Is ADHD Being Missed in Girls?

By Dr. Katia Fredriksen

Imagine yourself in an elementary school classroom, watching a lesson in progress. Many students are seated quietly, facing forward, with their eyes on the teacher. You notice a few who are fidgeting, looking out the window, or trying to chat with their neighbor. You naturally worry that these students may not be attending to the lesson – and this may be true! It’s important to realize, though, that this may also be a problem for some of the students who appear to be on-task. 

ADHD, which stands for Attention-Deficit/Hyperactivity Disorder, is one of the most common behavioral disorders in children. It is a neurodevelopmental condition, which means that it starts in childhood and affects brain development, particularly in the prefrontal cortex. Symptoms of ADHD include difficulty focusing/sustaining attention (particularly on less stimulating activities), staying organized, inhibiting impulses, and regulating physical restlessness. Boys are diagnosed with ADHD almost two times as often as girls, although research suggests that ADHD affects boys and girls at similar rates. As such, many girls with ADHD are not being identified. 

Girls with ADHD often present with more subtle difficulties related to attention and organization that are not evident to the observer. They may succeed in compensating for these difficulties via their intelligence and work ethic, though this gets harder as academic demands grow over time. Even if these students start to fall behind academically, they are often misdiagnosed, most commonly with anxiety and/or mood-related issues. While these girls may be in fact be experiencing emotional difficulties, the cause may be rooted in their undiagnosed and untreated ADHD. 

If you suspect that your daughter may have ADHD, I encourage you to consult with an appropriate professional (e.g., meet with your pediatrician or with a therapist, seek out a neuropsychological evaluation). Also, speak with your daughter’s teacher, to ask about the sorts of subtle issues that may be occurring in the classroom, and speak with your daughter herself, to learn more about her experience. Once a diagnosis is made, a treatment plan can be put in place to support your daughter at school, at home, and in other settings. 

Remember that while difficulties with attention, hyperactivity, and impulsivity can result in challenges, there are also advantages to having a different thinking style. Individuals with ADHD are often excellent at creative, out-of-box thinking and at passionately pursuing preferred topics and activities. In addition, they are generally more spontaneous and willing to take risks, and they can be very resilient. Many famous athletes, entertainers, and entrepreneurs have spoken about how their ADHD has helped them on their journey. Different thinkers can and do make wonderful things happen!  

Katia Fredriksen is a clinical psychologist at the Stixrud Group. Dr. Fredriksen can be found on Instagram sharing evidence-based information @neuropsychmoms.