What ADHD Looks Like in Girls
Attention Deficit Hyperactivity Disorder, also known as ADHD (and previously ADD), is commonly diagnosed in boys at nearly twice the rate of girls under the age of 18. This discrepancy was long thought to be the result of a sexual dichotomy in the disorder itself—meaning boys were simply more prone to ADHD than girls were. However, in the past decade and even as recently as the past few years, research has shown that this is in fact not the case, and that it is far more likely that girls are drastically underdiagnosed compared to boys. So the question has become: why? How is it that girls presenting with ADHD don’t receive a diagnosis?
The answer is quite simple: their symptoms don’t present the same way.
Boys presenting with ADHD are often seen as having the ‘classic’ symptoms of ADHD that most parents and pediatric specialists like teachers and pediatricians are familiar with. In reality, the ‘classic’ symptoms are only seen as such because they are more behaviorally obvious and draw more attention than other (just as common) presentations and behaviors of ADHD. Behaviors like interrupting, not being able to sit still, becoming disruptive in class, high levels of energy, and trouble following directions are more typically associated with ADHD and occur more commonly in boys due to their biological predispositions and, primarily, the way boys are socialized in society. For girls, the symptoms are much less active and far more passive, but no less disruptive to their functioning and no less ADHD.
In girls with ADHD, the experience of a much of their hyperactivity occurs primarily in their internal world, whereas boys tend to experience it in their external, physical world. This drastic difference in presentation has lead to a dramatically different diagnosis rate, which in turn has resulted in many young girls not being screened at all, simply because it’s perceived as unlikely a girl could have ADHD.
ADHD in girls will likely not result in the rambunctious, hyper, all-energy-all-the-time affect that many have come to expect, but still has distinct behavioral cues that can help us identify a child who may benefit from ADHD treatment. The possible permutations of symptoms and traits of ADHD in girls can include:
Talking very fast in situations in which the child is socially comfortable
Talking a lot or ‘filling the silence’, or telling stories with an abnormal amount of detail
Trouble keeping their personal spaces, such as their room, desks, cubbies, lockers, etc, clean and organized
Difficulty remembering assignments, chores, tests or projects, and other ‘planning’ related events
Doodling frequently in class, on homework and tests, and in other situations (which can include drawing on themselves or on other objects not appropriate for doodling, such as their clothing, books, their shoes, etc)
Continuous snacking behaviors between meals
Disengaging/ ”spacing out” during conversations they are not invested in
Overwhelmingly strong interests or desires in new activities or hobbies that are often temporary, lasting perhaps a few weeks before being replaced by a new interest
Difficulty in time management, which can include: taking very long showers/baths without realizing it, not being able to track time passing (e.g.: not realizing 15 minutes has passed after a 5-minute warning), not being able to accurately predict how long a task will take them
Difficulty with simple decision making or indecisiveness
Sensory sensitivities, particularly disliking the feel of particular clothing (like tags or seams, clothing that is too loose or too tight), struggling with bright lights, struggling in places where things are loud
Struggling to complete tasks they find ‘boring’, often resulting in the task taking much longer than necessary (taking an hour to empty the dishwasher, a 20 minute homework assignment taking all night).
Saying they feel ‘dumb’ or ‘stupid’ in classes or around specific subjects
And more…
The skills needed to address these experiences are different than the ones typically taught in classrooms, and many young girls with ADHD struggle with self-confidence and self-esteem because they feel they cannot do what the other children do, when they just need tools that are specific to their needs. If your daughter is struggling with several items on this list, or you suspect she may have ADHD, having her assessed by an ADHD specialist who has experience with girls with ADHD can be hugely beneficial for your child’s success and happiness.