How ADHD Presents Differently in Girls vs. Boys: What Parents Need to Know
As a psychologist who works with children and teens every day, I’ve seen a pattern that repeats itself time and time again. Parents bring in their sons for ADHD testing because they’re struggling with focus, impulse control, or hyperactivity. But when it comes to their daughters, ADHD often goes unnoticed—sometimes not until middle school, high school, or even adulthood.
Why does this happen? The truth is, ADHD in girls often looks very different than it does in boys. Unfortunately, this difference in presentation means that girls are often overlooked, misunderstood, or mistakenly labeled as “anxious” or “sensitive”—rather than being recognized for what they may truly be dealing with: ADHD.
If you’ve found yourself wondering whether your daughter’s struggles could be ADHD—or if you’re simply trying to make sense of why your child’s experience seems so different from others—this article is for you. Let’s break it down together.
The ADHD Stereotype: It Doesn’t Fit Everyone
When most people think of ADHD, they picture a young person who’s constantly moving, interrupting, and struggling to stay still in class. And while that’s one version of ADHD, it’s not the full picture. Children are diagnosed early when their symptoms—especially hyperactivity and impulsivity—are hard to miss. They might:
Get out of their seat constantly
Blurting out answers before being called on
Struggle with waiting their turn
Climb on furniture, fidget, or seem to be in constant motion
Have trouble regulating their emotions, often leading to outbursts
These behaviors tend to be noticed more easily, and it’s no surprise that teachers, parents, and even doctors are quick to recognize them as signs of ADHD. But with others—especially children assigned female at birth (AFAB) or those who do not fit the traditional gender presentation—ADHD symptoms may not be so obvious.
ADHD in Girls: The Subtle Signs You Might Miss
Imagine a child with ADHD. They’re not bouncing off the walls or making a fuss in class. Instead, they’re sitting quietly, perhaps lost in their thoughts or daydreaming. They’re polite, keep to themselves, and don’t cause disruptions. But inside? They’re struggling to keep up.
Children AFAB with ADHD are more likely to show the inattentive type of ADHD, which often means their struggles are internal rather than external. They may:
Daydream frequently and seem "spaced out"
Have difficulty following multi-step instructions
Struggle to complete tasks, even when they’re trying
Lose track of personal items like homework, water bottles, or jackets
Be overly sensitive to criticism and prone to self-doubt
Appear shy or withdrawn, rather than hyperactive
Mask their challenges by working harder than others, leading to exhaustion and burnout
Since they’re not causing disruptions, these struggles often go unnoticed. Instead of being flagged for ADHD, these children may be labeled as “unmotivated,” “lazy,” or “just anxious.” While anxiety and ADHD do overlap, it’s important to recognize that ADHD is not just about focus—it’s about how the brain processes information, manages emotions, and self-regulates.
The Impact of Late or Missed Diagnosis in Girls
By the time many children with ADHD are diagnosed, they’ve already spent years feeling like something is “wrong” with them. I’ve worked with so many young people who have shared things like:
I thought I just wasn’t trying hard enough.
I felt dumb because everyone else seemed to understand instructions easily.
I’d sit in class and have no idea what was happening, but I was too embarrassed to ask for help.
One young person I assessed broke down in tears during testing because, for the first time, someone was telling them that their struggles weren’t their fault. They had spent years being called “scatterbrained” and “too sensitive,” when in reality, their brain just worked differently. Unfortunately, this internalized struggle can lead to low self-esteem, anxiety, and even perfectionism—where kids overcompensate for their ADHD by obsessing over small details and setting unrealistically high standards for themselves.
What I See in Testing—and Why It Matters
When I conduct ADHD assessments, I often see similar patterns in female children:
Parents are surprised by how many ADHD-related struggles their child has—after all, they seem responsible and get good grades.
These children often score high in intelligence but struggle with processing speed and working memory, meaning they understand the material but have difficulty organizing and completing tasks efficiently.
Emotional dysregulation is a significant part of the puzzle. Many children AFAB experience intense frustration, anxiety, sadness, or overwhelm but don’t connect these feelings to ADHD.
This is why comprehensive testing is so important. It gives us the full picture—not just based on school performance or outward behavior—but also on how a child’s brain processes, organizes, and manages emotions. This allows us to ensure they get the support they need.
How to Support Your Child—No Matter What Type of ADHD They Have
If you suspect your child might have ADHD, the most important thing you can do is trust your instincts. You know your child better than anyone. If something doesn’t feel right, it’s okay to explore it. Here are some steps you can take:
Request an Evaluation - A comprehensive ADHD assessment can provide clarity and open the door to support for both you and your child.
Talk to Teachers - Ask them if they’ve noticed any signs of inattention, struggles with following through, or emotional challenges in class. Teachers can be key in identifying subtle ADHD symptoms.
Teach Self-Compassion - Help your child understand that their brain works differently—not worse. This understanding can foster self-compassion and a positive mindset about their struggles.
Explore Accommodations - Simple strategies like extra time on tests, checklists, or movement breaks can make a huge difference in helping your child succeed.
Validate Their Experience - Let your child know they’re not alone in this journey. Their challenges don’t define their intelligence or potential—they’re simply part of how their brain works.
The Bottom Line
ADHD doesn’t look the same in every child, and unfortunately, too many children AFAB slip through the cracks because their symptoms don’t match the traditional ADHD stereotype. But the good news is that as we begin to recognize these differences, we can provide better support for all children—no matter their gender or presentation—so they can thrive.
If any of this resonates with you, or if you’re wondering whether an evaluation might be the next step, please reach out. ADHD is about so much more than focus—it’s about understanding how your child’s brain works so they can succeed in their own way.
We offer ADHD testing in Oregon and Washington, and we’d love to help. Book a consultation today, and let’s make sure your child gets the support they deserve.
