Nam Kiwanuka: You're listening to Mistreated. I'm Nam Kiwanuka. A child with ADHD will receive an estimated 20,000 corrective or negative messages by age 10. This according to William Dodson, a noted psychiatrist. Historically, ADHD has been seen as a disorder that affects primarily boys. Girls have been largely ignored. Consider that while the symptoms of ADHD were first identified back in 1798, it wasn't until the 1990s that science began to study how ADHD presents in girls, and how it might be affecting them. ADHD was formally recognized as a mental disorder by the American Psychiatric Association, the APA, in the 1960s, and back then it was called a quote hyperinetic reaction of childhood. It would later be called ADD or attention deficit disorder. In 1987, the APA changed the name to ADHD or attention deficit hyperactivity disorder. Then in 2013, the APA reclassified it as a neurodedevelopmental disorder with three presentations, primarily hyperactive and impulsive, primarily inattentive, and a combination of the two.

Nam Kiwanuka: In the little time ADHD has been studied in girls, researchers have discovered many differences in how it presents compared to boys. The signs that we mostly associate with ADHD, hyperactivity, and impulsive behaviors are ones that usually impact boys. In girls, it's often the second subset, an internal presentation. Daydreaming, self-lame, masking, and disassociation. When they were younger. Girls with ADHD tend to do well in school. So often teachers don't think there is anything wrong. But many mask or hide their symptoms to fit in with their peers. And if they're unable to be organized or struggle in class, it is seen as a personal failing. Experts say ADHD is just as prevalent with girls as it is with boys. But girls are underdiagnosed and that quote "boys and men are more likely than girls and women to be referred for services even when their symptom profiles are exactly the same." Until 1999, 81% of ADHD studies were on men. So it is easy to see how ADHD presentation in women was not recognized or understood. But in the 1990s, Dr. Steven Henshaw led groundbreaking research on how ADHD impacts girls and the study has become known as the Be Gals or Berkeley Girls Study. The Be Gals study was a milestone and helped to establish ADHD as a serious condition for women and girls. In an interview on the podcast Hyperfocus with Ray Jacobson, Dr. Henshaw said this. For way too long, clinicians have thought, "Well, it must be depression and anxiety that goes along with being female. ADHD is a guy thing." Dr. Henshaw explained that undiagnosed ADHD in girls can have quote "devastating consequences." The Beal study found that girls with the combined type of ADHD were at a higher risk of selfharming or attempting suicide. Studies have also found that girls with ADHD were at higher risk of unplanned pregnancies, more likely to experience dating violence and intimate partner violence. Teens with ADHD are more likely to become pregnant, and quote, "are more likely to exhibit riskier sexual behaviors." Women with ADHD also suffer from depression, low self-esteem, sleep disorders, and fibromyalgia. A study published in the British Journal of Psychiatry in January 2025, found that women with ADHD have a shorter lifespan, 9 years shorter than women without. On today's episode, we speak to writer Carla Chiconei, who became one of the growing numbers of women to be diagnosed with ADHD during the pandemic. We speak to her about the quote "female protective effect," the challenges she felt in school as a young child, and why she wrote the book Nowhere Girl: Life as a member of ADHD's Lost Generation. She joins me now.

Nam Kiwanuka: Welcome to the podcast. It's so nice to have you here.

Carla Chiconei: Thank you for having me.

Nam Kiwanuka: Oh, can I just say your book is just like breathtaking. You talk about so many different things and as I said to you before we started recording, we go where you're comfortable.

Carla Chiconei: Okay.

Nam Kiwanuka: Okay. But first off, who are the Nowhere girls?

Carla Chiconei: Oh, well, we are a group of women and girls who were kind of left out of scientific research for a really long time and learned a little bit too late that our brains operate differently and that so much of what we blamed ourselves for in our life isn't necessarily our fault. It's because we have ADHD or autism or other neurode divergence. So,

Nam Kiwanuka: and science just forgot to include you.

Nam Kiwanuka: We'll talk more about The Nowhere Girls, but I wanted to talk to you first. This is a memoir, but it's also you've done a lot of studies and historical research on it. Yeah, we'll come we'll get back to that in just a second. But during COVID lockdowns, remember that time? It's so much fun.

Carla Chiconei: It feels like a dream now. Like a nightmare,

Nam Kiwanuka: right? It's just like I look back, I'm like, "Oh, that's why everything's the way it is now."

Carla Chiconei: it didn't recover.

Nam Kiwanuka: We did not recover. It broke everything. But, during COVID, at age 39, you're a mother to a toddler. You were officially diagnosed with ADHD.

Carla Chiconei: Yeah.

Nam Kiwanuka: You were also diagnosed with depression, generalized anxiety disorder or GAD, and perfectionism.

Carla Chiconei: Yes.

Nam Kiwanuka: After the diagnosis, you write that quote, "You found it impossible to talk about ADHD at first. How come?"

Carla Chiconei: I think because I had the stereotype of ADHD of being a little boy's disorder and and like hyper and hyperactive and disruptive and kind of like not the kind of kid I wanted to be associated with when I was in school. And so I think I had a lot of shame just from my misperception of what ADHD was. I also I also was hanging out with mostly my family members at the time who who weren't on the same journey as me, right? They weren't researching ADHD. They weren't overly concerned with mental health and what was going on. So, I wasn't comfortable talking to them about it because they kind of, oh yeah, everybody has that. Like, I got those kind of responses. So, it was something that was I just went through on my own.

Nam Kiwanuka: So, it it's interesting because you do write about your family and how you grew up. So, the back of your mind, you were worried about the stigma attached to you having ADHD, but not it not being an answer to maybe the way that you were, but something that made you even more different.

Carla Chiconei: Yeah, I think so. And I think, you know, there's there's nothing worse than trying to have open and honest conversations about mental health with somebody who doesn't isn't ready to or doesn't want to hear it or isn't on the same page as you. And so I think I kept a lot to myself because the people I was around weren't weren't on the same page.

Nam Kiwanuka: One of the diagnoses that you received was perfectionism. And you write this. While I was grateful for the diagnosis, both the ones I was expecting and the ones that surprised me, I was also bothered by them, mostly because they provided reasons for why I was struggling so hard, but they didn't offer a way out. Yeah.

Nam Kiwanuka: What did you mean by this?

Carla Chiconei: Well, I mean, when you get a diagnosis, I got a prescription for stimulant medication, but I didn't get a a handbook on how to live your life with these four disorders that you just got diagnosed with. So, again, it was kind of a lonely process for me. So, I got on the stimulant medication, which made my dayto-day a bit easier. But for me, I had to go back and unpack sort of the story I'd been telling myself about my life and that took a lot of time and it and therapy.

Nam Kiwanuka: Well, you write about a childhood where you were different

Carla Chiconei: and you felt like you were to blame for that difference.

Nam Kiwanuka: You were called lazy. You did well in school until you didn't.

Carla Chiconei: Yeah.

Nam Kiwanuka: You had a hard time making friends and feeling secure in those relationships. But you're right, my relationship to mental illness was complicated and in line with someone who grew up in a workingclass first generation family.

Carla Chiconei: I looked at it the same way I did those who put pineapple and pizza with intrigue and distrust. I actually like pineapple pizza.

Nam Kiwanuka: It's okay. This is a safe space.

Nam Kiwanuka: This is a safe space. But like I I'm just cuz I'm when I was reading it, I was rooting for you in the sense of like maybe you felt all these things, but maybe you just kind of felt, okay, it wasn't me.

Carla Chiconei: Yeah.

Nam Kiwanuka: Something else was going on.

Carla Chiconei: Yeah.

Nam Kiwanuka: Like a sense of relief, but you felt angry, stressed.

Carla Chiconei: Yeah. I mean, it's complicated when you get diagnosed so late with something that you have had all your life. I felt I I felt all those things. angry, frustrated, and also just sort of unseen, right? Because I, so much of what I went through, was blamed on personality defects, like you mentioned, like you're lazy or you're, you know, you're flighty or you're not a serious person or whatever. So,

Nam Kiwanuka: how did ADHD show up in your life?

Carla Chiconei: Well, at the time it it showed up in parent in my parenting. So, it was my main way of motivating myself was always to be really mean to myself to sort of spur myself into to action to get the things done because with ADHD you lack executive function. So, the little things that like make your day easier, we don't we don't naturally do those things

Nam Kiwanuka: like getting up on time.

Carla Chiconei: getting up on time or just like planning your day, like knowing what to prioritize in your day, knowing the things you need to do and like the right order to do them in. Often what I will do is get sort of like paralyzed with fear about doing those things and then not do any of them.

Nam Kiwanuka: So, which makes everything worse.

Carla Chiconei: It makes everything worse and then you panic and then you you do it in a rush at the end. Sometimes it works out because we have the ability to hyperfocus when when we really need to. And so like if I have a big deadline and I'm almost missing it, like I can pull an allnighter and like and do it. I mean less now because I'm old and child but like I humbled my age. Yes. But I could. Um but yeah, so those those little things um they really add up and so I feel like the older you get, the more that it is more apparent how behind you are in those things because doing adult life is just so much harder for you, right?

Nam Kiwanuka: And I guess too cuz I'm noticing online a lot of moms are finding out that they're like, "Oh, maybe I have ADHD."

Carla Chiconei: Yeah.

Nam Kiwanuka: What do you think that is?

Carla Chiconei: Well, it's interesting because Yeah. when anytime there's like a big hormonal disrupt like when puberty or after you have a baby or in pmenopause or menopause your estrogen which has like a protective effect on your brain is dipping and so I think that that's what we're seeing like when when there's a new mom and she's like you know her life is a mess and she's like oh do I have ADHD I think there's a huge hormonal equation there

Nam Kiwanuka: I want to come back to that in a it when we talk about medication. Yes. But you did a lot of research for the book, it's memoir, but it's also the history of how girls were not even considered to have ADHD. Who is Steven Henshaw?

Carla Chiconei: I love Steven Henshaw. He's a professor at the University of California, Berkeley, and he was the first researcher to look at girls with ADHD in the '9s. So he did a study called be gals and it was a study that looked at I think sixy olds to 13y olds and he's followed them since that time. So now they're like 40 in their 40s and 50s I think. Um, and so they give they're they're the first longitudinal study we have of women with ADHD that and so in their lives we can see a lot of the trends and a lot of the commonalities between us all.

Nam Kiwanuka: Well, I mean it's amazing that he um did that because at the time it wasn't even part of the conversation. So what did he find about ADHD and how it impacts girls?

Carla Chiconei: So he found that it's it's a more internal experience and what happens is when puberty hits a lot of that if it hasn't been identified it turns into anxiety and depression. And so there's a lot of misdiagnosing girls in that age group because the hor hormones take over and depression takes hold and that's what gets identified first.

Nam Kiwanuka: And when you when you say internal um I guess when we have a what we think is ADHD we have the image of the boy who's really hyper disruptive in class but for girls it's more something that's happening inside them.

Carla Chiconei: Yeah. So it's kind of that same hyperactivity. So it's called inattentive ADHD this type and and men can have it too. It's not just girls but it's predominantly girls that get it. And it is that hyperactivity sort of turned inward. So, it's a lot of daydreaming, like listening in class, but not actually hearing what the teacher is saying. It's a lot of like forgetting your homework and doing it at the last minute, but still doing it. So, nobody's noticing that you are struggling with anything really because it's all happening within you.

Nam Kiwanuka: Rumination maybe like,

Carla Chiconei: oh yeah, rumination big time. So you

Nam Kiwanuka: yeah because you have you have that emotional dysregulation piece of you know we get these really big feelings and don't know how to manage them and that combined with all the other stuff is just kind of like it it turns into a lot of low self-esteem.

Carla Chiconei: Yeah.

Nam Kiwanuka: You write about masking self-lame and then in school especially in the early years might do well in school and I actually often consider to be gifted.

Carla Chiconei: Yes. But in schools, there isn't a masking screening tool for ADHD. And the current screening and diagnostic tools for ADHD were based on research that was done on boys.

Nam Kiwanuka: Yeah.

Nam Kiwanuka: How does this harm young girls who have ADHD and are struggling internally?

Carla Chiconei: I think that that's like the biggest contributor to to the low self-esteem that we see in girls with ADHD is that it's such a lonely experience. And whether they get a like a good school experience or not is fully dependent on if their teacher understands ADHD and can identify it in a kid that maybe hasn't been diagnosed, which is a huge task for a teacher. And you need a very caring and astute teacher to even be able to do that. And then you might have a teacher like that one year and then have a teacher that's completely not understanding.

Nam Kiwanuka: So it's up and down for the student.

Carla Chiconei: And I think like my experience was like that too. Like some years I had more understanding teachers that, you know, knew how to connect with me and my interests and kind of like encourage me. And some years it was the complete opposite. So um there was a lot of um different things that you wrote about in the book that just broke my heart, took my breath away.

Nam Kiwanuka: Um, but it's um you cited a study that showed that quote, "It's estimated that a child with ADHD receives 20,000 more corrective or negative messages by age 10 and their self-esteem suffers as a result."

Carla Chiconei: Yeah.

Nam Kiwanuka: Um, as a mother now and looking back on your own childhood, you think what?

Carla Chiconei: Oh, I mean, I I can feel the effects of the 20,000. I felt like I felt them when I was young and I can still feel them. So, I think that I mean that's a big part of the reason why I wanted to write this book and to sort of change the way I was talking to myself and parenting myself because I knew I had this job of parenting a little girl and who was a lot like me. And so I could It's so weird when you become a parent, you kind of hear the automatic reactions of your own parents and it comes so out of nowhere. you're like, "Wait, I didn't want to I didn't want to talk to you like that. Where did that come from?" And so, I think the idea that I needed to change that and like learn a different way of parenting her, it was huge for me.

Nam Kiwanuka: And it's hard.

Carla Chiconei: It's so hard

Nam Kiwanuka: because it's like you feel it because you experienced those things. You want to protect them from that.

Carla Chiconei: Yeah.

Nam Kiwanuka: But then the way you were parented was in an environment where no one understood what was going on with you.

Carla Chiconei: Of course. Yeah. Yeah. And so having this awareness, it doesn't necessarily make it easier.

Nam Kiwanuka: You probably are harder on yourself. Yeah. Right.

Carla Chiconei: Yeah. It is another reason to be hard on yourself. So it is a slippery slope there. And I do think I see a lot of women, you know, especially on social media, you know, being like, I need to parent gentle and I these are the things I need to do to be a good mom. And a a part of that is great and I'm glad people are thinking that way, but also it does seem to be like the next avenue that women are being hard on ourselves for is like just overanalyzing our parenting and fixating on it.

Nam Kiwanuka: Yeah, kids are very humbling.

Carla Chiconei: Yeah.

Nam Kiwanuka: In so many ways. Um, so in writing in this book, you did a survey with the Nowhere Girls and you write that quote, "A staggering 90% of nowhere girls who answered my question about childhood trauma said they experienced it." Yeah.

Nam Kiwanuka: Um, did that shock you?

Carla Chiconei: It was It saddened me, but it didn't shock me because I mean my own story was full of childhood trauma and from speaking with Dr. Henshaw, I kind of knew that the girls he had studied also had a higher rates of childhood trauma and substance use and all of that. So I was kind of expecting it. But

Nam Kiwanuka: can you explain that a bit more? So is it genetic or is it if something happens to you like epigenetic?

Carla Chiconei: So it it is genetic. It's heritable. So 80%. So it's like if your if your parents had it, you have 80% chance of also getting it. But yes, the epigenetics, the environment that you grew up in, if it was calm and peaceful and organized and, you know, praised you for the right reasons, you might not develop ADHD for a long time or might not show the symptoms of it. And maybe it'll take you until like you become a mother and you're like, oh, like everything that I had in place has fallen away and that's when you start expressing symptoms of ADHD.

Nam Kiwanuka: But there is something called the female protective effect.

Nam Kiwanuka: What's that?

Carla Chiconei: So it's um because women have I think extra responsibilities on them from when they're quite young and we learn how to sort of mask and our lives are kind of set up in a way that protects us from everything falling away and and the ADHD symptoms taking over. Um that's why sometimes it takes longer.

Nam Kiwanuka: You write about masking more in the book. Can you explain what that is?

Carla Chiconei: Yeah. So masking is I mean it kind of is a way of um putting on a mask so that you can blend in in your life and also just like achieve what you need to achieve throughout the day. Like I was talking about executive dysfunction earlier and a lot of people use masking to just get through the tasks of the day and I used to do that by being mean to myself and motivating myself by being like come on you can do this. It's also a a huge part of masking is getting along socially and um blending into different groups and in school I kind of like collected traits from from my friends that I thought were like doing doing it well and then just sort of tried them on for size and I think I still carry some of that with me now. Right.

Nam Kiwanuka: Uh because your mom meant like when you're in the book you write about how your mom picked up on that.

Carla Chiconei: Yes. that you would um within certain friendships that you had, you started being more like that person.

Nam Kiwanuka: You said that ADHD you inherited like 80%.

Carla Chiconei: Yeah.

Nam Kiwanuka: So now that you know you have it

Carla Chiconei: Yeah.

Nam Kiwanuka: Um does everything make sense.

Carla Chiconei: Oh yeah. Very chaotic. Um yes it does make sense. And you know, I I have an aunt on my dad's side who was diagnosed when she was 55. So, it's kind of like easier to point to that side of the family's genes as um where it's coming from. But just yeah, the but it's it's hard because we're also Italian. So, like the loudness, the talking over each other, the interrupting, it's like, do we have ADHD or are we just Italian?

Nam Kiwanuka: So you could see why it might might take us longer to get diagnosed.

Nam Kiwanuka: Have you had conversations with your family since you had ADHD?

Carla Chiconei: Yes. And you know um my aunt who I mentioned, she's she's very into like the ADHD education and and learning more and we've had some really good conversations. Um my parents aren't as I think they're interested in it, but it's more just like I think they still think of it as a bit of an excuse. And it's really hard to get out of that mindset of like, you know, viewing mental health issues as weakness.

Nam Kiwanuka: Um, so it is harder to talk to them about about ADHD.

Carla Chiconei: Yeah. Yeah. Yeah. And I mean, I I can I can empathize with them because I understand where that came from. But yeah, it's it's hard to not be able to.

Nam Kiwanuka: That's another thing like once you become a parent, I I feel like um I didn't have the best relationships with my parents.

Carla Chiconei: Yeah.

Nam Kiwanuka: But since I had kids, I understand them more.

Carla Chiconei: Yeah.

Nam Kiwanuka: Um you can understand how how they develop and why they were the way they were.

Carla Chiconei: Yeah. I think I show them more grace.

Nam Kiwanuka: Um you write in the book too that quote "being diagnosed with depression and anxiety or misdiagnosed with a mood disorder long before ADHD is so customary among women. It's basically a right of passage. And quote, "To me the most shocking misdiagnosis for women with ADHD is also one of the most common uh bipolar 2 disorder or BD."

Carla Chiconei: Yeah.

Nam Kiwanuka: Why is that?

Carla Chiconei: Well, so with bipolar disorder, you get um like manic episodes and then depressive episodes. And so if ADHD doesn't get identified early and these patterns sort of take hold, I could see why you might get misdiagnosed with this because your hyperfocusing and your enthusiasm and your impulsivity might be misread as mania. But the difference is um with a bipolar you that starts in um adolescence. So the episodes start in adolescence whereas ADHD it starts long before then which is why it's really important to get a thorough assessment to figure out like what's going on cuz I've had friends who were misdiagnosed with bipolar and on the wrong medication for like 10 years and

Nam Kiwanuka: that causes a lot of harm, doesn't it?

Carla Chiconei: Yeah. Yeah. Um, but I can also see why that's happening because historically women, if you haven't considered that women and girls have ADHD,

Nam Kiwanuka: Yeah.

Carla Chiconei: you won't put them in that category. You won't even consider it.

Nam Kiwanuka: So, the other bipolar is like thought of more as like a women's disorder.

Nam Kiwanuka: And why is that, Carla?

Carla Chiconei: Because sexism.

Nam Kiwanuka: We're laughing, but

Carla Chiconei: Yeah. I mean, the history of women's mental health is like not

Nam Kiwanuka: It's hysteria, right?

Carla Chiconei: Yeah. It's hysteria. That's where it comes from. And you know, what they were willing to diagnose women with were the hysterical diagnosis versus, you know, the more typical male diagnosis of like autism or ADHD. They they didn't even think of that. So, which also I can see why families might want to shy away from a diagnosis like ADHD because of that stigma, too,

Nam Kiwanuka: right? So the harm just kind of dominal effect.

Carla Chiconei: Yeah, for sure.

Nam Kiwanuka: Um, what other conditions are women with ADHD likely to have?

Carla Chiconei: Oh, so many. Um, I mean a lot of us are hyper mobile, so meaning like our joints bend more easily, but also we have more pain in our bodies because of that. And um, that's something I didn't even know about until I went to this like physiotherapist who told me about it. Um, but there's more depression and anxiety as you mentioned. Um, even things like eczema and asthma and diabetes,

Nam Kiwanuka: stutters too.

Carla Chiconei: Yeah, stutters, ticks, all sorts of like basically everything you can think of is more common in this population. Um, you're right that there is also quote emerging evidence that some girls with anorexia may in fact be suffering from autism, but because it's not a typical male symptom, it's been missed. Similar studies exist for ADHD, but the pool of research is not large. Um, and there is also quote a connection between ADHD, eating disorders, and gender dysphoria.

Nam Kiwanuka: Yes.

Nam Kiwanuka: And I'm not I was just like I want to throw everything against the wall. and that quote, "Despite women with ADHD being underresarched, there is depressing amount of evidence that the disorder puts us at an increased risk of for unhealthy romantic relationships, higher divorce rates, and more unsatisfying sexual relationships. It also substantially increases the likelihood of experiencing intimate partner violence.

Carla Chiconei: Yeah,

Nam Kiwanuka: it just feels like these are really big things."

Carla Chiconei: I know. But I meant what I said when it's kind of like everything bad you can think of happens more in this population.

Nam Kiwanuka: Why did you want to write this book?

Carla Chiconei: Because I it was a book that I I wanted when I got diagnosed and I I mean I've gotten so many messages from people who have ADHD and have found the book and have been just like this is what I needed to read and has made me feel so much better about everything that I've gone through. Um, yeah. I I I wrote it for myself and all the other Nowhere girls.

Nam Kiwanuka: So, do you understand yourself better now?

Carla Chiconei: I think so. Like I feel like I understand myself a little too well. I'm like over aware of everything.

Nam Kiwanuka: But there must be some grace that you show yourself now.

Carla Chiconei: Yes. Yeah. And I think that was like my biggest my ultimate I wanted the ultimate takeaway of the book to be um like we can't really control what we have access to. We can't control if we have access to the resources that make life with ADHD easier, but we can control working on being nicer to ourselves. cuz so many of us struggle with that same like automatic negative patterns of thinking that we can at least try to say, "Oh, I'm doing that again. I'm trying to, you know, motivate myself by being mean to myself. I'm going to take a step back and I'm just going to like try to be nice to myself."

Nam Kiwanuka: Um, it's been so nice talking to you, Carla. I only have a few more minutes left. Um, but I wanted to talk to you about some solutions and maybe um what policy makers can do. Uh we talked a little bit about the hormonal shift that happens in adolescence. And because women and girls weren't considered to be impacted by ADHD, the research on ADHD has centered around boys to the point where if someone needs medication for ADHD, that medication wasn't studied on how it impacts women's hormones through puberty, pregnancy, or pmenopause. Yeah. Which is quite shocking.

Carla Chiconei: It is shocking. And I I spoke with um a Swedish doctor in the book who they have a different model of care that is basically gynecologists are working with psychiatrists and psychologists for this ADHD population to see whether it is hormones that people need or ADHD medication. And I just think that's so lovely. Can you just imagine if our doctors were able to work together collaborative collaboratively like that and just figure out like do the do the best for us like for the individual patients cuz so much of it is just put on us to figure out and you know if you have ADHD you have a you have a hard time just sorting things out in general. So it would be really nice to have like the healthare system backing you up.

Nam Kiwanuka: you wrote about like the how you came upon your ADHD diagnosis and you already part of the system. Um but for other people it's it seems to cost a lot of money.

Carla Chiconei: Yes.

Nam Kiwanuka: And you also have to have the curiosity around do I have this thing?

Carla Chiconei: Yeah. And you have to have some knowledge of it first, right?

Nam Kiwanuka: Yes. So what what do you want to say to policy makers about the urgency in course correcting this?

Carla Chiconei: Well, I'm the last I when I last looked into it, I think doctors, family doctors study ADHD for like half a day in their training. And so they and and they're not getting trained on what it looks like in women or even adult men quite frankly. Um, and I know when I first reached out to my family doctor about it, she said, "I'm so sorry. I just don't know enough about it to give you an assessment." And so I think that if that door could open a little bit more if family doctors were more informed about it, then it would it would free up so much space in in our health care system because we have like three-year weight list to get in to see psychiatrists who could do the assessment. So I mean like everything else, we just need more doctors and more training.

Nam Kiwanuka: And and what do you say to parents who maybe think that their child isn't trying hard enough or, you know, uh or maybe they think that they have ADHD?

Carla Chiconei: Yeah. Um well, I mean, yeah, in the system it it's hard to navigate, but if you do think your child has ADHD, I think you need to be their advocate. Like that's what you become, right? So you need to find a way or find go to different doctors and research and figure it out. That's basically what our health care system has come to at this point is just like you need to become a researcher.

Nam Kiwanuka: And finally in schools cuz I think this is where this is really magnified. Yes.

Carla Chiconei: Um I think teachers are heroes and um having a child in the Ontario public school system they're doing what they can with what they have.

Nam Kiwanuka: Absolutely. Um, but they have certain markers when they're looking for children who might need additional supports.

Carla Chiconei: Yeah.

Nam Kiwanuka: But when it comes to girls, they might not always have what is perceived to be those markers.

Carla Chiconei: Sometimes girls because they become so good at masking at such a young age, um, they don't get identified. So the teachers aren't aren't aren't missing them necessarily because they want they they don't care, but because girls are so good at pretending. So, it does take a really astute teacher to notice what's going on with girls, but the signs are there, right? Like there's daydreaming, there's like um jittery like fidgeting, there's talking a lot, like just being a a chatterbox um and like forgetting things. And you know, there there are signs that set little girls with ADHD apart from the population, but you just have to notice them

Nam Kiwanuka: and know what it what it is, right?

Carla Chiconei: Yeah. And know what to do about it, too, right?

Nam Kiwanuka: Um is there anything that I you wanted to talk about that I didn't ask you?

Carla Chiconei: I don't think so. Yeah. Thank you so much.

Nam Kiwanuka: Thank you so much for writing this book. Um I think it's going to help so many people and thank you so much for sharing so many parts of yourself with us.

Carla Chiconei: Thank you so much for having me. N

Nam Kiwanuka: this was Mistreated. Thanks for listening. You can follow our show wherever you get your podcast so that you can get notified each time a new episode is available. We would love to hear your feedback. You can write me an email at mistreatedpodcast.org or reach out to me on social media. This week's episode was produced by Matthew Omar and me and edited by Colin Kish. Digital shorts by Ariana Longley. Camera work by Max Dussy. Teleprompting by Christy Mloud. Production support from Jonathan Hallowell and TVO's digital media services team. Lori Fu is the executive producer of digital. John Ferry is vice president programming and content. Thanks so much for listening.