When asked what a child or teen with Attention Deficit Hyperactivity Disorder (ADHD) might behave like, many people might use words such as “hyper,” “full of energy,” “inattentive” or even “destructive” to describe these individuals. While this can often be the case, there are several other symptoms that sometimes go unnoticed in children and teens with ADHD, especially girls. Lack of research pertaining to females with ADHD suggest that the disorder may be underdiagnosed in girls. Why? ADHD can present differently in girls than in boys, which can also lead to a difference in the challenges that they face at school, at home or in a social setting.

What is ADHD?

Before diving into the way ADHD can present itself in girls vs. boys, it’s important to have a general understanding of what ADHD is. ADHD is a neurodevelopmental disorder that can cause problems with inattention, hyperactivity and impulsivity. According to 2022 research from the Centers for Disease Control and Prevention (CDC), the disorder affects approximately 11 percent of school-age children with boys (15%) being more likely to be diagnosed with ADHD than girls (8%). Most experts believe that ADHD isn’t less prevalent in females, but rather that the way symptoms manifest in females and the lack of research pertaining to female mental health conditions result in ADHD being missed in girls.

ADHD is categorized into 3 types:

• Hyperactive type– examples include fidgeting, inability to sit still, excessive talking and interrupting others.
• Inattentive type– trouble paying attention and/or focusing, missing details, daydreaming and difficulty finishing tasks.
• Combination type– a combination of hyperactivity and inattentiveness.

Common Symptoms of ADHD in Boys

Hyperactive and impulsive symptoms of ADHD aren’t strictly limited to boys, but it is more common for ADHD to manifest in these ways in males.

• Fidgeting or trouble sitting still
• Difficulty staying seated when instructed to
• Excessive talking
• Others may describe the child or teen as “high energy” or always “on the go”
• Often finishes others sentences, impulsively shouting out answers to questions (such as in a classroom setting) or frequently interrupting
• Difficulty doing activities quietly
• Often unable to wait their turn

Common Symptoms of ADHD in Girls

While boys often experience more of the hyperactive and impulsive side of ADHD, it is more common for girls to experience more of the inattentive symptoms. Some of the symptoms can include:

• Difficulty paying close attention to detail
• Trouble staying focused, such as listening to a lecture in a classroom setting
• Daydreaming or “zoning out” often
• Lacking follow through and/or has difficulty finishing tasks
• Poor organizational skills or time management
• Forgetfulness
• Frequently loses or misplaces items

Why Girls May Be Underdiagnosed

Researchers believe that girls may be underdiagnosed because the symptoms that they often display aren’t as noticeable as the symptoms that boys present. For example, in a classroom setting, a teacher is more likely to notice a child or teen who is constantly leaving their seat or talking over other students. This behavior is often deemed “disruptive” and is easier for other people to pick up on. It also makes it easier for parents and teachers to notice recurring patterns.

While the hyperactive and impulsive symptoms manifest outwardly, this means that the inattentive symptoms that girls with ADHD often experience manifest internally. For example, it’s much more difficult for parents and teachers to recognize when someone is daydreaming or unfocused, which means girls’ symptoms are often unacknowledged when girls are struggling. Compounding the problem, experts say that many girls with ADHD develop coping strategies to mask these symptoms, making it even more difficult for others to spot.

It’s also important to keep in mind that ADHD can sometimes be overlooked in both boys and girls if there is a coexisting mental health condition occurring at the same time. This can make it more difficult for professionals to diagnose an individual properly because symptoms of disorders, such as anxiety, can overlap with symptoms of ADHD.

What To Look For

If you suspect that your child or teen might be experiencing symptoms of ADHD, pay close attention to the issues they face at school, home or in their personal relationships.

The following are some struggles that your child or teen might experience if they are dealing with undiagnosed or untreated ADHD:

• Difficulty at school, such as lower grades, forgetting assignments or leaving due dates until the last minute
• Teachers express concern about teen often being disruptive during class, such as difficulty staying seated, constant fidgeting or interrupting during discussions or lectures
• Impulsive or “risk taking” behavior, such as experimenting with drugs or alcohol or breaking enforced rules
• Difficulty maintaining friendships or relationships
• Poor organizational skills and time management skills, such as often being late for school or extracurricular activities

What To Do Next

If you start to notice a pattern in your teen’s behaviors that coincide with symptoms of ADHD, it might be time to start thinking about the next steps to take. There is always a chance that these symptoms are not in fact ADHD, but it is always a good idea to seek help from a medical professional, especially if your child or teen is struggling at school, home or in relationships.

Some possible next steps include:

• Have a talk with your teen about what you’ve noticed. Ask your teen open-ended questions about behaviors that seem like ADHD. It’s important to make sure that your teen knows they are not in trouble and are not being criticized for their behavior. Be sure to express your concerns while also allowing your child to weigh in on the conversation. Their feedback and personal experience matters.
• Ask for teacher input. Talk to other important adults in your teen’s life, such as teachers and coaches, that could offer their perspective of your child’s behavior in other settings.
• Keep a record. Sometimes keeping a journal of problematic behaviors helps you to gain perspective on what is happening, and it will certainly help you provide examples of your concerns if you take your child to a medical professional.
• Seek professional help. The only way to be sure of an ADHD diagnosis is to get your teen tested. Talk to your pediatrician first. You could also look for psychiatrists in your area that specialize in ADHD or ask your primary care physician for referrals.
• Find a therapist. Regardless of whether your teen has ADHD or not, it still might be a good idea to look into therapy. There could be another mental health condition presenting as ADHD, such as anxiety, that needs attention. Therapy is a great way for your teen to process what they are dealing with, as well as to learn healthy coping skills and strategies.

Treatment for Teens with ADHD

Luckily, there are several treatment options if your teen is diagnosed with ADHD. The most common approach is typically a combination of Cognitive Behavioral Therapy and medication management. Other alternative approaches that may be of benefit include, elimination diets, supplements and memory training. It’s always recommended to seek professional help after your child or teen is diagnosed with ADHD or any mental health condition. This will ensure that your teen receives the best possible treatment plan catered to their needs.

Article written by guest writer, Julia Teters.