Research suggests boys are more likely than girls to receive an ADHD diagnosis — but that doesn’t mean the condition affects more males than females. In fact, women are more commonly diagnosed with ADHD later in life — and girls may present different symptoms of ADHD from boys.
“ADHD symptoms in girls tend to be more subtle and less disruptive than ADHD symptoms in boys,” says pediatric behavioral health specialist Michael Manos, PhD. “As a result, ADHD in girls goes undetected for longer — if it’s diagnosed at all.”
Why are symptoms so often different between boys and girls? Is it because of genetics? Are there other external or internal factors at play when it comes to neurodevelopmental disorders? Or can anyone experience any of the symptoms associated with ADHD regardless of sex and gender? The numbers and the reasons may surprise you.
ADHD in children
In order to receive a diagnosis of either inattentive or hyperactive/impulsive ADHD, a child must exhibit at least six of the symptoms associated with either condition. To receive a diagnosis of a combined type, a child must exhibit at least 12 of the total behaviors. And these different types of ADHD all have different symptoms.
Hyperactive and impulsive ADHD symptoms
Hyperactive and impulsive ADHD behaviors in children include:
- Running around or climbing during inappropriate times.
- Difficulty engaging in quiet or seated leisure activities.
- Excessive talking.
- Fidgeting, squirming or restlessness.
- Leaving their seat when the expectation is to remain seated.
- Blurting out responses or finishing someone else’s sentences.
- Inability to wait their turn.
- Seeming “on-the-go,” on “auto-pilot” or “driven by a motor.”
- Interrupting other people’s conversations, activities or games.
Inattentive ADHD symptoms
Inattentive ADHD behaviors in children include:
- Being easily distracted by external stimuli.
- Forgetful when participating in daily activities.
- Daydreaming or seeming easily distracted.
- Chronically losing or misplacing items.
- Difficulty following instructions or missing important details.
- Making careless mistakes in school, sports or other activities.
- Avoiding or prolonging tasks like homework or chores.
- Trouble staying organized.
- Difficulty remaining focused on tasks and activities until they’re completed.
What’s the difference between ADHD symptoms in boys and girls?
Research shows that girls are 16 times less likely than boys to receive an ADHD diagnosis and treatment. When girls do get diagnosed, some studies indicate they’re more likely to have the inattentive type of ADHD, while hyperactivity and impulsivity are more common in boys. But other studies suggest this is actually a common misconception, and more in-depth research is needed to determine the exact cause-and-effect relationship of sex differences and ADHD.
Researchers suggest that these sex and gender differences may be partially attributed to social and cultural influences.
A growing awareness among healthcare professionals, parents and teachers about the many ways ADHD can present in children — and how the condition can look different in boys and girls — should lead to earlier detection and care.
Common ADHD symptoms in boys
ADHD symptoms in boys are often considered disruptive and, therefore, more visibly noticeable — and it’s those symptoms specifically that people look for more often when diagnosing boys with ADHD.
Because inattentive symptoms are harder to spot in general (given their internalized nature), boys who are naturally shy, quiet or follow the rules may have inattentive ADHD and still fly under the radar because they aren’t presenting what’s considered typical ADHD behavior for boys.
Common ADHD symptoms in girls
In comparison, the most common ADHD type in girls is thought to be inattentiveness. It’s more subtle and internal, unlike an external display of hyperactivity. Girls with ADHD may also be more likely to be verbally aggressive (making hurtful comments or teasing others) rather than physically aggressive like their male counterparts, notes Dr. Manos.
Teachers are ideally positioned to provide insights into a child’s academic performance and work habits, and can note patterns of inattention, hyperactivity, and impulsivity. Check out our article about how teachers play a crucial role in ADHD diagnoses .
Because of these perceived differences, parents and teachers may dismiss a young girl’s inability to focus or pay attention as characteristic daydreaming or spacey-ness.
In addition, hyperactive or impulsive behaviors in a girl may sometimes be perceived as part of an overemotional or pushy personality — rather than a sign of ADHD — no matter how wrong that perception may be.
The important thing when it comes to these sex differences is to acknowledge that many of these observations lend themselves to gendered stereotypes and what we’ve come to expect in terms of how young girls should act in today’s society. And these stereotypes may play a large part in girls being underdiagnosed for inattentive ADHD until later in life.
ADHD in girls tends to become more noticeable during middle or high school. That’s when inattentive tendencies affect a child’s ability to stay organized and on task and complete assignments on time. A young woman with undiagnosed and untreated ADHD may really start to have difficulties when they begin college or get their first full-time job.
Girls with ADHD may also be more likely to:
- Be perfectionists.
- Have anxiety, depression or low self-esteem.
- Have trouble maintaining friendships.
- Pick at their skin or cuticles or twirl their hair.
- Underachieve and get poor grades.
Final words
ADHD affects everyone a little differently. Regardless of sex or gender or ADHD symptoms or type, ADHD medications, combined with cognitive behavioral therapy (a type of psychotherapy), can help. Your child’s healthcare provider will recommend a treatment plan based on their age and symptoms.
A growing awareness among healthcare professionals, parents and teachers about the many ways ADHD can present in children — and how the condition can look different in boys and girls — should lead to earlier detection and care. And the more research we do into the field of sex and gender differences as it relates to ADHD, the more aware we can all be about embracing gendered stereotypes.If you’re concerned about your child’s behaviors or symptoms, talk to your pediatrician who can guide you to the right care.
Excerpted from “How Are ADHD Symptoms Different in Boys and Girls?” from Cleveland Clinic. Read the full article online.
Source: Cleveland Clinic | How Are ADHD Symptoms Different in Boys and Girls?, https://health.clevelandclinic.org/adhd-symptoms-boys-vs-girls | © 2024 Cleveland Clinic. Retrieved December 2024.
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