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When most people think about a typical child with attention deficit hyperactivity disorder (ADHD), they usually picture a young boy who is impulsive, impatient, and always on the move. While these certainly are traits seen in boys with ADHD, it is rare that we hear of girls being described in the same way.
Dr. Stephen Hinshaw, a professor of psychology at the University of California, has spent many years researching ADHD in girls. In 2002, his research led him to some interesting discoveries, and he revealed that “we were initially taught that ADHD is a boys’ phenomenon.” However, “three decades later, we know this is an equal opportunity condition.”
So, in terms of ADHD in girls vs. boys, the condition doesn’t discriminate on the basis of gender. Since the Centers for Disease Control and Prevention (CDC) has determined that boys are far more likely to receive an ADHD diagnosis than girls, it leads us to wonder why this may be the case.
Types of ADHD
ADHD is a neuro-developmental disorder often diagnosed during childhood. It’s usually characterized by difficulties in concentrating and staying still. While these behaviors can be considered typical in childhood, they become a problem when they significantly impact a child’s ability to participate, engage, and learn effectively at school and home.
This is the time when parents usually seek support from a doctor. If children meet certain criteria in a diagnostic assessment, they will be diagnosed as having ADHD.
There are actually three different forms of ADHD:
- Inattentive ADHD: A person with this form of the disorder struggles mostly with staying focused and paying attention. A child who has inattentive ADHD is not usually disruptive in the classroom.
- Hyperactive and impulsive ADHD: A child with hyperactive and impulsive ADHD might be able to focus fairly well, but their behaviors can cause much disruption in a classroom.
- Inattentive, hyperactive, and impulsive ADHD: A person with this kind of ADHD will experience all of the symptoms of both forms mentioned above. They will have difficulty focusing and will be hyperactive and impulsive.
While both boys and girls can exhibit the main symptoms of ADHD, females are generally more likely to experience the inattentive form of the disorder. Girls with the hyperactive and impulsive component to their ADHD can display behaviors very different from those typically observed in boys.
ADHD symptoms in girls
It’s still unknown why ADHD presents differently in girls and boys, but a parent data report for the National Survey of Children’s Health (NSCH) revealed that boys are three times more likely to be diagnosed with ADHD than girls.
Since we now know that ADHD is an “equal opportunity condition,” it’s concerning that girls are being diagnosed far less often than boys. With the NSCH report also stating that up to 80% of children diagnosed with ADHD get interventions and support at school, it’s entirely possible that a vast number of girls miss out on beneficial support due to their ADHD going unrecognized and undiagnosed.
One of the most obvious aspects of ADHD is the hyperactivity. Boys may appear unable to sit still; they are fidgety and often described as “bouncing off the walls.” This same aspect isn’t as easily identified in girls as ADHD symptoms in girls tend to be far more subtle.
Signs of ADHD in girls include:
- Difficulty paying attention and focusing
- Frequent daydreaming
- Difficulty regulating their emotions (this can include frequent crying)
- Frequent interruption of conversations
- Excessive talking
- Difficulty completing tasks
- Poor organization (which can manifest in a messy bedroom)
- Taking longer to do homework due to becoming easily distracted and leaving tasks to the last minute
- Poor reading comprehension
- Regular misplacement of things and forgetfulness
- Struggling with friendships and reading social cues
- Difficulty seeing projects through to completion despite creative thinking
- Often running late
- Frequent mood swings
Why is ADHD diagnosed less often in girls than boys?
The simple fact is that ADHD is diagnosed less often in girls because they tend to be less disruptive in class and at home compared to boys. In the classroom, the impulsive, fidgety, disruptive child is far more likely to be identified as needing intervention and support. When managing a child’s behavior becomes an issue for a teacher or a parent, they quickly recognize there is a problem that needs some exploration. Quite simply, the obvious nature of the behaviors that boys with ADHD tend to display means that they are easier to notice.
In contrast, a girl who daydreams in the corner without disrupting the class is less likely to be identified as needing some kind of intervention and support to help her learn and engage effectively. This lack of diagnosis leaves girls struggling on their own despite there being various means of intervention that could positively impact their learning and relationships, both at school and at home.
Another difference is that girls often work very hard to meet adult expectations. Girls typically desire strongly to fit in and be accepted by adults and peers; therefore, they strive to follow social norms and avoid trouble. Girls with ADHD often try very hard to please others and are usually agreeable.
Despite their best efforts, girls with ADHD tend to be described by adults as overly dramatic or ditzy. These unfavorable perceptions can result in poor self-esteem and lead to depression and anxiety later in life.
Girls tend to become very good at masking their ADHD, and they’re experts at finding ways to adapt. A boy with ADHD may shout out, spin in his chair, or throw things around the classroom, but a girl with ADHD might appear to be extremely helpful, taking an active role in assisting the teacher to meet her need for movement. Thus, it’s easy to see why the male child would draw the most attention.
Additionally, girls often don’t meet the criteria for an ADHD diagnosis because the most commonly used rating scales in the diagnostic process generally don’t pick up on the more subtle behaviors a girl might display—they focus strongly on the behaviors of a child who is being disruptive.
Thousands of parents around the world have found successful ways of dealing with ADHD to allow their children to be successful within a classroom environment and maximize their potential. While medication is frequently used to treat the symptoms of ADHD, there are many other methods of intervention and strategies that can be helpful.
Changes in diet, the use of meditation, and practical classroom intervention have all proven beneficial for many children with ADHD. Since we know that these treatments and strategies can support and improve learning, it’s important that all children with ADHD have the opportunity to access them, regardless of their gender.