Girls with ADHD often appear as daydreamers, rather than troublemakers. Maybe that's some reason why their ADHD condition remains undetected. Here you read about what characterizes girls with ADHD, and why it is important to identy and support these girls.

Image: Dreamstime (with licence)


 

ADHD is a developmental disorder with core symptoms that include poor ability to concentrate, hyperactivity and difficulties related to impulse control. According to the US diagnostic system, there are several subtypes of ADHD; where, among other things, it is possible to get the diagnosis even without hyperactivity and difficulties with impulse control. Then we like to talk about ADD, or about "ADHD inattentive type."

What is ADHD?

ADHD Norway writes:

ADHD stands for Attention Deficit Hyperactivity Disorder. The symptoms can in most cases be understood as a neurological disorder which primarily involves hyperactivity, impulsivity and difficulty paying attention. ADHD is referred to as a condition, not a disease.

 

Girls also have ADHD

ADHD is not something that only affects boys, although it is often the hyperactive, unconcentrated and "behaviorally difficult" boy many associate with the ADHD diagnosis. Doctor Patricia Quinn tells in an article on American WebMD:

Boys with ADHD often have behavioral problems, and a main theme with their ADHD disorder is therefore often how this affects others.

In girls, a main theme is rather how the disorder affects themselves.

Precisely the fact that the symptoms are expressed in slightly different ways can be an important reason why ADHD has traditionally been understood as a disorder that primarily affects boys. New research findings suggests that girls to a far greater extent than previously thought may also have ADHD.

Knut Halvar Bronder writes about this problem:

We most often associate the ADHD diagnosis with boys and adults. 25 years ago it was said that there were 9 boys for every girl with ADHD, today the ratio is more 3: 1. One of the reasons why more women are diagnosed is an increasing focus on the difficulties women with ADHD face.

  

Different types of ADHD in girls

The following descriptions of girls with ADHD are based on information from ADHD Norway, and are reproduced in a blog post from a woman who writes about life with ADHD. There are descriptions that can help to make visible the different variants of ADHD as the diagnosis appears from the DSM system. 

 

ADHD combined type (hyperactivity, impulsivity, inattention)

 

  1. Restless and fussy 
  2. Sits restlessly on the chair, twists his hair, chews gum, bites nails 
  3. Often hyperverbal 
  4. Low tolerance threshold for frustration 
  5. Can seem irritable and negative, and quick to blame others if something is wrong. 
  6. Forgetful and poorly organized 
  7. Says things without thinking about it 
  8. Feel that they are not able to perform their best 
  9. Have many projects running at once.

 

ADHD hyperactive / impulsive type

 

  1. Noisy, overactive, loud, worn out and seeking a lot of attention. 
  2. Daring and prefer to play violent games with boys than with other girls. 
  3. Aggressive, strong-willed and responds with strong emotions. Typical "boy girls" 
  4. Schoolwork and handwriting are often in a hurry. 
  5. So-called "mouth diarrhea", ie uninterrupted and fast chatter, without letting others get into the conversation. 
  6. Great social activity, interruption of others in the middle of a conversation. 
  7. Abnormally large thought activity 
  8. More predisposed to substance abuse problems than others. 
  9. Lack of impulse control 
  10. Coordination problems 
  11. Thrill seeker

 

ADHD inattentive type

 

  1. The daydreamer girl sitting at the back desk of the class and looking out the window 
  2. Behaves nicely and does not break with the expected behavioral norms 
  3. Passivity, shyness 
  4. Inability to concentrate on what is happening 
  5. Therefore struggles with school work and other concentration work 
  6. Perceived as lazy 
  7. Forgetful and messy 
  8. Struggling with anxiety and poor self-esteem

 

Less extravagant behavior in girls than boys with ADHD

In a meta-analysis of gender differences in relation to ADHD, the authors conclude:

Gender differences were not found in relation to impulsivity, school performance, social functioning, fine motor skills, parenting skills than depression in parents.

In contrast, compared with boys with ADHD, girls with ADHD had a greater impairment in intellectual abilities, lower levels of hyperactivity, and a lesser degree of externalized (outspoken) behaviors.

In other words, there is good research evidence to say that there are some clear gender differences in how ADHD disorders are expressed - and it is very important that girls with ADHD often have less behavioral problems than what is often seen in boys with ADHD.

However, some girls with ADHD may also have extravagant behaviors. Each person must be considered for themselves, also when it comes to girls with ADHD.

 

Daydreamers rather than troublemakers

The article on WebMD goes on to say:

Instead of being troublemakers, girls with ADHD tend to be daydreamers.

A common statement that parents of girls with ADHD hear, for example from the teacher, can therefore be:

Your daughter is happy to do what she is told, but she has difficulty keeping up, keeping focus on the work, and completing work, says PhD Michael Manos in the mentioned article.

Girls with ADHD often have a normal level of ability, but often perform worse academically than what they are good at in terms of ability. At the same time, it is in fact not guaranteed that the girls with ADHD get directly bad grades. Patricia Quenn says:

They compensate. Parents can actually avoid acknowledging that it is a problem, but the girls themselves experience that they need much more help than anyone else, and they actually experience being different. 

 

Not always as unconcentrated

PhD Dave Anderson points out in the article on WebMD that it is important to know that difficulty concentrating does not mean that you are unfocused all the time. At some point, a girl with ADHD may be very concentrated. He tells:

Parents often see that the child is able to stay focused on certain activities such as playing video games or chatting with friends, and they can assume from this that the child cannot have ADHD.

We look at the child's ability to stay focused during tasks they find boring or that require a lot of effort, and then how this affects their daily functioning.

The fact that concentration difficulties are not always visible is also the case in boys with ADHD. The concentration difficulties seen in people with ADHD rather mean that it requires much more energy to do tedious or thought-provoking tasks for those with ADHD than for those without. Some neuropsychological tests are then precisely about measuring the ability to concentrate in boring, repetitive tasks - and then the concentration difficulties quickly become visible.

 

Mental health problems in girls with ADHD

Although it is most common to diagnose boys with ADHD, this does not mean that girls are less bothered by the condition. Some studies show that girls may actually be more bothered by the ADHD condition than boys. In particular, they are more likely to develop anxiety, depression, and low self-esteem, according to the WebMD article. It is confirmed in a meta-analysis that Girls with ADHD have more internalized difficulties than boys with ADHD.

Michael Manos explains:

A girl without ADHD may be worse at playing volleyball than other girls, but that does not mean that she necessarily concludes that there is something wrong with her. Girls with ADHD, on the other hand, tend to be more self-critical.

As a result of the widespread tendency to self-criticism, sequelae such as self-harm, eating disorders, and even suicide attempts may be more common in girls with ADHD than in girls without the disorder.

 

To be diagnosed with ADHD in girls

Because ADHD in girls is a condition that can create many and serious difficulties, not least with regard to mental health, says Patricia Quinn:

Getting a diagnosis is important even if your child is able to compensate for the difficulties.

In the article on WebMD they write:

There is no single test to diagnose ADHD, and the symptoms can be difficult to distinguish from normal behavior in children. If you think your daughter has ADHD, it is important to find a doctor or professional who has experience diagnosing this condition, especially in children. 

They mention that it can be useful to discuss with a child group, or with a child psychiatrist or psychologist. Capturing the symptoms will require expertise from the investigator, not least because the symptoms at first glance may be less noticeable than in some boys with ADHD. 

 

Differential diagnostics and comorbidity

Even if a girl has many symptoms of ADHD, it is important with a thorough mapping, to assess whether the symptoms may have other explanations than ADHD (differential diagnosis) and to what extent there may be additional difficulties (combo). 

 

Sources

Cite this article

 

Feel free to use information from this article on your website, but remember to add a link.

 

Written by

ove heradstveit

Ove Heradstveit

Psychologist, specialist in clinical community psychology. PhD.
 Facebook -  Twitter -  Scholar
- Helpseeker.net 

Read more about ADHD