ADHD in Girls: An Overview of Its Unique Characteristics

*This information is adapted from an articles by Maureen Connolly and Sharon Saline, Psy.D.

ADHD, or attention-deficit/hyperactivity disorder, is a common condition that affects many children, but it often goes undiagnosed in girls. This can be detrimental to their well-being, as untreated ADHD can impact various aspects of life, from academic performance to social relationships. The presentation of ADHD in girls tends to differ from that of boys, and understanding these differences is crucial for early diagnosis and intervention.

How ADHD Manifests in Girls

ADHD in girls often looks quite different from the stereotypical image of the disorder. While boys with ADHD are more likely to display hyperactivity through impulsive behaviors like blurting out answers or fidgeting, girls often present with more subtle signs. Girls with ADHD, particularly those with the inattentive type (formerly known as ADD), may experience:

• Quiet daydreaming during class

• Anxiety or feelings of sadness

• Excessive talking or appearing overly silly

• Inattentiveness or shyness

• Difficulty maintaining friendships

• Nervous habits, like picking at skin or cuticles

• A tendency toward perfectionism

Why ADHD in Girls is Often Missed

ADHD in girls is frequently overlooked because the symptoms are less disruptive compared to boys. Patricia Quinn, M.D., an expert on ADHD and gender differences, explains that while boys might act out by interrupting class or fidgeting, girls might simply talk a lot, which is often seen as typical behavior for girls and not necessarily a sign of hyperactivity. This can cause teachers and parents to dismiss these behaviors without considering ADHD as a potential cause.

Another challenge in diagnosing ADHD in girls is that they are more likely to have the inattentive subtype, which doesn’t disrupt the classroom in an obvious way. Inattentive symptoms like distractibility, forgetfulness, and difficulty completing tasks can easily be mistaken for laziness or daydreaming. For example, a girl who twirls her hair while gazing out the window may not attract the same attention as a boy who repeatedly taps his desk.

The Impact of Undiagnosed ADHD in Girls

When ADHD goes undiagnosed in girls, it can have serious consequences. Many girls may struggle silently, experiencing emotional distress, poor academic performance, and difficulties in social situations. A survey by Drs. Quinn and Wigal revealed that 85% of teachers believe that girls are more likely to go undiagnosed than boys, with girls often suffering in silence or displaying fewer overt symptoms.

One major concern is that girls with ADHD are more likely to be held back a grade due to academic struggles. When boys face difficulties, teachers are more likely to consider ADHD as a potential cause and refer them for evaluation. However, girls with ADHD, particularly those who struggle with disorganization or meeting deadlines, are often seen as lacking effort rather than needing support. This delay in diagnosis can worsen their academic challenges and lead to lower self-esteem.

The emotional toll of untreated ADHD in girls can be significant. Girls with ADHD tend to experience higher rates of anxiety, depression, and self-esteem issues compared to boys with the disorder. Their struggles in school are compounded by the pressure to be socially adept and academically successful, which can make them feel inadequate or "not good enough."

Why ADHD in Girls is Harder to Identify

As ADHD presents differently in girls, it is often not recognized by parents, teachers, or even medical professionals. Girls with ADHD may compensate for their difficulties by working extra hard or developing strategies to mask their struggles. For example, a girl might stay up late working on a project, striving for perfection but unable to complete it on time. In contrast, boys might procrastinate until the last minute without attempting to meet deadlines. This difference in coping mechanisms can further obscure the ADHD symptoms in girls.

Girls with ADHD may also have more complex social dynamics, which can exacerbate feelings of isolation or rejection. Friendships for girls often require more effort, and girls with ADHD may struggle to maintain these relationships due to impulsivity or social awkwardness. Their difficulties with attention and social cues can make them appear disengaged or odd, which may result in exclusion by their peers.

Practical Advice for Parents of Girls with ADHD

If you suspect your daughter may have ADHD, it is essential to advocate for her early diagnosis and support. Here are some practical steps you can take:

1. Observe Your Daughter’s Behavior: Pay close attention to signs such as distractibility, daydreaming, anxiety, or perfectionism. These may not be as obvious as the hyperactive symptoms often seen in boys, but they can indicate ADHD.

2. Talk to Teachers: If your daughter is struggling in school, discuss her behavior with her teachers. They may be able to provide valuable insight into her classroom performance and whether ADHD symptoms are present. Keep in mind that teachers might not recognize ADHD in girls as easily as they would in boys, so it’s important to bring up your concerns.

3. Seek an ADHD Evaluation: If you and your daughter’s teachers notice symptoms that point to ADHD, consider getting a professional evaluation. An ADHD specialist can assess your daughter’s behaviors in both the classroom and at home. A thorough evaluation should include gathering information from school, teachers, and even peers to understand how ADHD may be affecting her in various settings.

4. Support Your Daughter’s Emotional Health: Girls with ADHD often struggle with self-esteem and anxiety, so providing emotional support is crucial. Encourage open communication with your daughter about her feelings, and consider involving a therapist if she is dealing with mood issues or low self-worth.

5. Develop Coping Strategies Together: Help your daughter build organizational and time-management skills to cope with her ADHD. Techniques like breaking down large tasks into smaller steps, setting timers, and using checklists can help her stay focused and organized.

6. Encourage a Healthy Balance: Encourage your daughter to engage in activities that boost her confidence and help her build strong social connections, such as sports, clubs, or hobbies. These experiences can foster positive self-esteem and help her develop lasting friendships.

Conclusion

ADHD in girls is often overlooked, but with early diagnosis and the right interventions, girls with ADHD can thrive. Parents, teachers, and healthcare professionals need to recognize that girls with ADHD may not exhibit the classic symptoms seen in boys and that the condition can affect their emotional well-being and social lives. By taking proactive steps and seeking appropriate support, parents can help their daughters succeed academically and emotionally, empowering them to overcome the challenges posed by ADHD.

References

Connolly, M., and Saline, S. 2019. ADHD in Girls: The Symptoms That Are Ignored in Females. ADDitude.

Connolly, M. 2022. Easy-to-Miss ADHD Symptoms in Girls. ADDitude.