ANALYSIS

Objectives:

1. Discern a diagnosis of attention deficit disorder based on the symptoms presented. (EPA 1, 2)
2. Understand the differences between the subtypes of attention deficit disorder. (EPA 2)
3. Understand the best treatment choices for this condition. (EPA 4)

Considerations:

Emma’s history aligns closely with attention-deficit/hyperactivity disorder (ADHD), predominantly inattentive presentation (ADHD-PI) rather than the hyperactive/impulsive or combined types.

Unlike children with the hyperactive/impulsive or combined presentations, Emma does not exhibit behaviors such as:

• Fidgeting or squirming excessively

• Getting out of her seat frequently

• Running, climbing, or engaging in physically disruptive behavior

• Talking excessively or interrupting conversations

• Being constantly “on the go” or acting as if “driven by a motor”

Instead, her primary challenges are inattention, distractibility, and disorganization, which impact her academic performance and daily functioning.

This predominantly inattentive subtype is often more common in girls than the hyperactive/impulsive subtype, which tends to be diagnosed more frequently in boys. Girls with ADHD-PI are often overlooked because their symptoms are less disruptive, leading to delayed diagnosis and intervention. Emma’s daydreaming, forgetfulness, and difficulty following instructions align with how ADHD-PI commonly presents in young girls.

Given her lack of disruptive behaviors, Emma’s difficulties might not have been as noticeable in structured settings like school until academic demands increased. This explains why her teacher identified the issue at the start of the new school year, when expectations for focus and independent work became more challenging.

Understanding that ADHD-PI presents differently in girls is crucial for early diagnosis and intervention. Emma’s case highlights the importance of tailored support strategies that address her inattention without focusing solely on hyperactivity, ensuring she receives the help she needs to succeed academically and socially.