Though modern efforts against discrimination and towards diversity, equity, and inclusion are justly prized as marvels unthinkable in past decades and centuries, we sometimes get caught up in the historical injustice overcome only to be blind to that still experienced despite the immense progress. Sexism in modern society is one such example of the inequity largely disregarded following milestones like voting rights and Roe v. Wade; yet it remains alive and well, especially as it pertains to mental health. Due to gender-based inequality, girls often face greater hurdles than their male counterparts when it comes to mental disability; when this disparity remains unaddressed, it leaves neurodivergent girls behind in school, placing them at a disadvantage for future careers, adulthood, and independence.
Specifically, disparities exist for girls with Attention Deficit Hyperactivity Disorder (ADHD), which, experts say, is increasingly prevalent among students in the United States today (Bernardi). Due to increased availability of diagnosis, research, and proliferating public awareness of the disability, educators and school officials within the U.S. are burdened with the task of ensuring equitable access to education for all students whose needs have yet to be met under traditional circumstances. Yet, visible disparities exist across the female population: girls simply are not receiving the help they need, and thus legislation and implementation has, perhaps unknowingly, fallen short in its efforts to provide equity for all.
As per the New York State regulations for Section 504 accommodation plans, students are required to meet two specific standards. The first stipulates that one has a “physical or mental impairment” which includes learning disabilities, mental conditions, etc. (“Special Education Fact Sheet Section 504 Accommodation Plans”). This easily includes ADHD which is a documented disability and mental condition which by nature impairs a person in a neurotypical environment. Yet where students often face hardship in acquiring a 504, is the second stipulation which requires that the disability “substantially limit one or more major life activities” (“Special Education Fact Sheet Section 504 Accommodation Plans”). Many students with ADHD meet this description, including me. These “major life activities” include “learning,” “focusing,” and “staying on task,” as well as the more obvious physical impairments with which one might be afflicted (“Know Your Rights: Students with ADHD”). The aforementioned activities are common symptoms defining ADHD in the DSM-5 and, regardless, are experienced across the board when it comes to the disability.
Often, issues in these areas are the only motivation in searching for a diagnosis, and yet, determination of whether a child’s education is burdened in such a way is up to the discretion of school psychologists and 504 coordinators; these are individuals who may or may not have a correct understanding of the disability and struggles of the student in question. The solution to ensuring equity for ADHD students is thus immensely simple: a psychologist’s determination should supersede that of any council of school employees, and guarantee that accommodations are afforded as per their professional analysis.
It would seem to be common sense that this would be the case, which begs the question of why it isn’t. As a girl diagnosed at practically 17 and a half, I had fewer resources than those diagnosed at younger ages, and yet, a psychologist discerned my struggle and urged that I receive accommodations in school. Nevertheless, the Section 504 Committee told me I was not in need of accommodations, citing my high grades and class rank as proof. When pressed further, they asserted that mental health was not at all considered, and rather, that I would have to receive failing averages in order to acquire an official 504 plan. Denying accommodations only serves to further the truth that girls are ignored when it comes to ADHD, and feeds a larger problem.
As aforementioned, research and attention to neurodivergence has never been more prolific – nor are fewer girls being diagnosed than any time in history. However, in tandem, psychological knowledge of ADHD has not developed across the board proportionally to these other advances; had it, esteemed medical and education researchers assert that we might better understand gender disparities affecting presentation of the disability (Slobodin and Davidovitch). Many gender-nonspecific conditions appear differently in men than they do in women – ADHD included – and yet, most research into the disability has pertained solely to men, which is why some programs like the Summer Scholars program are encouraging university students to look into the gender gap (Mohr). Boys traditionally display more hyperactivity and visible attention deficiency that can manifest in energetic and disruptive behavior (“How the Gender Gap Leaves Girls and Women Undertreated for ADHD.”). This not only burdens the child in question, but those around him from learning to their fullest potential, and research from Capital University shows this makes ADHD in boys quite easy to study (Mohr). Yet girls often align more so with the discrete attention deficiency and internal hyperactivity range of the ADHD spectrum which produces very different behavior. Little girls may look withdrawn, appear to daydream – and oftentimes, the hyperactivity in their thoughts fails to manifest in physical actions akin to those of boys – hence their symptoms are often discounted as anxiety if noticed at all, cite mental disability advocates, CHADD (“How the Gender Gap Leaves Girls and Women Undertreated for ADHD.”).
Girls, however, tend to internalize their struggle, either due to sexist pressure that girls should be the “good ones” in the class, or simply due to the nature of the condition’s presentation in their brain, and thus face difficulty being noticed even by most renowned professionals. Yet they struggle no less than boys, and this makes one thing very clear: mental disability cannot be determined by behaviorism alone.
Research has, of course, advanced, and diagnoses do not rely solely on behavior, yet the impetus for diagnosis still remains largely rooted in the stereotypical behavior of a hyperactive boy. Thus the methods by which we discern the presence of disability are not as much of an improvement as one would like to think, since they fail to help the average teacher, parent, or guardian to realize there is an issue to be discussed with a professional. Girls are thus far less likely than boys to receive accurate diagnosis for their condition and are on average diagnosed much later in life, if ever (Slobodin and Davidovich). As a result, boys are more likely to receive earlier treatment for stimulant medications and be under the supervision of teachers, parents, and aides, monitoring their needs (“How the Gender Gap Leaves Girls and Women Undertreated for ADHD.”). While boys have a name for their challenges and are provided numerous resources, a little girl grappling with ADHD might never be validated as the boy is; her hardship never realized, her condition never diagnosed. Hence, when she struggles, psychologists note she will likely attribute that to personal failure, and internalize any symptoms so as to appear “normal” (Yoo). This is incredibly dangerous; often leading to perfectionism, depression, OCD, and anxiety, pressuring oneself to conform incurs immense mental turmoil that only proliferates through increasingly challenging school curricula. It is easy to recognize this snowball effect, wherein one mistake – here: the lack of diagnosis – goes on to cause the compounding of issues that could have been avoided.
This is a societal failure. Girls deserve diagnoses and should have equal attention given to their hardships as provided to boys. There is no argument here. It is a mere hurdle psychology and education must work towards so that these issues may be caught early on and be realized by the general public, since teacher and parent worries are the most common catalyst for diagnosis. Yet for those diagnosed, there remain similar hurdles surrounding classroom accommodations. Thus, denial of aid to girls with ADHD only enhances the trend of gender disparity in mental health services.
My campaign for accommodations may seem quite niche, pertaining to female traits in ADHD, exceptional performance in school, and lacking history of recognized struggle in education; however, this situation is more prevalent than many would like to think. In an anonymous forum on LD Online, a mom recounts that her “twelve year old daughter was diagnosed with ADD. She had a 504 last year, and it was the best year she’s ever had” but now, the plan is being revoked (Cohen). The same excuse surfaces that was used to deny me: academic success. With her 504 plan, this middle schooler was performing very well, and therefore deemed unneeding of specialized conditions in school, she was simply told to focus on time management. The mom goes on to recount the more prevalent obstacles she sees her daughter manage following the revocation of official accommodations, citing the four to five hours her daughter spends daily on homework as a mere preteen (Cohen). This is incredibly harmful to let slide, since time needed to complete the ever-increasing difficulty of homework may very easily increase exponentially for the girl in the coming years.
Likewise, my parents witness the utter lack of free time I am awarded due to the plethora of assignments, extracurricular activities, and other endeavors that have brought me to the successful stature the 504 Committee cited to dismiss me. Rachel Smathers, recent graduate of Capital University, did extensive research into differences in childhood male and female diagnoses in ADHD through the university’s Summer Scholars program in 2023, and recounts her own experience with lack of accommodations in grade school. As a young girl without a diagnosis, she recalls, “I struggled and my teachers really didn’t know how to help me” (Mohr). Smathers never received accommodations due to her success and a lack in knowledge of how to help her, and her research portrays a similar trend of early childhood ADHD disparities between boys and girls. Teachers and 504 Committees do not know how to help us – they do not know best.
Those reviewing my case had the most minute knowledge of me and my issues. Since my struggle is largely internalized, they were unable to decipher anything from my grades, report cards, etc., nor did they take any of my psychologist’s recommendations and my personal testimony into account when deciding they knew best how to handle the situation. Their prime excuse was New York State law – which supposedly ties their hands in situations like this – yet as aforementioned, the criteria is quite easily met. My struggle to focus, get started on tasks, and process information quickly are prime examples of why I was in need of a 504 plan. Yet, despite psychological support and diagnosis, behaviorist analysis – from strangers, no less – that strips me from my performance in school, permitted the Committee to disregard all the evidence in my favor.
Upon fervent argumentation and explanation of the very facts already portrayed, my 504 Committee offered informal accommodations. They were adamant that I had no other options, and so I agreed to the same classroom and local testing accommodations I had requested knowing it simply would not be “official.” In this instance one could argue that I still received what I desired when all was said and done, and yet it became wildly apparent that this was not the case. My teachers were contacted as to the extra time and leniency I was to receive but no official plan was placed in my file. School work is something to which I am more easily adaptable since various teachers and twelve years of experience have allowed me to find breaks when I need them, yet standardized testing is entirely different. The psychologist’s analysis of my issues in school dictated a specific struggle with testing on account of my anxiety and inattentive nature, but informal accommodations do not transfer to standardized testing. As a result I was forced to take the SAT – a test which holds much bearing on my future – without needed accommodations, and hence, after three sittings, scored much lower than I would have with extended time.
Regardless of accommodations, my grade point average is first in my class, my SAT score is above average, however, these metrics are ridiculous because they do not determine how well I might be performing were I not handicapped. Whatever success I have achieved has been done through immense effort in spite of my disability. According to Mizrahi and Kroub, lawyers specializing in this field, schools cannot purely cite grades and rank to dismiss accommodations, and yet the gray area remains that allows one to do so (“Who Qualifies for a 504 ii in New York?”). I was unaware of this, and even if I were to appeal the decision, as is my right, I would then have to leap more hurdles and might still face the same decision. In my senior year of high school, I simply wanted a break from the endless stress I have had to put myself through in order to appear thriving in my educational career, and appealing, hiring a lawyer to ensure my rights, should not be something I – or anyone else – should be forced to go through in order to be given equitable treatment. Across the board, national research by foremost education professionals has shown that students in middle school and up are less likely than younger students to receive accommodations, putting girls at a disadvantage since they are more often diagnosed in these later years (DuPaul et al.). Furthermore, one out of three students with ADHD does not have an official IEP or 504 plan to support them in school, while nearly 70% request one (“One in Three Students with ADHD Not Receiving Accommodations.”). Knowing the aforementioned gender disparity in addition to these statistics makes one thing very: clear: schools are failing to provide equitable access to education for girls with ADHD.
A psychologist’s analysis is thorough and encompasses more than Section 504 Committees can comprehend. Not all students with ADHD need accommodations, but clearly, not all who do are receiving adequate aid. A psychological analysis should dictate this, not a body of often lesser-educated, ill-informed individuals. What do we have to lose if more children are supported? The “smart ones” are not given a leg up but an even playing field and everyone is supported to their fullest potential. Girls face an uphill battle in many areas of their lives, but school is supposed to foster their achievement, progression, and learning, and the current method of ensuring this for neurodivergent girls is not working.
Accountability does not rest solely on the shoulders of school officials, yet the decisions school psychologists, counselors, and administrators continue to make will influence the futures of many students to come. They have the opportunity to either bolster support systems, educational outcomes, and future preparedness, or prevent success when it could have been accomplished. 504 Committees might like to be let off more easily as they are but one well-meaning yet flawed entity affecting equity for neurodivergent girls, but I disagree.
Works Cited
Bernardi, Dan. “What’s Driving the Rise in ADHD Diagnosis Among Children and Adults?” Syracuse University, College of Arts and Sciences, 30 September 2024, artsandsciences.syracuse.edu/news-all/news-2024/whats-driving-the-rise-in-adhd-diagnosis-among-children-and-adults/. Accessed 19 December 2024.
Cohen, Matt. “My Daughter Receives Accommodations for ADHD, but Doesn’t Have a Formal 504 Plan. What Can I Do to Make Sure She Gets This Documentation?” My Daughter Receives Accommodations for ADHD, but Doesn’t Have a Formal 504 Plan. What Can I Do to Make Sure She Gets This Documentation? | LD OnLine, ……;…ldonline.org/ld-topics/adhd/questions/my-daughter-receives-accommodations-adhd-;;;;;;;;;.;;;;;;;;;doesnt-have-formal-504-plan-what. Accessed 19 Dec. 2024.
DuPaul, George J et al. “Predictors of Receipt of School Services in a National Sample of Youth
With ADHD.” Journal of attention disorders vol. 23,11 (2019): 1303-1319.
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“How the Gender Gap Leaves Girls and Women Undertreated for ADHD.” CHADD, chadd.org/adhd-news/adhd-news-adults/how-the-gender-gap-leaves-girls-and-women-undertreated-for-adhd/. Accessed 19 December 2024.
Jelinek, Joslyn. “School accommodations for ADHD and 504 plans.” MedicalNewsToday, 4 October 2023, medicalnewstoday.com/aricles/school-accommodations-for-adhd#communication. Accessed 19 December 2024.
“Know Your Rights: Students with ADHD.” US Department of Education, ed.gov/media/document/dcl-know-rights-201607-504pdf. Accessed 20 Dec. 2024.
Mohr, Rebecca. “Unmasking the Gender Gap in ADHD Diagnosis.” Capital University, September 2023, capital.edu/about/capital-stories/unmasking-the-gender-gap-in-adhd-diagnosis/. Accessed 19 December 2024.
“One in Three Students with ADHD Not Receiving Accommodations.” CHADD, 2019, chadd.org/adhd-weekly/one-in-three-students-with-adhd-not-receiving-accommodations/. Accessed 19 December 2024.
Slobodin, Ortal, and Michael Davidovitch. “Gender Differences in Objective and Subjective Measures of ADHD Among Clinic-Referred Children.” Frontiers in human
neuroscience vol. 13 441. 13 Dec. 2019, doi:10.3389/fnhum.2019.00441
“Special Education Fact Sheet Section 504 Accommodation Plans.” New York Lawyers for the Public Interest, nylpi.org/wp-content/uploads/2018/11/Section-504-Accommodation-Plans.pdf. Accessed 19 December 2024.
“Who Qualifies for a 504 Plan in New York?” Mizrahi Kroub LLP, 24 January 2024, mizrahikroub.com/blog/who-qualifies-for-a-504-plan-in-new-york. Accessed 19 December 2024.
Yoo, Cynthia, et al. “Girls with ADHD – Symptoms and Treatment.” freedom psychology, 24 November 2022, freedompsychology.ca/post/girls-with-adhd-symptoms. Accessed 19 December 2024.