General Info

General Info
What is ADHD
Females & ADHD
Getting a Diagnosis
Medication
In Education
In Workplace

What is ADHD

  • ADHD is a chronic neurodevelopmental disorder that affects approximately 5%-9% of children and 3%-5% of adults.
  • ADHD is the most common neurodevelopmental disorder in children
  • ADHD impacts people from all ethnicities and socioeconomic backgrounds
  • ADHD is highly hereditary – comparable to heritability of height 75%
  • There are three types of ADHD
    • Hyperactive
    • Inattentive
    • Combined (most common)

What ADHD Is Not

  • ADHD is not a behaviour disorder
  • ADHD is not an illness or a disease
  • ADHD is not only a childhood disorder
  • ADHD is not due to bad parenting
  • ADHD does not affect your intelligence
  • ADHD is not caused by too much screen time
  • ADHD is not caused by too much sugar

ADHD Symptoms/Impairments

  • Hyperactivity
  • Executive Functions
    1. Attention
    2. Organization/time management
    3. Self-Regulation/Self monitoring
    4. Impulsivity
    5. Working memory
    6. Processing speed
    7. Flexibility/rigid
    8. Emotional Regulation
Additional Resources

What you need to know about ADHD

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Females & ADHD

It is easy to spot the student with a strong hyperactive and impulsive component in the classroom, however spotting the quiet, undemanding, student who spends much of their time daydreaming is more of a challenge. Often, but not always, this is the way that girls with ADHD present in an academic setting. For this reason, girls are frequently not diagnosed until later in adolescence or adulthood. Girls that do end up in a doctor’s office for an assessment are most often those with the hyperactive/impulsive presentation, or those with symptoms on the severe end of the spectrum.

The primarily inattentive presentation of ADHD more frequently found in females, although not exclusively, can often go undiagnosed resulting in later coexisting disorders of anxiety and depression. ADHD can also be misdiagnosed as one of these disorders. Unfortunately, even today many females with ADHD may be treated for depression and anxiety, often unsuccessfully, while their underlying ADHD remains undiagnosed and untreated.

Interestingly, new research has shown that girls with ADHD also have an increased risk for an additional diagnosis of Oppositional Defiant Disorder (ODD) and Conduct Disorder. Girls who have a high level of intelligence are even less likely to be diagnosed at school age, but will most often not reach their academic potential. Females with ADHD may be able to obtain some academic success due to obsessional and perfectionist tendencies, spending long hours on home work and assignments in order to compensate for their ADHD, further increasing their anxiety. Boys’ symptoms of hyperactivity decrease in adolescence, but girls’ symptoms of mood swings, anxiety and depression often increase.


GIRLS

  • Struggle to make and maintain friends
  • Low self-esteem
  • girls with ADHD have higher rates of self-harm, substance abuse, and suicide attempts
  • youth with ADHD are 3x more likely to use, abuse or become dependent on nicotine, and marijuana during adolesence
  • Teens with ADHD are 3 times more likely to be obese and develop type 2 diabetes
  • Females with ADHD are 3.5 times more at risk of developing an eating disorder

WOMEN

  • Adults with ADHD are 20% less likely to be employed and earn an average of 16% less than their counterparts. (Biederman, et al., 2006)
  • Individuals with ADHD are 45% to 47% more likely to be involved in a serious transport accident. (Chang 2014)
  • Adults with ADHD are 10 times more likely to visit physicians and had higher rates of emergency room visits and hospital stays. (Katzmanet al., 2017)
  • 1 in 4 women with ADHD has attempted suicide.
  • Inattentive Sub-type
  • Daydreamers
  • Not willing to take risks and easily discouraged
  • Shy
  • Easily overwhelmed
  • May be under active
  • Self-blaming
  • Anxious and depressed
  • Anxiety around school performance
  • Hyperactivity may be expressed in being over-talkative “Chatty Cathy”
  • Fidgety
  • Bossy
  • Risk taking
  • Unable to keep up with work load
  • Problems with times of transitions
  • Immature
  • Unable to read other’s cues
  • May not have friends
  • Difficulty fitting in

Did you know that research indicates that that up to 75% of girls with ADHD never get diagnosed. This leads to consequences of low self-esteem, substance use challenges, unemployment and higher rates of mental health challenges including depression and anxiety.
  • Boys are three times more likely to be diagnosed with ADHD than girls
  • Girls are diagnosed with ADHD on average five years later than boys — boys at age 7 and girls at age 12.
  • Many girls never get diagnosed.
ADHD and Women Awareness Videos

Getting an ADHD Assessment

The assessment and potential diagnosis of ADHD is not an easy fifteen-minute doctor’s visit. The process should be thorough and take more than one visit. The process is one of evaluating symptoms and defining their inclusion into the typical ADHD symptom profile, while at the same time excluding any other possible reason or medical condition for these symptoms to occur. A thorough assessment by the physician should include a complete medical history and physical (the physical may be done by a family physician prior to the assessment). A screening to rule out any possible physical disorders such as, hyper or hypo thyroid disorder, kidney or liver disorders and epilepsy should also take place. If not recently done, a general hearing and vision test should take place to ensure hearing or vision is not compromised.

A Thorough Assessment Should Include:

  • A comprehensive physical history paying particular attention to disorders that may mimic the symptoms of ADHD – blood tests may be ordered to rule out any thyroid and kidney issues.
  • A personal and family history of mental health disorders paying particular attention to disorders that may mimic the symptoms of ADHD –anxiety disorders, mood disorders, substance abuse issues and personality disorders.
  • A personal and family history of cardiac issues.
  • A review of childhood symptoms – for a diagnosis to occur symptoms must have been present by the age of 12. If possible, a review of old report cards or a discussion with parents can be helpful.
  • Rating scales of symptoms completed by the adult being assessed and a significant other -those with ADHD are not always best at recognizing their own symptoms and areas where they have difficulties in functioning.

Medical professionals that may assess/diagnose (and treat) ADHD:

The most important thing to note is that the medical professional you choose must be knowledgeable about ADHD.

Who can Assess and Diagnose ADHD
Wait time
Is there a Cost
Referral from a family physician or walk in clinic
Who can Assess and Diagnose ADHD
Family Physician (with ADHD training)
Wait time
1-8 weeks
Is there a Cost
No - Covered under provincial health plan (i.e OHIP)
Referral from a family physician or walk in clinic
No
Who can Assess and Diagnose ADHD
Child and adolescent AND Adult  psychiatrist
Wait time
1-12 months
Is there a Cost
No - Covered under provincial health plan (i.e OHIP)
Referral from a family physician or walk in clinic
Yes
Who can Assess and Diagnose ADHD
Developmental Pediatrician
Wait time
2-8 months
Is there a Cost
No - Covered under provincial health plan (i.e OHIP)
Referral from a family physician or walk in clinic
Yes
Who can Assess and Diagnose ADHD
General Pediatrician (with ADHD training)
Wait time
1-6 months
Is there a Cost
No - Covered under provincial health plan (i.e OHIP)
Referral from a family physician or walk in clinic
Yes
Who can Assess and Diagnose ADHD
Psychologist (with ADHD training) – Psychologists cannot prescribe medication
Wait time
2-8 weeks
Is there a Cost
Yes – workplace or private benefits may cover a portion of the cost. Fee is approximately $1,000-$4,000
Referral from a family physician or walk in clinic
No
Wait time
Neurologist (with ADHD training)
Is there a Cost
Referral from a family physician or walk in clinic
Who can Assess and Diagnose ADHD
No - Covered under provincial health plan (i.e OHIP)
No

Questions to ask your healthcare provider:

  • What is the current wait time?
  • Do they provide long term follow-up care?
  • Is a full screening for other potential medical disorders part of the assessment process?
  • Are there additional cost associated with the ADHD assessment

Physicians, Pediatricians, Psychiatrists, Neurologists

The assessment and diagnosis of ADHD by a medical professional is generally covered by your provincial health care plan, however, always ask if any additional fees will be charged.


The potential diagnosis of ADHD should include;

  • A medical history
  • A psychiatric medical history
  • Screening to rule out any possible physical disorders
  • Vision and hearing test

Psychologist

Psychologists may assess and diagnose ADHD, but they cannot prescribe medication. Psychologists are not covered by provincial health care plans, but may be partially covered by private health coverage. Speak to the psychologist prior to contacting your private insurance provider.

Psychoeducational assessments are different from an ADHD assessment.

Children who are struggling academically may seek a psychoeducational assessment to assess whether any coexisting learning disabilities (LDs) may exist along with ADHD. A complete assessment of a child’s learning strengths and needs is essential for a student who continues to be impaired at school. Psycho-educational assessments cost approximately $2,000-$4,000


Important Things to Know About the Health Care Professional that you choose:

  • Their expertise in the area of ADHD
  • Their accreditation and registration (pertinent to a psychologist’s ability to diagnosis)
  • What is the current wait time?
  • Do they provide long term follow-up care?
  • Is a full screening for other potential medical disorders part of the assessment process?

For more information about ADHD assessments please contact our Resource Navigator at info@caddac.ca

Medication Management

In uncomplicated cases of ADHD, medication management is straight forward and typically effective with minimal side effects. ADHD medication has been around for more than fifty years and there are thousands of published research papers on their safety and efficacy.


There are two types of medications used to manage ADHD medication. For more information on medication please speak with a medical professional

  • Stimulant medication.
  • Non-stimulant medication

Please refer to the charts below for information on specific medications

  1. Medications access by province - https://www.caddra.ca/provincial-and-federal-public-formulary-overview/
  2. Medication charts - https://www.caddra.ca/wp-content/uploads/Final-Laminate-Card-2019_9-1.pdf

Free Medication Cards that Cover the Difference between Generic and Brand Name Medications. You may be able to access co-pay assist cards for:

Concerta and Adderall XR  (https://www.innovicares.ca/)
Strattera Rxhelp  (https://www.rxhelp.ca/en/default.aspx)
Vyvanse - (https://vyvansesupport.com/)
Intuniv – inquire with your prescribing physician

ADHD in Education

Education can be challenging for individuals with ADHD. The impairments in Executive Functioning can make it difficult to succeed. Most individuals with ADHD benefit from classroom accommodations regardless of age. For more information on school accommodations refer to the age specific webpages.

Information for Parents

ADHD Students' Right to Education

    • Students with ADHD have an automatic right to attend class for the same amount of time as their typical peers. They are not required to earn these rights!
    • The only time a shortened day would be an option is to allow for a student’s slower integration into a program. This should only be a temporary option. Shortened days are not an option if the sole beneficiary is a school with inadequate staff, resources or if the school lacks a plan to deal with the student’s needs. The school needs to find a way for the student to remain at school for the entire day. It is not a matter of IF the student can attend for the entire day.
    • If educators do not have sufficient knowledge to manage a student’s behavior they are required to contact the board’s behavioural experts. A written behavior plan should be developed after a meeting so the plan can be revisited and assessed. A meeting alone is not sufficient.
    • Suspension for “disability-related” behavior in unacceptable.

    Questions to ask:

    • How will suspension help the child to correct their behavior?
    • Does the student have a good understanding of why they were suspended?
    • Do the parents feel the suspension will favourably impact the child’s behavior in the future?
    • Is the suspension of a student with ADHD “a failure to accommodate” under Human Rights?
    • How are the suspensions impacting the student’s self-esteem?
    • How will the suspension impact the student academically?

For more information on Ontario Human Rights Policy please see document below and/or watch this video

 

Facts on ADHD and Learning

  • Students with ADHD are at higher risk for lower levels of academic achievement, higher rates of disciplinary referrals, grade repetition, placement in special education, and spending more years in special education.
  • Students with ADHD are 2.7 times more likely than those without ADHD to drop out of school before graduation.
  • Students with ADHD score 8 to 10% lower in literacy and numeracy than their classmates without ADHD, even when a learning disability does not exist.
  • Although some incorrectly believe medication will treat all ADHD impairments, research shows that medication treatment alone does not improve many of the skills required to be academically and socially successful.
  • While most classroom interventions focus on decreasing disruptive behaviour and increasing on-task behaviour, these changes do not result in better learning and academic outcomes.

Additional Resources

Types of Classroom Accommodations

For various types of classroom accommodations pleae access this document

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Teaching strategies for Typical ADHD and EF impairments

For tips and strategies for educators/parents on how to teach students with ADHD please access this chart

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Elementary school classroom accommodations

For a list of elementary school accommodations please access this document

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Secondary school classroom accommodations

For a list of highschool accommodations please access this document

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Post-secondary classroom accommodations

For a list of post-secondary accommodations please access this document

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Instructions on using the ABC Charts

For Instructions on how to use the ABC chart please access this document

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Sample Behaviour Tracking Chart

For an example of a behaviour tracking chart, please access this document

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Accessible education for students with disabilities

The Ontario Human Rights Commission Policy

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ADHD and the Workplace

Many adults with ADHD perform their jobs extremely well and find that some of their ADHD traits: high energy, problem solving, creativity, and being able to hyper-focus, are significant benefits in their chosen career. However, for other adults with ADHD at least some of their ADHD symptoms will cause difficulties in the workplace.

If you are experiencing difficulties at work do not immediately assume that your current job is the wrong job for you. While thought needs to be put into selecting a job tailored to your strengths rather than your weaknesses all jobs include boring mundane tasks, some of the time. Adults with ADHD may impulsively decide that a chosen career is not for them and jump to another career without reviewing all options. Sometimes finding a particular niche within a career can allow you to succeed. Being passionate about aspects for your career can often be the key to keeping yourself engaged and working on improving your current job success.

ADHD is a very treatable disorder. A variety or both medication and non-medication treatments for those with adult ADHD now exist. Receiving a proper assessment and using multimodal treatments may be extremely helpful with: increasing focus and attention, decreasing distractibility, impulsivity and hyperactivity, and assisting with emotional regulation and organization. However, there is no magic cure or solution for those experiencing difficulties in the workplace. Taking time to assess your situation, implementing strategies, and asking for accommodations when appropriate may also be a part of becoming successful in your chosen career.

Are you a business owner or HR professional interested in educating your workplace about ADHD?

CADDAC's new ADHD in the Workplace workshop is designed for Managers and HR Professionals working with people with ADHD. By the end of the workshop, participants will have a deeper understanding of ADHD and how it can impact work performance, as well as practical tools and strategies to ensure employees with ADHD are able to thrive in the workplace.

Learn more

Additional Resources

How is ADHD Affecting You at Work?

How your ADHD impacts your job performance depends on many factors

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Workplace Accommodations Chart

For a detailed list of possible workplace accommodations please access this chart

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Tips and strategies for working from home

For helpful tips and strategies to be more productive working from home please access this document

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Choosing the Right Career

How to choose the right career when you have ADHD

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ADHD and Human Rights in Canada

What are you rights when it comes to disclosing your disability to your employer

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