The stereotypical image of a child with ADHD tends to be a young boy who is hyperactive, impulsive, and struggling in school. While this may be an accurate profile for some children, the ease of spotting these symptoms in male students can make it easy to overlook others with less “classic” profiles. The fact is, there are many other children—especially girls—who also have ADHD whose experience is going undiagnosed because their expression is much more subtle.
The evidence of this becomes clear in studies of ADHD in adulthood where the ratio of men to women starts to even out. When girls become adults, they may begin exploring answers for lifelong challenges resulting from undiagnosed ADHD, and it’s shedding light on the stark diagnostic biases represented in current childhood statistics.
There is growing evidence that girls with ADHD present differently, and the best way to prevent them from flying under the radar is for healthcare professionals, educators, and social workers to be better informed about what to look for and how to help.
Girls and ADHD by the Numbers
From 2016 to 2019, the CDC estimates that about 6 million children were diagnosed with ADHD in the U.S. Within that group, females were diagnosed at less than half the rate of their male counterparts. 13% of young boys were identified as having ADHD, but only 6% of girls.
In contrast, we know that the ratio of women to men being diagnosed or living with ADHD in adulthood is nearly equal, at about 1:1.6. While this is not well understood and could be impacted by how ADHD develops and changes as we mature, there are concrete reasons to believe that the gap in childhood statistics is the product of other factors.
In many cases, the starting point for ADHD conversations begins because of behavioral problems in the classroom. A traditional understanding of ADHD can mean that the hyperactivity of the boys may be drowning out the needs of girls with ADHD. Behavioral indicators in girls are more easily dismissed as personality quirks, inattentiveness, or socialization challenges, and it can lead to a lack of identification and an absence of support they need to be successful.
Knowing the Symptoms of ADHD in Girls
For reasons that are still being explored, the symptoms of ADHD in girls tend to be different than in boys. ADHD indicators fall into three main categories: inattention, impulsivity, and hyperactivity, and certain clusters tend to be more prevalent in girls than boys. When it comes to understanding girls with ADHD, it’s important to look for traits that indicate inattention and impulsivity that may be less overt than other ADHD symptoms. These include:
- Being easily distracted and forgetful
- Appearing to lack in motivation
- Disorganization or messiness
- Appearing withdrawn and prone to crying
- Appearing shy
- Problems completing tasks
- Verbal impulsivity
- Taking excessive time to process information, and appearing like they may not have heard you
- Trouble forming or maintaining friendships
Differentiating between common childhood behaviors and ADHD in girls can be subtle, but taking the time to talk to students and their parents and monitor their individual struggles can have a profoundly positive impact on their ability to succeed.
The Impact of ADHD
The chance of the symptoms of ADHD improving on their own is unlikely, and living with an undiagnosed condition creates significant challenges across all aspects of life. In school, girls without a diagnosis run the risk of blaming themselves for the difficulties they’re experiencing, especially if their behavior is resulting in negative consequences. They may feel frustrated with their lack of success, and being told they need to try harder and focus can quickly become overwhelming. These experiences likely contribute to significantly higher levels of anxiety and depression among girls with ADHD.
Undiagnosed ADHD can also have serious long-term impacts as girls grow into young women. Without support and in the absence of information and answers, girls are forced to cope with increasing complexity through a lens of personal shame, failure, and guilt. In their professional lives, they may be unsuccessful in keeping up with the demands of their jobs, while at home they may experience frustration managing their family’s needs.
The persistent uphill battle with routine tasks and important life maintenance has the potential to exacerbate anxiety and depression, leading to additional challenges like self-harm, problems socializing, and turning to unhealthy coping mechanisms that put them at risk for substance abuse issues.
Managing the Symptoms
Mental health treatment modalities are not a one-size-fits-all type of process, and in many cases, it takes time, patience, and expertise to dial in exactly what works best for a given individual. ADHD is no exception, but with proper intervention, symptoms can be largely controlled.
For understanding girls with ADHD and how to manage it, there is great benefit in an interprofessional approach. Addressing the symptoms from many angles requires the support of doctors, nurses, teachers, therapists, and parents.
Therapy focused on the management of ADHD can include exercises in communication, organization, and reinforcement of healthy personal interactions. Proper strategies and guidance can help enhance healthy behaviors and introduce ways to manage emotions when overwhelmed or frustrated. Therapy can also introduce meaningful parenting techniques so that parents can effectively support their children through their challenges via organization and structure in the home.
In some instances, it may be useful to consider the use of medications. While medications won’t cure a child’s ADHD, under the direction of a trained medical or mental health professional, pharmaceuticals can offer a way to manage symptoms to support daily routines and function.
Elevate Your Understanding to Support Girls with ADHD
The symptomatic presentation of girls with ADHD can be subtle. Without well-informed professionals in key positions, many young women will continue to be undiagnosed, which will extend their challenges into adulthood and increase their vulnerability to an expanding profile of risks.
Premiere is committed to increasing awareness and empowering workers in front-line roles with the knowledge and skills to make a difference. Courses like ADHD in Focus - Spotlight on ADHD in Girls and ADHD Unmasked - Recognizing and Reshaping Girls’ Learning Experiences, both created by Megan Arbour PhD, RN, CNM, CNE, and Jenna LaPointe, LICSW, offer healthcare and teaching professionals working with children a critical insight into the challenges faced by girls with ADHD, and how to best support them.
Every course created by Premiere is developed by leading clinical and educational experts, and gives professionals the up-to-date, science-backed information they need to give the populations they serve the best possible outcomes.