Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood.
But what happens if it's missed?
Amy Goodman knows firsthand. A provisional psychologist who works for Challenge Community Services in Tamworth, Ms Goodman was diagnosed with ADHD two years ago at 37.
She said obtaining a diagnosis in a rural area can be a challenge due to lack of services, especially when it comes to diagnosing ADHD in girls and women.
With an increase in the number of adults being diagnosed with ADHD and the subsequent impact on diagnosis and treatment services and support, the Country Women's Association (CWA) of NSW has chosen to highlight the need for urgent changes to the current system during its annual Awareness Week campaign, which runs from September 3 to 9.
Ms Goodman believes what is needed are more psychiatrists, more awareness, and more psycho-education of what ADHD looks like in females.
She hopes to shed a little light on the issue by sharing her experiences with ADHD during an Awareness Week event on Tuesday, September 5, as guest speaker for Tamworth CWA Evening Group.
"We're seeing more information these days on social media and from bloggers talking about ADHD, and this is helping to raise awareness in the community - more people are thinking 'that's me'," she said.
She said Australian comedian and television and radio presenter, Em Rusciano, who was diagnosed with autism in November 2022, just one year after being diagnosed with ADHD, had been open about her diagnosis.
Ms Goodman said this type of discussion was great for raising awareness and encouraging people to the doctor, but then there was the challenge of the screening process to map out if you do or don't have ADHD.
"There are many barriers to obtaining a diagnosis for ADHD, especially for adult women who were as missed children, and the diagnostic criteria was heavily geared towards boys under 12," she said.
Once over 12, Ms Goodman said diagnosis became harder but not impossible, although females presented differently to males.
Ms Goodman said there were three presentations of ADHD: ADHD inattentive, ADHD hyperactive and ADHD combined which is both.
"If you are inattentive you won't be bouncing off the walls, supper chatty, or disruptive," she said.
"In the case of an inattentive girl, who struggles with focus she's often labelled as day-dreamy but lovely, polite, and compliant - and she's often going to miss being diagnosed.
"When she hits high school, when the workload piles and her executive functioning starts failing her with planning, organising her time table, extra homework, different classrooms, and different teachers, that's when her difficulties will show up but the diagnostic criteria is still focused on symptoms that may be present in children under 12.
"With an older child you need to go back to their school reports, and interview family to assist with the diagnosis, but with girls it's sometimes not evident in their school reports because they did enough to get by, weren't disruptive - they flew under the radar," she said.
It's for that reason, Ms Goodman said a lot of women were now being diagnosed - like herself - as an adult.
Ms Goodman's diagnosis was prompted by her daughter.
"My daughter was diagnosed when she was 6 - she's now 15 and a mini me," Ms Goodman said.
Working through her degree in psychology and completing her thesis were really hard, "one of the worst experiences of my life", Ms Goodman said.
The experience was also an eye opener for her as she started ticking a lot of the ADHD boxes.
Ms Goodman, who is now on regular medication, spoke to her doctor on and off for about three years, and while the doctor agreed she probably did have ADHD, her feelings were that Mrs Goodman had "coped this far".
"Doctors don't like pushing patients onto a controlled medication," Ms Goodman said.
While Ms Goodman doesn't think ADHD is over-diagnosed in Australia, she does think everybody has a "little ADHD" in them.
"Everybody gets distracted sometimes, is tired, finds it really hard to focus or chats a lot, runs late...everyone's a little ADHD," she said.
Tamworth Evening Group vice president Jane Gardiner said the Tamworth CWA Evening Group had sought a guest speaker who could speak to the association's chosen subject.
"To have somebody who has the personal and professional experience Amy brings to our event is wonderful," Mrs Gardiner said.
The Tamworth CWA Evening Group Awareness Week event is open to the public and will be held at Weswal Gallery, from 6pm.
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