children's functioning and adjustment as it does in boys. Overall, the correlates of AD/HD in girls were remarkably similar to what is known to be true for boys. Among the few differences found were that girls were less likely to be diagnosed with a co-morbid behavior disorder than boys (i.e. oppositional defiant disorder or conduct disorder) and perhaps more likely to have problems related to substance use. Rates of mood and anxiety disorders, and impairment in academic functioning appeared to be quite comparable.

The lower rates of disruptive behavior problems, along with the preponderance of inattentive symptoms relative to hyperactive/ impulsive symptoms, may partially explain why AD/HD in girls may often not be recognized. Because rates of mood and anxiety disorders were similar to what has been found in boys, the authors speculate that in conjunction with the lower levels of disruptive behavior and hyperactive/impulsive symptoms, this may lead clinicians to diagnose girls with the former types of disorders rather than AD/HD. In fact, in a study recently published in the journal Pediatrics it was reported that pediatricians were significantly more likely to diagnose boys with AD/HD than girls, even when the problems described by parents were quite comparable.

The authors stress that clinicians need to be aware that, despite their lower rates of disruptive disorders, AD/HD in girls is a serious condition associated with impairment in multiple areas of children's functioning. Thus, there is no reason to assume that the treatment of girls with AD/HD should be any less aggressive or comprehensive than that of boys.

Parents need to be aware that their daughter with AD/HD is at significantly increased risk for a variety of other conditions as discussed above. In fact, in this study, almost 50% of girls with AD/HD had at least one other diagnosable disorder. It is thus essential that evaluations of girls for AD/HD take a broad look at their emotional, behavioral, social, and academic functioning so that a comprehensive treatment plan addressing all areas of important difficulty can be developed and implemented. In particular, given the indication of possible increased risk of substance use in girls with AD/HD, this may be an area that is especially important for parents to monitor.

Too often even if AD/HD in females is identified, necessary attention to areas of difficulty apart from core AD/HD symptoms may not be targeted in a child's treatment, or may not be addressed in the most helpful way. This is especially likely to be the case when a primary care physician is the sole treatment provider, as physicians are typically less attentive to a child's overall emotional and behavioral functioning in their evaluations, and may tend to rely on medication treatment alone when other interventions may also be needed.

There are several limitations to this study that the authors acknowledge. First, the girls with AD/HD were referred from both psychiatric and pediatric facilities/practitioners, and the degree to which they are representative of girls with AD/HD in the general community can not be determined with any certainty. Thus, it is quite possible that the girls in this study were more impaired than would be girls with AD/HD from the general population.

In addition, it is clear that research on treatment specifically in girls with AD/HD is sorely needed. Currently, most of the data on both medical and non-medical treatment of AD/HD is also based predominantly on boys.