Are ADHD symptoms different in boys and girls?

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins in childhood but often persists into adulthood. People with ADHD exhibit behaviors that are associated with impulsivity and hyperactivity, inattention, or both.

According to the Centers for Disease Control and Prevention (CDC), as of 2016, approximately 6.1 million children (9.4%) in the United States were diagnosed with ADHD. The diagnosis rate was 12.9% for boys, higher than 5.6% for girls.

The researchers noted that the difference in diagnosis rates for boys and girls may be due to differences in ADHD manifestations in girls, which may lead to underdiagnosed conditions in girls.

This article will explain ADHD symptoms in girls and boys and when to talk to your healthcare provider.

ADHD in children

ADHD is generally divided into three categories, which are:

  • Impulsive and hyperactive, such as restless, talkative, interrupted, unable to sit still
  • Inattentive type, such as difficulty concentrating, easily distracted, unable to complete tasks
  • Combination

To be diagnosed with ADHD, a person must exhibit symptoms of impulsivity and hyperactivity, symptoms of inattention, or a combination of both. These symptoms must be persistent and affect their ability to function in their daily lives.

ADHD begins in childhood, but depending on the type and severity of ADHD symptoms, it may continue into adulthood. Several studies have shown that as many as 80 percent of children with ADHD will still experience ADHD symptoms into adulthood, although this statistic varies from study to study.

Symptoms can also change over time. For example, a child’s external hyperactivity may turn into an adult’s inner restlessness.

Are the differences universal?

While ADHD usually manifests differently in boys and girls, it’s not common. There is no separate set of standards for boys and girls.

It’s important to know that these differences exist so as not to miss ADHD, but the information is representative of general trends. Regardless of gender, any ADHD symptoms should be taken seriously.

ADHD in boys and girls

Boys are diagnosed with ADHD about 3 times more often than girls, but the adult male to female ratio is closer to 1 to 1. The researchers believe this may be due to underdiagnosed girls, rather than ADHD being more prevalent in boys.

There are many possible reasons for this difference:

  • Girls tend to show symptoms of inattention, while boys are more likely to show symptoms of impulsivity and hyperactivity.
  • Girls often develop compensatory adaptive behaviors and coping strategies to mask their symptoms.
  • Girls tend to be more internal, while boys tend to be more external.
  • Girls with ADHD are often misdiagnosed with different disorders such as anxiety or depression, or miss ADHD when they have comorbidities.
  • Symptoms of inattention are more likely to occur in structured educational settings, such as in high school or college, making girls more pronounced in adolescents and young women than in children.

In general, boys with ADHD are more likely to have more disruptive symptoms and behaviors, and therefore more pronounced. Not only does this have a “squeaky wheel” effect, but it reinforces the ADHD child’s stereotype of the boy who is “moving” and constantly busy in the classroom.

Because girls with ADHD are generally less disruptive, their struggles may not be as pronounced. Daydreaming does not trigger signs that are hard to miss or ignore, such as frequent interruptions or inability to stay seated.

Even if girls do show symptoms similar to boys, ADHD may be ignored or minimized because they don’t fit the mental picture of a typical ADHD child.

Two studies were conducted in which teachers were provided with short descriptions similar to ADHD, but with different names and pronouns of the children attached to them. When there were male names and pronouns in the description, the teachers in the study were more likely to suggest that the child was referred for additional support and better suited for therapy.

Common ADHD Symptoms

girls

  • self-abasement

  • anxiety

  • poor academic performance

  • inattention

  • Need extra homework help

  • executive function problem

  • Difficulty listening

boys

  • impulse

  • Hyperactive or aggressive behavior

  • Difficulty sitting/staying still

  • talk too much

  • Interrupting others (talks, activities, etc.)

Source: Drake Institute for Neurophysical Medicine

ADHD brain vs non-ADHD brain

boy’s symptoms

While boys may exhibit symptoms of inattentiveness, they are more likely than girls to exhibit impulsive and hyperactive behaviors rather than inattentive behaviors.

Impulsivity and hyperactivity symptoms include:

  • fidgeting, clapping hands or feet, or writhing in your seat
  • Difficulty staying seated in expected situations, such as in a classroom
  • Running or climbing around at inappropriate times or places
  • Inability to play or move in peace
  • Constantly “on the road”, like being driven by a motor
  • talk too much
  • blurts out before a question is done, finishes people’s sentences, has difficulty waiting to speak in a conversation
  • Difficulty getting their turn, such as waiting in line
  • Interrupting or interfering with others in conversations, games and activities, taking over what others are doing, using other people’s things without permission, etc.

Boys and men are more likely to exhibit externalizing (extroverted) behavior and have comorbidities (co-occurrence). These can include:

  • Oppositional Defiant Disorder (ODD)
  • Conduct Disorder (CD)
  • Irregularities
  • Fighting or aggressive behavior at school
  • Antisocial Behavior Traits of Antisocial Personality Disorder (Adults)

girl’s symptoms

Girls can have both impulsivity and hyperactivity, but more often they show symptoms of inattention.

Symptoms of inattention include:

  • Lack of attention to detail
  • Making ‘careless’ mistakes in assignments like homework
  • Difficulty concentrating on tasks or activities for long periods of time, such as lectures, conversations, or reading
  • Doesn’t seem to listen when speaking, or “partitions”
  • Not following instructions and not completing (or starting but losing focus) tasks such as schoolwork, housework, or work duties
  • Organizational difficulties such as poor time management, cluttered work and life spaces, disorganized work (like homework), missed deadlines, etc.
  • Avoid or dislike tasks that require constant mental effort
  • Frequent loss of needed items such as school papers, books, cell phones and glasses
  • easily distracted
  • Forgetting common tasks like housework or, in teens and adults, running errands, returning phone calls, paying bills and keeping appointments

Girls and women tend to have built-in symptoms such as:

  • emotional problems/sensitivity
  • Somatic (physical) symptoms
  • Self-esteem and self-image issues

delayed or missed diagnosis

When girls’ ADHD diagnosis is late or missed, and support is not given, they experience repeated failures, alienation and inadequacy, which they often interpret as a personal deficit rather than ADHD. This increases the risk of developing comorbidities, such as:

  • frustrated
  • anxiety
  • sleep disorder
  • eating disorder
  • substance use disorder
  • self-abasement

Many women are only diagnosed with ADHD as adults learn more about ADHD and how it manifests in women. Some describe it as a light bulb moment, or as if they were checking off a list when looking at common tendencies in women with ADHD.

Looking back, most women diagnosed with ADHD as adults can identify childhood experiences and behaviors as examples of ADHD, even though their ADHD was not recognized at the time.

How to Identify ADHD in Women

ADHD in all genders

While researchers are increasingly understanding and interested in the differences between cisgender men and cisgender women with ADHD, there is a lack of research on people with ADHD who don’t fit this gender binary.

More research needs to be done to understand how ADHD affects all genders, not just cisgender people.

When to talk to your healthcare provider

With support, ADHD can be managed. Early access to an accurate diagnosis and appropriate treatment can go a long way in helping children with ADHD function well in childhood and adulthood.

If you or your child’s teacher notice signs of ADHD of any kind, regardless of their gender, talk with their healthcare provider to discuss next steps.

observe symptoms

ADHD symptoms, especially the inattention type, can sometimes be difficult to notice. Even if you have a child with ADHD or have ADHD yourself, you may have another child with ADHD who behaves differently.

Knowing the symptoms of the different types of ADHD can give you an idea of ​​what to look for.

generalize

ADHD is three times more frequently diagnosed in boys, but research suggests girls may be underdiagnosed. That’s because ADHD manifests differently in boys than in girls. Boys tend to be impulsive, hyperactive, and externalizing. Girls tend to have inattentive, internalized characteristics.

Because of these factors, girls are usually diagnosed at an older age than boys, usually in adulthood. Girls are also less likely than boys to be sent for support or treatment. Research is needed on the effects of ADHD on non-cisgender individuals.

What are the benefits of having ADHD?

VigorTip words

ADHD often manifests differently in girls than in boys, but knowing what to look for means you can help your daughter or struggling schoolgirl—or recognize the signs in yourself.

If you or your child shows signs of ADHD, make an appointment with a healthcare provider. Treatment and support can be provided to help people of all genders manage their symptoms.

Frequently Asked Questions

  • Is ADHD hereditary?

    Genetics is thought to play a role in the development of ADHD. About three-quarters of children with ADHD have a relative diagnosed with ADHD.

  • Do you develop ADHD over time?

    ADHD is thought to begin in childhood before age 12, but it can persist into adulthood and change over time.

    Many adults, especially women, only realize they have ADHD as adults. However, when looking back, they could identify signs of ADHD as a child.