Gender differences: There have always been more boys than girls in programs for ADD children. It may be that many of the features attributed to hyperactivity in children can be accounted for by normal differences between boys and girls. Boys may be at risk of being identified as ADD simply because their gender-favored activities clash with the expectations of a highly verbal, schedule-oriented, usually female-dominated classroom.

Where there is a "goodness of fit" between child and environment, where parents respond to any difficulties or differences in an individual child's nature with facilitating responses, there often won't be a behavior problem. A "poorness of fit" between a child's temperament and parents' expectations and behaviors can result in behavioral disturbances. A child with a difficult temperament, for example, will likely exhibit more behavioral problems in a family with a rigid parenting style than in a family that provides some structure within a loving and accepting environment. ADD may then be the result of a "poor fit" between a child's temperament and the quality of his environment. The problem is not in the child or parent, but in the "chemistry" between the two. As David Kiersey's work on temperaments demonstrates, opposite types can offer each other a real gift—given the opportunity.

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