June 9, 2014 -- Weeping in a red-and-white strapless gown, now-six-time Tony Award-winner Audra McDonald gave a shout-out to "the most important people in my life," as she acknowledged a childhood struggle with hyperactivity.
"Thanks mom and dad up in heaven for disobeying doctors' orders and not medicating their hyperactive girl, and find[ing] out what she was into and, instead, pushing her into the theater," said McDonald, accepting the award for Best Performance by an Actress in a Leading Role in a Play for her role as Billie Holiday in "Lady Day at Emerson's Bar & Grill" at the 68th annual Tony Awards.
McDonald now has more Tony Awards than veteran Broadway stars Angela Lansbury and Julie Harris, who have five apiece, and has won in all four major female acting categories -- as Best Lead Actress and Best Featured Actress in both plays and musicals.
It was not clear that the actress was ever officially diagnosed with attention deficit disorder, or ADHD, a neurodevelopmental disorder that is usually diagnosed in childhood and often continues on into adulthood. ABC News reached out to McDonald’s publicists for comment, but they did not immediately return calls or emails.
According to the Centers for Disease Control and Prevention, the disorder's hallmark symptoms are having difficulty paying attention, impulsive behavior and being hyperactive, but many children outgrow those behaviors. Other symptoms can include excessive daydreaming, forgetfulness, talkativeness and risk-taking.
An estimated 5 percent of children in the United States have ADHD, according to the American Psychiatric Association. However, the CDC has said that community samples show “higher rates.”
The CDC has said that about 11 percent of children aged 4 to 17 -- or 6.4 million -- had been diagnosed with the disorder as of 2011. That rate continues to rise an average of 3 percent a year.
From 2003 to 2011, boys (13.2 percent) were more likely to be diagnosed than girls (5.6 percent), according to the CDC. The highest rates have been seen in Kentucky; the lowest in Nevada.
But a March 2014 report from Express Scripts, a company that provides prescriptions to insurance carriers, revealed that the largest jump in prescriptions for treatment of ADHD was among women 19 to 34. The company looked at the pharmacy claims of 15 million people aged 0 to 64 who were privately insured.
Dr. Patricia Quinn, a pediatrician and co-founder of the Washington, D.C.-based national Center for Girls and Women with ADHD, said McDonald’s message was “one of empowerment” not a chastisement of the proper use of medication.
“This is a very complex issue with females, and we don’t have simple answers,” she told ABC News.
More girls have been diagnosed with ADHD in late adolescence and early adulthood because their symptoms -- very different from boys’ -- were overlooked as children, according to Quinn, who is co-author of “Understanding Girls with ADHD.”
“We find that early on, though, girls may be more inattentive than hyperactive and they don’t draw attention to themselves," she said. "They internalize more.”
Longitudinal studies have revealed that girls with ADHD in childhood often go on to often develop more serious issues such as eating disorders, anxiety, self-injury and depression.
Like McDonald’s parents, Quinn said she looks for an “island of confidence” to help girls.
“We need to prevent a sense of shame and stigma, and loss of self-esteem,” she said. “Girls suffer tremendously.”
“These girls don’t feel smart,” she said.
“Instead, what we need to do is empower them and provide support them,” said Quinn. “And part of that are medications we know work for certain of their issues like attention, focus, concentration and impulsivity.”
She said research shows a combination of strategies that includes both medication and behavioral or cognitive therapy can help girls with their coping skills and self-esteem.
“Not everyone is as talented as [McDonald] and rise to the top,” said Quinn. “We want to help them be successful so that ADHD does not interfere with their pursuits, relationships, academics or career issues.”