Effectiveness of a Tailored Occupational Therapy Intervention for Women With ADHD

Attention-deficit hyperactivity disorder (ADHD) is believed to be neurologically based and
characterized by enduring attentional problems, motor restlessness, and cognitive and motor
impulsivity that impact one's ability to function optimally in daily life activities. ADHD is
commonly diagnosed in childhood at a prevalence rate of 11% and a male to female ratio of
3:1. The prevalence of adult ADHD varies from 4 to 6% and it is estimated that two-thirds of
adult ADHD disorders are extensions of childhood ADHD. Researchers have suggested that the
male to female prevalence ratio is inaccurate and that females experience ADHD at similar
levels to males but are underdiagnosed. While boys with ADHD are often identified by their
teachers because of motor impulsivity and inattention, girls with ADHD who may experience
attentional problems and impulsivity without significant hyperactivity, may fail to be
identified by teachers as needing evaluation and treatment. Some studies have found that
female children and adolescents who experience the ADHD symptoms of inattention,
disorganization, poor time management, and distractibility are more likely to be misdiagnosed
with depression and anxiety. When depression and anxiety occur in children and adolescents
with undiagnosed ADHD symptoms, they may result from the inability to manage ADHD symptoms as
they impact functional performance in the home, school, and community.

Much of the research exploring ADHD has been devoted to children and adolescents. The
research examining adult ADHD has thus far largely attempted to describe the phenomenon of
adult ADHD. Research investigating intervention effectiveness for adult ADHD has primarily
focused on pharmacological treatment. The small body of research examining
non-pharmacological treatment has found moderate effectiveness for pharmacological
intervention combined with cognitive behavioral therapy and psychoeducation.

Missing from this body of literature is research specifically examining interventions for
women with ADHD, who present symptoms that are both overlapping with and unique from their
male counterparts.

Studies have found that women with ADHD tend to have difficulty maintaining and succeeding in
employment, school, and parenting and spousal roles. The ability to organize and implement
tasks associated with each role, follow daily schedules and routines needed to support
desired roles, prioritize and manage tasks in a timely manner, and regulate internal and
external stressors to maintain consistent emotional responses may be difficult for with women
with ADHD.

In this study, the investigators aim to provide a 7-week tailored intervention for women with
ADHD who have difficulty carrying out student, worker, spousal, and parenting roles due to
poor time management, organization of their physical environments, management of internal and
external stressors, and regulation of internal and external stimulation.

This intervention effectiveness study will use randomization and control. Twenty-four women
who self-report diagnoses of ADHD will be recruited to participate and randomly assigned to
either the intervention group (n=12) or control group (n=12). The intervention group will
receive the 6-week intervention; the control group will not receive intervention (bit will
receive an organization toolkit at study end).

Inclusion Criteria:

- Females aged 21-55 years

- English-speaking

- Self-reported ADHD

Exclusion Criteria:

- Severe co-morbid condition such as an eating disorder, major depression, bipolar
disorder, schizophrenia spectrum disorder, or substance use disorder