ADHD is gender-neutral.
Boys are no more likely to have it than are girls. But they are much more likely to get diagnosed. In fact, boys diagnosed with attention deficit hyperactivity disorder (ADHD or ADD) outnumber girls by roughly three to one. And this disparity is fueling a serious public health problem for girls with ADHD.
Unlike boys, who are more often diagnosed with hyperactivity or impulsivity and can draw more attention to themselves, girls tend to show fewer outward symptoms of ADHD. These differences fuel the erroneous belief that girls don’t have ADHD as often as do boys.
The truth is that traits of ADHD can look different in girls: daydreaming in class, silliness or spaciness, shyness, picking at self, perfectionism, feeling anxious or sad, forgetfulness, emotional dysregulation, and trouble keeping friends. When girls receive early and appropriate diagnoses, they will benefit from effective interventions and flourish. There is plenty of hope and promise for girls with ADHD.
The Dangers of Untreated ADHD in Young Girls
Still, it’s important for caregivers and educators to be aware of studies from the University of California, San Francisco (UCSF) that paint a sobering picture of possible outcomes, especially for untreated girls with ADHD.
Compared to young women without ADHD, those with ADHD are less likely to complete their college degrees and more likely to have unplanned pregnancies. Most concerning, especially for impulsive girls, is their potential for self-harm, which is significantly higher than for girls without ADHD.
Taken as a whole, these findings are a wake-up call for both parents and clinicians, and they underscore the fact that, even as girls with ADHD mature and appear less symptomatic, they continue to suffer silently.
As with many adverse effects of ADHD, timely intervention, diagnosis, and treatment can make an enormous impact. But, left unrecognized and untreated, symptoms of ADHD in girls can cause significant, life-long struggles. To help their daughters maximize their potential, parents must get informed, act early, and obtain necessary support services.
The following sections contain information on steps to follow to help Young Girls with ADHD cope with some of the symptoms.
ADHD Symptoms May be Diagnosed as Young as Age 4
If you suspect your daughter may have ADHD, don’t wait to seek help.
Each year without a diagnosis, she loses access to treatments that can help her gain social, academic, and self-regulation skills. As girls fall farther behind, it’s harder to catch up, making them more likely to face greater challenges later on.
Even if your daughter has a diagnosis and seems to have her ADHD symptoms under control, stay vigilant, Littman says. For many girls, internalizing symptoms like anxiety and depression blossom around puberty, as estrogen levels increase. As hormone levels fluctuate throughout the month, medications may vary in effectiveness. Even with a prescriber knowledgeable about the hormonal effects on girls with ADHD, finding the optimal regimen can take time and patience.
Be watchful for small changes in behavior, that can be subtle but rapid. A girl might be doing great when she’s 13 and a half, but at age 14, a change in her peer group can trigger emotions that can derail her. Girls are not comfortable revealing the extent of their difficulties, but a good clinician will know the right questions to ask and how to ask them in order to help girls navigate some of these complex transitions.
Build an ADHD Treatment Team that Understands Girls’ Symptoms
From conducting a thorough assessment to monitoring medication to tracking ongoing behavior-management training, your daughter’s ADHD treatment team can play a huge role in improving her well-being and long-term outcomes. The first step is ensuring she receives a thorough assessment.
A 10-minute visit with a general pediatrician is not going to cut it. Instead, parents need to find a provider experienced in treating girls with ADHD who will build an in-depth developmental history using parent and teacher rating scales, as well as family conversations. Experience with related conditions such as generalized anxiety disorder and depression is also critical.
A lot of things, including seizure disorders or maltreatment, look like the inattention and impulsivity of ADHD. Unless you rule out differential diagnoses, you may think it’s ADHD when it’s not.
Make Home a ‘Safe Place’
Research suggests that individual therapy for children with ADHD isn’t particularly effective. Nadeau and other experts agree that ADHD therapy often works best when it involves parents, particularly mothers. This can help ensure everyone in the family is doing all they can to support the child with ADHD, who may also feel less alone.
Mothers of girls with ADHD should learn how to be more supportive and less critical at home, and help them have more realistic expectations about their daughters’ difficulties with keeping an organized room organized, completing homework, and keeping track of time.
Since ADHD often can be genetic, never assume that the mother has it all together herself. Sometimes encouraging moms and daughters to help each other stay organized helps normalize the process for everyone.
Work Closely with School Staff
School is often a source of intense frustration and shame for girls with ADHD. Because girls often exhibit symptoms of inattention rather than hyperactivity, they aren’t as likely as restless, disruptive classmates to be identified and referred for help by their teachers.
Set up a meeting with your daughter’s teacher at the beginning of every school year to discuss the concerns you might have. During this meeting, explore goals for the year and how to work together collaboratively to meet them.
You don’t have to mention ADHD specifically, but describe the challenges to make [the teacher] more aware that, even though your daughter might seem passive and doesn’t participate in class, she wants to be successful and is trying her best. When you help the teacher better understand your daughter, the teacher will be more attentive to her problems and be able to offer you concrete solutions.
Promote Her Strengths
To build resilience, help your daughter find things she likes to do and at which she excels. Name and nurture her interests so she develops a sense of competency. Support her in whatever ways you can in pursuing that strength, Hinshaw says. Whether it’s playing soccer or the piano, drawing, writing, or singing, help your daughter cultivate her passion and encourage her to make time for it by carving out time in your own schedule — a signal that these pursuits matter.
This can also be important later in life when your child begins exploring career paths. Parents and school counselors must work as a team to support girls with ADHD to consider pursuing careers that play to their strengths — and interests.
The Latest Research on Girls and Women with ADHD
In adolescence, gender disparities emerge between boys and girls with ADHD. While research shows that fidgety and restless symptoms tend to subside in middle and high school, the learning gap between girls with ADHD and their non-ADHD peers often widens — and eating disorders, risky sexual behaviors, and substance use issues begin to surface.
While participants with ADHD reported average rates of high school graduation, their test scores were significantly lower and they were more likely to have failed a grade, gotten suspended or expelled from school, and dropped out of college.
For some girls, self-esteem continues to suffer and self-doubt grows. These girls are despairing, ashamed, isolated, and can’t always see a way forward. More than one-fifth of the BGALS study participants with ADHD had attempted suicide, compared to only 6 percent of the girls without a history of ADHD.
And more than half of the participants with a history of inattention and impulsivity reported that they’d engaged in moderate to severe self-harm, including cutting, burning, or other forms of self-mutilation, compared to 19 percent of typically developing young women. The risk for self-harm was particularly high among those who had symptoms of inattention plus high rates of hyperactivity and impulsivity.
In the team’s most recent follow-up, when participants’ average age was 26, they found that about 45 percent of the girls with ADHD had experienced an unplanned pregnancy, compared to 10 percent of the control group. More research of girls with ADHD, including larger studies across diverse geographies, is warranted.
Here at Neurohealth Associates, we specialize in Neurofeedback treatments. Neurofeedback may be helpful for treating ADHD symptoms, especially if you are unsure about putting yourself or your child on medication. The easy, noninvasive treatments can painlessly improve your mental health condition and outlook on life.
Schedule a consultation with NeuroHealth today and find out how we can help you.
ADDitude MagTags: add, adhd, attention deficit, behavior, clinical research, emotions, mental health, parenting