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An ADHD in Girls Checklist

ADHD manifests differently in girls compared to boys, often presenting challenges that can be overlooked or misinterpreted.
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An ADHD in Girls Checklist

14/01/2024
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ADHD manifests differently in girls compared to boys, often presenting challenges that can be overlooked or misinterpreted.

ADHD UK reports that the global prevalence of children with ADHD is approximately 5%. However, diagnostic data reveals a significant difference between genders, with 3.62% of boys diagnosed, compared to just 0.85% of girls. That translates to a gender split of roughly 4:1, boys:girls.

As we delve into the complexities and manifestations of ADHD in girls, it’s crucial to recognise the distinct – and often misinterpreted – signs and symptoms that may indicate the presence of this neurodevelopmental condition.

From inattentiveness to potential emotional struggles, understanding the truth behind these gender differences is the first step toward providing the necessary support.

Join us as we present an ADHD in girls checklist, tailored to identify the unique aspects of ADHD in young females. Along the way, we’ll discuss the pathways to awareness, importance of early intervention, and comprehensive well-being for girls with ADHD.

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Is ADHD More Common In Boys or Girls?

Despite prevalent stereotypes, ADHD is not biased towards a specific gender.

Historically, the disorder has been predominantly associated with hyperactive males – we’ve all heard the expression, ‘boys will be boys’, right? – leading to a skewed perception of its prevalence.

Contemporary research (Skogli, 2013; Slobodin, 2019) challenges this narrative, emphasising that ADHD occurs in both boys and girls. However, the way symptoms manifest can differ significantly, contributing to a higher likelihood of boys being diagnosed.

Girls with ADHD often exhibit inattentiveness rather than hyperactivity, for instance, making their symptoms less conspicuous. This gender-based discrepancy in symptom presentation contributes to the underdiagnosis of ADHD in girls.

In reality, the disorder is equally distributed across genders, but societal expectations and diagnostic biases have led to a disproportionate representation in clinical settings.

Learn more about ADHD in girls & child ADHD assessment with The ADHD Centre

So Why the Diagnostic Disparity?

The diagnostic disparity between boys and girls in ADHD can be attributed to a myriad of complex factors.

Understanding the reasons for female underdiagnosis is crucial for dismantling gender bias and ensuring that girls with ADHD receive the attention and support they deserve. Here are key contributors to the underdiagnosis of girls:

  • Symptom Presentation: Girls with ADHD commonly exhibit inattentiveness and internal struggles, whereas boys often display more overt hyperactivity. This variance in symptom presentation leads to girls’ symptoms being overlooked or attributed to other causes. Societal Expectations: Societal norms and expectations play a significant role. There’s a stereotype that ADHD is synonymous with disruptive behaviour, aligning more with traditional perceptions of ‘boyish’ behaviour. Girls may internalise their struggles, making their symptoms less visible.
  • Gender Bias in Research: Historical research on ADHD has primarily focused on male subjects, influencing diagnostic criteria.
  • Coping Mechanisms: Girls with ADHD often develop coping mechanisms to mask their difficulties, such as perfectionism or withdrawal. While these strategies may help manage symptoms temporarily, they hinder the recognition of underlying issues.
  • Comorbidity with Other Conditions: ADHD in girls often presents with comorbid conditions like anxiety or depression. These accompanying issues can overshadow the primary symptoms.
  • Educational Environment: Girls may adapt better to the structured and verbal aspects of a school or classroom environment, masking struggles with attention and executive functions. This adaptability can lead educators to overlook potential ADHD indicators.
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The ADHD in Girls Checklist

ADHD in girls often presents differently than in boys, with symptoms that may be less conspicuous – but equally impactful on daily life.

Here’s our ADHD in girls checklist to help identify potential signs:

Sign / Symptom:

Explanation:

How to Help:

Daydreaming or Seeming WithdrawnGirls with ADHD may have wandering minds, or appear distant, as they struggle with maintaining focus.Providing a quiet space for concentration and offering gentle prompts can help alleviate this.
Frequent Crying, Mood Swings, HyperreactivityEmotional dysregulation is a common symptom of ADHD for young females.  Encourage open communication and teach emotional coping strategies, like deep breathing or mindfulness.
Sensitive to Certain StimuliSensory sensitivities may manifest. For example, a particular sound or place can be triggering. Creating a sensory-friendly environment, and allowing breaks in overwhelming situations can be supportive.
Appearing to ‘Not Hear You’Inattentiveness might make it seem like girls with ADHD are not listening.Use clear and concise communication, and check for understanding.
Very Talkative or Often InterruptingImpulsivity can result in excessive talking or difficulty waiting for their turn.Practice turn-taking strategies in conversations and encourage active listening techniques.
Messiness or UntidinessChallenges in organisation may lead to a messy environment or appearance. Introduce organisational tools and structured routines to promote tidiness.
Easily DistractedGirls with ADHD may struggle to maintain focus, especially on unappealing tasks like homework. Minimise distractions, break tasks into smaller steps, and provide positive reinforcement for sustained attention.
Difficulty Staying OrganisedStaying on-task and organisation can be a significant challenge for all children with ADHD.Establish clear organisational systems, including visual aids, to help with planning and task management.
Frequently Forgetting ThingsForgetfulness is common, whether that’s leaving a coat at school or forgetting about responsibilities. Again, utilise memory aids like calendars, reminders, or checklists to support memory recall.
Constantly Flitting Between ActivitiesImpulsivity may lead to jumping between activities, which can appear erratic.Encourage task completion by setting realistic goals and offering positive reinforcement.
Apparently Careless MistakesInattentiveness may result in ‘simple’ errors with homework or chores.Emphasise the importance of double-checking work and breaking tasks into manageable steps.
Lack of MotivationGirls with ADHD may struggle with starting tasks they don’t find engaging. Identify areas of interest and try to  incorporate them into tasks, to boost motivation.
Lack of Time Management SkillsDifficulties in time management may arise, leading girls to lose track of time or struggle with planning. Teach time management techniques and use visual schedules to help structure time effectively.
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Things to Remember About ADHD in Girls

Unfortunately, the gender disparities in ADHD diagnosis can make treatment, and symptom navigation, more complicated for girls. The condition is often not recognised until later in life, when comorbidities may have become more prevalent, and coping mechanisms more deeply-ingrained.

Recently, a Dutch study found that:

  • 47% of boys received medication, compared to 6% of girls, and
  • 38% of boys underwent counselling compared to 8% of girls.

As our clinical understanding of ADHD and girls develops, researchers point to several gender-based nuances that parents and carers should be aware of.

1. Hormones Make a Difference

Girls with ADHD may experience symptom fluctuations during hormonal changes, such as puberty and the menstrual cycle (or menopause, later in life).

For instance, increased oestrogen levels can influence neurotransmitter activity, affecting attention and mood. Clinicians must consider these hormonal dynamics when assessing and managing ADHD symptoms in girls.

At The ADHD Centre, we observe variations in symptom severity throughout the menstrual cycle. This can be particularly impactful for girls as they make the transition into puberty. Understanding these patterns helps us tailor treatment plans more effectively.

2. Silent Trauma May Be At Work

Girls often internalise ADHD-related struggles, leading to trauma that goes unspoken or unrecognised. It’s crucial to recognise signs of emotional distress, such as anxiety or depression, and provide a safe space for expression.

Identifying and addressing these emotional aspects is vital for comprehensive ADHD care.

For instance: imagine a teenage girl with ADHD, struggling silently with feelings of inadequacy. Regular counselling sessions can help her articulate these emotions, fostering a healthier emotional well-being; but, without that clinical recognition, the trauma is allowed to fester beneath the surface.

3. Eating & Self-Esteem Can Be Affected

ADHD’s impact on executive functions may affect eating habits and self-esteem. Girls might use food as a coping mechanism; equally, parents might notice their daughter avoiding food altogether.

Clinicians should explore the relationship between ADHD, eating patterns, and body image to develop targeted interventions.

We often work with girls to develop mindful, proper eating habits. Connecting their nutritional choices with overall well-being helps establish a healthy relationship with food.

4. Treatment Doesn’t End With Medication

While medication can be a valuable component of treatment, a comprehensive approach involves a holistic approach, including strategies such as behavioural interventions and academic support.

Clinicians collaborate with educators, parents, and mental health professionals to create a supportive environment for girls with ADHD.

From a clinical perspective, truly effective treatment extends to the school and home environments.

Accommodations, understanding, personalised learning plans, and teacher/parent collaboration, for instance, demonstrably enhance academic success for girls with ADHD.

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A More Inclusive Diagnosis

Ultimately, promoting a more inclusive ADHD diagnosis involves challenging stereotypes, raising awareness, and advocating for personalised assessments.

In brief, here’s how we can contribute to a more comprehensive understanding:

  • Gender-Informed Screening Tools: We aim to implement ADHD screening tools that consider gender-specific manifestations. This ensures a more accurate identification of symptoms in girls, preventing misdiagnosis or overlooked cases.
  • Educational Initiatives: Campaigns for parents, teachers, and healthcare professionals highlight the diverse ways ADHD can present in girls, fostering awareness and reducing stigmas.
  • Parent and Teacher Collaboration: Work toward open communication with teachers. Creating a collaborative environment ensures that observations from both home and school factor in a more accurate diagnosis.
  • Holistic Assessment Approach: A holistic assessment approach considers not only observable behaviours, but also emotional well-being, academic performance, and social interactions.

By challenging existing norms and embracing a gender-sensitive perspective, we can ensure that every individual, regardless of gender, receives the support and understanding needed for effective ADHD management.

If you think your daughter or a young female in your life may be dealing with the effects of undiagnosed ADHD, don’t hesitate to book an ADHD assessment today.

FAQs

Are ADHD symptoms different in girls compared to boys?

Yes, ADHD symptoms can manifest differently in girls. While boys often display more overt hyperactivity, girls may exhibit inattentiveness, daydreaming, or emotional sensitivity. Recognizing these gender-specific symptoms is crucial for accurate diagnosis and tailored treatment.

What are some common challenges faced by girls with ADHD in school?

Girls with ADHD may encounter academic challenges related to inattention, organisation, and time management. They might struggle with completing tasks, staying organised, and managing their time efficiently, impacting their academic performance.

How can parents and teachers collaborate to support girls with ADHD?

Open communication is key. Parents and teachers should share observations and insights to create a comprehensive understanding of a girl’s behaviour. A collaborative approach ensures that both home and school environments contribute to effective support and intervention.

What role do hormones play in ADHD symptoms in girls?

Hormonal changes, especially during puberty, can influence the manifestation of ADHD symptoms in girls. Understanding these hormonal dynamics is essential for recognizing the nuances in symptom presentation and adapting treatment strategies accordingly.

Is medication the only treatment option for girls with ADHD?

No, medication is just one aspect of ADHD treatment. A comprehensive approach includes behavioural therapy, lifestyle adjustments, and support systems. Tailoring interventions to address individual needs ensures a more holistic and effective management of ADHD symptoms in girls.

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