Easy to Miss: The Signs of ADHD in Girls

ADHD is one of the most common neuro-differences identified in children and teens. In spite of its prevalence, however, ADHD is often overlooked in girls. Let’s look at why this happens, why it matters, and what parents can do to help.

Why is ADHD Overlooked in Girls?

One student can’t stay in their seat and frequently causes disruptions in the classroom. The other sits quietly in the back of the room, occasionally staring off, but never “acting out.” Which one has ADHD?

We don’t know enough about either student to answer that question, but we do know which student is more likely to be identified for testing and a possible diagnosis. And that’s a problem because ADHD doesn’t manifest as hyperactive behavior in all students, especially not in girls.

There are three subtypes of ADHD: hyperactive, inattentive, and combined. While most people tend to associate ADHD with hyperactivity and impulsivity, those aren’t the primary symptoms in all cases.

For students with the inattentive subtype, ADHD looks much more like the student staring off than the one disrupting things. These students can be inattentive and distractible but tend not to show signs of hyperactivity or impulsivity.

Most girls with ADHD have the inattentive subtype, meaning that they have symptoms that (1) not everyone knows to associate with ADHD and (2) are less likely to cause a “problem” in class that will catch the eye of teachers or parents.

Additionally, girls may be more likely to compensate in ways that “mask” their symptoms, but this doesn’t mean that they couldn’t benefit from addressing the differences just beneath the surface. Indeed, ADHD masking can lead to its own challenges and mental health risks.

Getting an ADHD Diagnosis Matters

Much of the mass media attention given to ADHD in recent years has focused on the question of overdiagnosis, so it might seem surprising that we’re focusing on underdiagnosis.

All students should be able to get a diagnosis when one is warranted and have confidence that the diagnosis is accurate. The ability to do this varies significantly by population and, for girls with ADHD, both of these important steps can be a challenge. That’s problematic for all kinds of reasons.

Students need an accurate picture of their learning profile in order to receive the type of instruction, support, and accommodations that works best for them. Students who have an attention difference that goes undiagnosed can face stigma and mental health challenges. They may be prone to feedback like, “You’re smart - you should be able to get your homework done!” Or they may question their own abilities, “What’s wrong with me? Why can’t I get it together?”

We want every student to have the power that comes with self-knowledge, not the self-doubt that comes from being in the dark about why their mind works the way it does.

What Parents Can Do to Help

If you suspect that your child might have a learning or attention difference, then you’re doing the right thing by getting informed. Talking to a professional, such as a child psychologist or your pediatrician, about your concerns is also an important step.

Armed with the knowledge that ADHD does not look the same in all students and that it may manifest in more subtle ways in girls, you can now take a more nuanced look at things.

Some common and often overlooked ADHD symptoms in girls include: a tendency to daydream and/or hyperfocus, perceived sensitivity or emotionality, perfectionism (as a masking mechanism), low self-esteem, and trouble with making friends.

Of course, a list of potential symptoms is never sufficient - it’s just a place to start. Many neuro-differences and mental health concerns can often have overlapping or similar symptoms, so talking to a professional about your concerns is an important step. It all comes back to getting an accurate diagnosis. And an accurate diagnosis can make a world of difference.