Attention deficit hyperactivity disorder (ADHD), a mental health condition commonly diagnosed in childhood, involves patterns of inattentive, hyperactive, or impulsive behavior. These symptoms can lead to difficulties at home, school, and other areas of daily life.
Plenty of stereotypes frame ADHD as a condition that mostly shows up in boys.
Evidence even seems to back this stereotype up: A
While it may be true that boys have a higher chance of receiving an ADHD diagnosis, that doesn’t automatically make them more likely to have the condition.
- they more often have internalized (and less noticeable) symptoms
- they’re more likely to use coping strategies that help hide their symptoms
- parents and teachers are less likely to refer girls for diagnosis and treatment
Girls who don’t get the right diagnosis generally won’t get the right kind of support. As a result, the challenges they experience at home and school often persist into adulthood, where they can have a far-reaching impact on work, social relationships, and overall quality of life.
A note about language
In this article, we use “male” and “female” and “boy” and “girl” to refer to sex assigned at birth. This reflects existing research on childhood ADHD, which mainly uses “gender” to refer to sex assigned at birth.
That said, at Healthline we recognize gender as a spectrum, not a male-female binary. We also realize that gender identity doesn’t always align with sex assigned at birth.
Parents and other caregivers might begin to suspect ADHD in boys who:
- can’t sit still in school
- disrupt learning by constantly calling out of turn
- spend hours playing video games but get frustrated after a few minutes of homework
They might not notice or look for similar behaviors in girls, but girls often don’t show those signs, either.
Instead, maybe your daughter:
- reads far ahead in the novel assigned for class but consistently fails to do the homework questions
- spends hours working on math homework but often forgets to turn it in
- sits quietly in class, doodling in her notebook instead of paying attention and taking notes
- has trouble making and keeping friends
- constantly seems lost in her own thoughts
- is often called a “chatterbox” by teachers and other adults
In short, girls with ADHD might seem distracted, dreamy, or forgetful instead of outwardly disruptive. As a result, caregivers often don’t make the connection, especially in the absence of hyperactive or disruptive behavior.
Girls are also more likely to compensate for symptoms with coping strategies like:
- spending extra time to get schoolwork and chores just right
- avoiding people, tasks, or events they find challenging
- creating conflict to deflect attention from any problems they’re having
- checking work or tasks repeatedly to make sure they’re complete and correct
These coping methods might offer some short-term benefits, but they don’t always help. Sometimes, they can even create more challenges — including making ADHD symptoms even harder to recognize.
Gender stereotypes can have an impact, too. Caregivers might assume quiet and dreamy girls, or overly talkative ones, are simply “being girls.” They might chalk these signs up to personality instead of considering them in the context of other key signs, like distractibility, fidgeting, or difficulty managing emotions.
What’s more, girls with ADHD are more likely to also have mental health conditions that involve internalizing symptoms, like anxiety and depression. Symptoms of these conditions can resemble ADHD symptoms, further complicating diagnosis.
ADHD has three main presentations:
- hyperactive-impulsive type
- inattentive type
- combination type, which involves combined symptoms of the other two types
While girls can have any of the three types, girls who do get an ADHD diagnosis more commonly have the inattentive type. Symptoms of this type include trouble with concentration, organization, and learning and processing new information.
To put it another way, not everyone with ADHD will seem hyperactive, fidgety, impatient, or impulsive. When kids don’t act out or disrupt others, it may take more time for parents and teachers to notice the symptoms they do have.
Some key signs of ADHD in girls include:
- talking frequently or excessively, even when parents or teachers ask them to stop
- extreme emotional sensitivity and reactivity, such as crying or becoming upset easily
- extreme focus on things that interest them
- trouble paying attention to directions at home or school
- a tendency to daydream or seem lost in their own world
- slow or distracted movements
- a habit of blurting out thoughts or acting on impulses without thinking things through
- frequent forgetfulness
- a habit of abandoning goals or plans halfway
- disorganization, which might show up as a messy bedroom, desk, or backpack
- constantly interrupting peers during conversations and activities
- trouble forming and maintaining friendships
- difficulty completing schoolwork on time
- trouble sleeping, including difficulty falling asleep or waking up too early
- relational aggression toward peers, including gossip, bullying, intimidation, and other controlling behaviors
- a preference for strenuous outdoor activities and sports that require a lot of energy
Some girls may notice more severe symptoms
The symptoms listed above aren’t the only signs of ADHD, just examples of the ways the condition often shows up in girls.
While experts haven’t identified one specific cause of ADHD, they do know certain factors can contribute to the condition.
Factors that might increase your child’s chances of developing ADHD include:
- family history, or having a parent or sibling with the condition
- prenatal or childhood exposure to lead and some pesticides
- prenatal exposure to alcohol or tobacco
- trauma or injury to the brain
- premature birth or having a lower birth weight
ADHD symptoms often don’t improve without treatment, and undiagnosed ADHD can worsen over time. Even milder symptoms can cause plenty of distress and affect daily life at school or home, along with friendships and relationships.
Plus, girls who never get a diagnosis may end up blaming themselves for the difficulties they experience. Instead of accepting these symptoms as signs of a mental health condition that requires professional support, they might:
- feel frustrated with their lack of success
- believe they need to try harder
- frequently feel overwhelmed and exhausted by their efforts
- wonder why they “can’t do anything right”
- have difficulty achieving goals and lose their motivation to keep trying
Over time, this internalization can affect self-esteem and self-worth. It can also lead to self-punishment and an overall sense of hopelessness.
Other possible complications include:
- regular conflict in relationships with parents, teachers, and friends
rejection or bullying from classmates and peers
- social isolation, or few close friendships
- increased chance of eating disorders
- persistent sleep problems
- trouble succeeding at school or work
- increased chance of other mental health conditions, including substance use disorders and depression
It’s also worth keeping in mind that treatment for anxiety, depression, and other mental health symptoms might have less effect when ADHD symptoms go unaddressed.
Need support now?
Some girls with ADHD self-harm in order to cope with feelings of overwhelm and distress. A
Always take a child seriously when they talk about suicide. You can offer support by:
- staying with them
- listening to what they have to say with compassion, not judgment or denial
- calling or texting a crisis help line for more guidance
- reaching out to their therapist or finding a new therapist as soon as possible
- talking through a few alternatives to self-harm
Reach a trained counselor 24/7, any day of the year, by:
- calling the National Suicide Prevention Lifeline at 800-273-8255
- texting HOME to the Crisis Text Line at 741-741
You might notice key signs of ADHD in your child at home, but your child’s teacher might also mention any concerns they have about your child’s schoolwork, attention in the classroom, and interactions with others. They might suggest meeting with a school counselor to explore helpful next steps.
If your child shows signs of ADHD at home or in the classroom, it’s generally best to connect with a mental health professional who specializes in childhood mental health conditions.
Your child’s therapist will start by asking you and your child more questions about:
- symptoms they’ve noticed
- trouble they have completing tasks at school and home
- whether symptoms seem to get worse at school or home
- how long they’ve had these difficulties
- how those symptoms affect daily life
- their friendships and relationships with family members
- any strategies they use to manage their symptoms
- any unwanted emotions, feelings, or thoughts, including feelings of anger, frustration, or sadness
They might also ask about other physical and mental health symptoms to rule out underlying conditions.
From there, the therapist will have more information to offer a diagnosis and more guidance on the type of support your child might need.
It’s always a good idea to reach out for support as soon as you notice your child having difficulties that don’t seem to improve.
Even if they don’t have ADHD, a trained therapist can still help uncover what’s causing their symptoms.
Tip: Create a list of concerns you (and possibly your child’s teacher) have noticed beforehand so you go into the appointment with a clear outline of what you’d like to discuss.
Not sure how to go about choosing a therapist? Try starting by connecting with the guidance counselor at your child’s school. You can also ask your child’s pediatrician for a referral.
Keep in mind: Children with ADHD often have a hard time asking for support or admitting they’re having difficulties. Letting them know you’ll always listen to any challenges they’re experiencing can help them feel more comfortable opening up.
ADHD treatment can take a different shape for every child.
Effective treatment generally involves a combination of approaches and requires a coordinated effort from your child’s therapist, teacher, and you.
Therapy offers a safe space for your child to:
- practice skills for communication, organization, and interpersonal interactions
- learn and practice new behaviors
- get support with accepting and managing difficult and overwhelming feelings
Therapists may also recommend family therapy or parent training. These approaches offer the opportunity to learn helpful skills for parenting a child with ADHD, from positive discipline practices to organizing and structuring daily activities.
Depending on the severity of your child’s symptoms, they might also refer you to a psychiatrist to explore medication options. While not always necessary, ADHD medication can help relieve severe symptoms, which can go a long way toward improving your child’s daily function and quality of life.
At school, your child’s teacher might:
- create an individualized plan for your child, which might involve specific words or hand signals to remind them to stay on task
- offer small tasks with easy-to-understand directions
- give them more time to organize their work, complete assignments, or take breaks
- provide encouragement and support for positive behavioral changes
Older 2007 estimates suggested that ADHD in girls goes undiagnosed between 50 and 75 percent of the time. But increased awareness of the unique ways girls experience ADHD symptoms can help them get the right diagnosis and treatment. This support can make a big difference in their performance at school and personal relationships, not to mention overall mental health and well-being.