ADHD in Girls: An Undiagnosed Epidemic?

Page content

Say the term ADHD, and images of boys running wild are likely to spring to mind. And it’s no wonder, given that more than twice as many boys are diagnosed with the disorder than girls. However, experts now say the numbers don’t tell the whole story, and many warn that attention deficit disorder in girls is often overlooked.

Girls and ADHD: Missed Diagnoses

According to the Centers for Disease Control and Prevention (CDC), as of 2007, 5.4 million children in the United States had been diagnosed with ADHD. While this disorder was previously referred to as attention deficit disorder, the American Psychiatric Association now uses the term ADHD when referring to attention disorders that may or may not include hyperactivity.

For some, the use of the term ADHD may be part of the reason why attention deficit disorder in girls is often missed. ADHD implies hyperactivity and impulsive behavior, but many girls with attention disorders do not demonstrate these behaviors. The National Center for Gender Issues and AD/HD reports that many of the checklists used by pediatricians and schools tend to focus on hyperactivity which means that girls with ADHD don’t score as high as boys on these evaluations.

Rather than running and jumping, girls with ADHD are prone to be quietly distracted or daydream. Girls with attention deficit disorder may appear disorganized and careless. Instead of recognizing their ADHD, parents and teachers may think they are not intelligent or simply not trying hard enough.

Studies on the Impact of the Disorder in Girls

It has only been in the last ten years that researchers have begun seriously studying the extent and impact of ADHD in girls. One of the earliest studies conducted on the subject was published in 2002 by psychologist Stephen P. Hinshaw. A follow-up study by the same research team was published in 2006. The studies followed a group of girls from elementary school into middle and high school.

The results indicated that girls with ADHD face significant difficulties in both social interactions and academics. Specifically, there were gaps in reading and math abilities between girls with ADHD and those without the disorder. More concerning were the significant social issues that emerged for ADHD girls as the study progressed. In the 2006 report, approximately 30 percent of the girls in the ADHD group struggled with mild depression or substance abuse compared to 10 percent of girls in the control group.

A separate study by Joseph Biederman looked at how ADHD affected girls making the transition to adulthood. Published in 2010 in The American Journal of Psychiatry, the report found that attention deficit disorder in girls is associated with an increased risk for a number of other disorders as they age. These include antisocial, eating, mood, anxiety and addictive disorders.

Treatment Options for Girls with ADHD

Although ADHD manifests itself differently in girls, treatment for the disorder is largely the same for both genders. A number of medications – with stimulants such as Ritalin being the most popular – are used to provide focus and control hyperactivity. In addition, other therapies such as behavior modification and neurofeedback are often used to help children with ADHD control their impulses.

However, even when diagnosed with ADHD, girls tend to receive treatment for the disorder less often than their male counterparts. For example, the CDC reports that boys with ADHD are 2.8 times more likely to receive medication for the disorder than girls.

With ADHD having the potential to lead to lifelong mental health struggles if left untreated, it is imperative that girls be properly evaluated for attention disorders. It is important that they not only receive the right diagnosis, but also the skills needed to overcome the inattention, disorganization and stress that often mark attention deficit disorder in girls. Fortunately, a new generation of researchers is finally paying attention to girls with ADHD so those girls can, in turn, find the attention and peace of mind they need to succeed.

Disclaimer: This article is informational in nature and is not a replacement for a medical evaluation. If you believe your child may suffer from ADHD, please seek help from a trained health professional who can help you determine the right treatment options.


Attention-Deficit / Hyperactivity Disorder (ADHD), CDC (Accessed 5/12/2011)

Attention-Deficit/Hyperactivity Disorder, National Alliance for Mental Health (Accessed 5/12/2011)

Boodman, Sandra. “At Last, Attention Shifts to Girls.” The Washington Post, July 11, 2006.

Attention-deficit/hyperactivity disorder (ADHD) in children, Mayo Clinic (Accessed 5/12/2011)

Biederman, Joseph et al. (2010) Adult Psychiatric Outcomes of Girls With Attention Deficity Hyperactivity Disorder: 11-Year Follow-Up in a Longitudinal Case-Control Study. The American Journal of Psychiatry

Quinn, Patricia O. and Nadeau, Kathleen G. Understanding Girls with AD/HD - Part I, National Center for Gender Issues and AD/HD