The Gender Divide in ADHD

Studies indicate that 5% of children have Attention-Deficit/Hyperactivity Disorder, otherwise known as ADHD.   Although the name of the neurodevelopmental disorder has changed over the years (i.e., past names included hyperkinetic impulse disorder, minimal brain dysfunction, and ADD), the key symptoms involve significant challenges with inattention, hyperactivity, and overall behavior dysregulation that results in impairment across multiple settings and is developmental in nature (symptoms must be present prior to 12 years of age).  Weaknesses with executive functioning skills often co-occur in ADHD, as do behavioral challenges, anxiety, and depression.

Of note, according to the CDC boys are far more likely to receive a diagnosis of ADHD, in fact two times as likely.  What might account for this diagnostic discrepancy?  Psychologist Dr. Stephen Hinshaw at UC Berkley states, “We were initially taught that ADHD is a boys phenomenon.  Three decades later we know this is an equal opportunity condition.”  The reality is that symptoms of ADHD present differently in girls versus boys.  In general, symptoms in girls can present as more subtle and do not match the stereotype of a child with ADHD who is fidgety, running or climbing around uncontrollably, or acts like they are “driven like a motor.”  Females with ADHD often attract less attention in the classroom, as they frequently daydream or are easily distracted rather than engage in behavioral disturbance which can draw the attention of teachers.  Instead of showing the traditional signs of hyperactivity, they may present as overly talkative or more easily reactive.  Yet there is a significant cost for not diagnosing girls with ADHD, as they often experience academic underachievement, loss of self-esteem, and heightened mental health concerns such as depression, anxiety, and eating disorders.  Additionally, girls often blame themselves for problems associated with ADHD.  Girls with ADHD often experience social challenges as well, as they may not be as self-controlled or tune in to social dynamics.  Dr. Kathleen Nadeau, director of the Chesapeake Center for ADHD, notes that being unable to fit in, or perform up to girl-code can make them a target for mean girls and leave them isolated and confused.  Girls may hide behind a façade of having everything under control but inside may feel overwhelmed.  They may compensate by becoming hyper-focused on areas of their life where they feel they do well, yet in the process neglect expectations to turn in a homework assignment, feed the cat, or clean their room.

ADHD affects both boys and girls, and the lens we use to view potential symptoms may be distorted based on our preconceptions of what ADHD is “supposed” to look like.  Diagnosing ADHD accurately and as early as possible is critical in order to provide appropriate supports, treatment, and demystify the underlying cause of a child’s struggle.

If you have concerns about possible symptoms of ADHD in yourself or your child, contact us to schedule a consultation.

How Girls With ADHD Are Different

ADHD In Girls: What You Need To Know

ADHD or ADD in Girls: Why It’s Ignored, Why that’s Dangerous