ADHD and Girls: It’s not only about boys

ADHD is often thought of as a boys’ disorder. While the percentage of boys who are diagnosed with ADHD is greater than for girls, it is by no means a disorder only for boys. In December 2015, The Journal Of Clinical Psychiatry published a study on the prevalence of ADHD [1] The researchers in this study found a 43% increase in the prevalence in all children from 2003 to 2011. Notably the prevalence of ADHD in girls was the most dramatic – an increase of 55% from 4.7% to 7.3%.

Why then do we often still consider ADHD for be a boy-only disorder? There are several reasons:

1. ADHD in girls often looks different than in boys
2. The diagnostic community has only recently begun to understand ADHD in girls
3. Girls are often better at compensating for and internalizing their ADHD

But, ADHD in girls can look very different than it does in boys. While boys tend to be more hyperactive, girls tend to be more inattentive. Girls with ADHD can make themselves “invisible” in the classroom. Their ADHD may be interpreted as daydreaming or disorganization. Girls often internalize their symptoms, and become embarrassed or humiliated. At some point, often in high school, all of this becomes too much for them to manage. So, girls with ADHD can experience poor grades depression, anxiety, or suicidal behaviors.

Before 1999, the majority of studies done on ADHD were done on boys only. There was no information available on girls. Since 1999, a number of studies have included girls, thereby allowing the diagnostic community to understand that girls have ADHD too. But, even today, girls are diagnosed 5 years later than boys[2] and it is believed that 50% to 70% of girls with the disorder are still missed[3]

It is very important for teachers and parents to become better attuned to the symptoms of ADHD in girls. The primary characteristics of ADHD are inattention, hyperactivity and impulsivity. What might be different in girls?

Caralee Adams provides 6 signs of ADHD in girls.

1. Nonstop Talking. Girls with ADHD can often use “hypertalk” by talking excessively with their friends, or being disruptive in the classroom
2. Friendship Troubles. Girls with ADHD may not be able to pick up on social cues or they may be verbally aggressive. They can have trouble developing close relationships with others
3. Difficulty Paying Attention. Like boys, girls can have trouble keeping their attention on the subject being discussed in the classroom. They can be easily distracted and lose focus. However, girls with ADHD are not often disruptive in the classroom, so their ADHD can be easy to miss.
4. Exceptional Messiness. Organization is a major challenge for all students with ADHD. Girls are no exception. They often have messy rooms, messy desks, and messy backpacks . Their organization deficits make it difficult for them to find needed items in a hurry.
5. Unfinished Work. Girls with ADHD may have difficulty keeping up with their assignments. Homework may take much longer to finish, or it does not get done. When girls stay up late to try to complete their homework, they then suffer from sleep deprivation. This only serves to exacerbate their symptoms.
6. Emotionality. The frustrations of having ADHD combined with the efforts to hide the symptoms can cause a roller coaster of emotions. Girls with ADHD often display “hyperreactive” behavior by crying a lot or slamming doors.[4]

It is imperative that we continue to recognize that girls have ADHD, and that we provide them with the support that is needed. I am available for teacher and parent presentations on the subject as well as individual coaching.  If you would like to hear more, contact me.

[1] Kevin P. Collins, BS, and Sean D. Cleary, PhD, MPH (2015) Journal of Clinical Psychiatry.Racial and Ethnic Disparities in Parent-Reported Diagnosis of ADHD: National Survey of Children’s Health (2003, 2007, and 2011)

[2] Carolee Adams. Girls and ADHD – Why Teachers Miss the Signs. http://www.scholastic.com/browse/article.jsp?id=3746286

[3] ADD (ADHD) Checklist for Girls Do you think your daughter might have ADD (ADHD)?http://www.addvance.com/help/women/girl_checklist.html

[4] Carolee Adams. Girls and ADHD – Why Teachers Miss the Signs.http://www.scholastic.com/browse/article.jsp?id=3746286