What Healthcare Providers Should Look for When Diagnosing ADHD in Girls

Key Takeaways

• Nearly 7 million people under the age of 17 are diagnosed with ADHD, but girls are identified at much lower rates than boys.
• Diagnosing ADHD in girls is more challenging because they tend to exhibit inattentive symptoms instead of “classic” hyperactivity.
• Continuing education is vital for empowering frontline healthcare workers to spot, treat, and refer girls with ADHD.

With greater awareness from teachers, parents, and healthcare providers, nearly 7 million people with ADHD aged 3-17 have been identified today. However, ADHD remains highly undiagnosed and misdiagnosed, and girls and women are disproportionately affected.

In a recent study, 14% of the adult cohort was found to be undiagnosed, and women accounted for nearly two-thirds of them. Why? The answer may lie in catching it early.

Trained healthcare professionals are in prime positions to support diagnosing ADHD in girls—if they have the right training. Continuing education coursework like ADHD in Focus – Spotlight on ADHD in Girls is essential for helping healthcare workers understand the unique indicators that young girls exhibit.

What should you look for when evaluating your female patients? Here’s an overview of the unique symptoms of ADHD in girls.

ADHD Basics

Attention-deficit hyperactivity disorder (ADHD) affects executive functioning and impulse control. It is one of the most common mental disorders in children, and comes in three types:

• Predominantly inattentive. Young people may experience difficulties paying attention, staying on task, becoming easily distracted, and demonstrating increased forgetfulness.
• Predominantly hyperactive. This includes fidgeting, difficulty sitting still, moving around at inappropriate times, and other physical impulse control symptoms.
• Combination. Some people exhibit a combination of both inattentive and hyperactive behaviors.

While diagnosing ADHD in girls ultimately requires the input of mental health experts, doctors and nurses with proper training can effectively screen their young patients and refer them for interprofessional support. ADHD also tends to be easiest to diagnose between ages 4 and 12, as school experiences highlight these challenges for parents and professionals.

Regardless, many misconceptions still persist in the healthcare industry that lead to incorrect or missed diagnoses, and ongoing training is a vital tool for identifying ADHD early.

ADHD Underdiagnosed in Girls

Because boys with ADHD tend to exhibit the more “classic” hyperactive symptoms, they are often identified more easily in social settings like classrooms. Girls, on the other hand, often fall on the inattentive spectrum. As a result, behavior that results from ADHD may be more subtle and misinterpreted as forgetfulness or daydreaming.

These differences, layered with socialized behaviors like being more comfortable existing in the background with lower verbal participation, often allow these young women to be overlooked by teachers, parents, and their healthcare providers.

The subtlety of ADHD and girls, paired with an overall lack of awareness and understanding among healthcare professionals about critical gender differences, can result in delayed or overlooked diagnoses. The impact of this can be stark. People with undiagnosed ADHD may experience the following consequences:

• Social difficulties, including difficulty developing and maintaining relationships
• Academic and professional struggles
• Higher rates of depression and anxiety
• Increased risk of substance abuse

Key Signs of ADHD in Girls

When screening or diagnosing girls for ADHD, healthcare providers should be aware of the following symptoms and diagnostic factors.

Inattentiveness

Inattentiveness is characterized by difficulties in organization and time management in both daily activities that are familiar to them, as well as new activities.

Healthcare providers who notice atypical patterns of inattentiveness or “zoning out” during office visits, hospital stays, or routine interactions should consider consulting family members or interprofessional colleagues for more guidance.

Subtle Symptoms

Girls with ADHD frequently exhibit other subtle symptoms that can easily be missed. Daydreaming and distractibility experienced by girls with ADHD allow them to be easily lost in thought. They may struggle to stay on task and appear forgetful. Girls with ADHD can be seen as disorganized or having difficulty managing their time.

When younger, this could take the form of missed assignments and trouble keeping track of personal items, and as they grow older, it may expand to atypical difficulty meeting expectations and deadlines. Girls with ADHD may also experience difficulty with social cues and internalize struggles they experience at school or in their personal relationships.

Critically, diagnosing ADHD in girls requires a consistent pattern of behavior, not occasional forgetfulness that coincides with common personality or developmental issues. There are often significant academic and social consequences for their behaviors that indicate a larger mental health concern.

Hormonal Considerations

Hormonal changes in young women during puberty and menstruation can impact the symptoms of ADHD or mask them behind more superficial explanations. Anxiety, which is linked to hormonal shifts, is also often closely associated with ADHD as girls and young women manage their daily challenges amid fears of being judged by their peers and family members.

Similarly, mood disorders also often carry the same attributes as those with ADHD, and while they can be impacted by hormonal changes, the overlapping symptomology can allow healthcare providers to make assumptions in error.

Family History

Current research indicates that both genetic and environmental factors are associated with the development of ADHD. If other family members are known to have ADHD, it’s important to explore the possibility in your female patient population. Those family members may have different signs and symptoms, but we know that there is no one-size-fits-all set of symptomology when it comes to ADHD.

Becoming an Ally for Diagnosing ADHD in Girls

Girls and young women face many challenges as they develop, and undiagnosed ADHD can result in a wide range of painful consequences that extend far into the future. Fortunately, healthcare professionals are increasing their awareness every day, leading to earlier diagnoses and better outcomes.

Premiere is committed to helping healthcare providers take an active role in diagnosing ADHD in girls. Courses like ADHD in Focus – Spotlight on ADHD in Girls offer essential insights into the subtle symptoms girls and young women often present, as well as strategies for supporting their experience with the healthcare industry.

All of Premiere’s award-winning online courses for healthcare workers are created by industry experts, and make it easy to meet your professional obligations and develop your career on a timeline that matches your busy schedule.

FAQs

What are the obvious signs of ADHD in girls?

While symptoms are often subtle, pronounced and ongoing difficulty paying attention, distractedness, and inattentiveness resulting in personal and social consequences may indicate ADHD.

At what age do ADHD symptoms appear in girls?

Most girls are diagnosed between the ages of 4 and 12, but many are undiagnosed well into adulthood.

Do girls with ADHD do well in school?

For a variety of reasons, girls with ADHD may fly under the radar in school settings. And while it may impact their academic performance and social experience, coping pressures may further mask the diagnosis of ADHD in girls.