How ADHD Presents in Boys vs Girls
As parents and caregivers, the best for your child is always a top priority. Your child’s
growth, success, well-being, and joy in life are ultimately what really matter, but when external factors that are out of your control impede this ability, it may be confusing or even intimidating.
For children with attention deficit/hyperactivity disorder (ADHD), many questions may
arise for caregivers. Am I providing the right resources for my child? Are they just naturally full of energy? Are they able to understand what I am asking of them?
Understanding the signs, effects, and different presentations of ADHD is crucial to
allowing us to better help our children. Moreover, these characteristics can differ between our boys and girls, making it important to understand these differences to adjust our expectations and support.
What exactly is attention deficit/hyperactivity disorder (ADHD)?
ADHD is the most common childhood neurodevelopmental disorder, affecting an
estimated 6 million American children between 2 and 17. It is a condition that impacts these children’s functioning, whether in the home, at school, in public, or with friends, and is seen through a persistent pattern of certain behaviors.
As per the DSM-5 (Diagnostic and Statistics Manual), there are three types to consider
when assessing an ADHD diagnosis: hyperactive and impulsive, inattentive, and a combination of inattentive, hyperactive, and impulsive. Symptoms of the hyperactive and impulsive type may include difficulty engaging in stationary or quiet activities, interrupting or difficulty waiting their turn, and fidgeting or restlessness. For the inattentive type, symptoms may look like being easily distracted, chronically misplacing items, avoiding prolonged activities, or daydreaming. Lastly, for combination types, symptoms may present as a mix of both inattentive and hyperactive.
How is ADHD diagnosed differently in girls and boys?
Research and statistics show that boys are far more likely to receive an ADHD diagnosis
than girls – almost 16 times more likely. While sex does play a factor in the differences, this
statistic may be the result of a common cultural misconception.
In society, it is common to expect boys to be more hyper, aggressive, or overall
“rambunctious.” For girls, however, expectations are to be quieter, more reserved, and polite. These stereotypes can influence how we recognize ADHD in girls and boys, possibly causing many girls to be undiagnosed or boys to be over diagnosed. For example, girls being perceived as very quiet and reserved may actually fit the inattentive type of ADHD.
How does society shape ADHD presentations for girls and boys?
As disruptive behavior calls more attention to a child at home or in school, this leads to a
more likely diagnosis for hyperactivity and impulsive types. Moreover, as boys are already
perceived and expected to behave this way, this behavior is more likely to be recognized.
For boys who may experience the inattentive type, they are more likely to be
undiagnosed, as this behavior is rather seen as oddly shy or well-behaved for a boy and isn’t necessarily “typical behavior” for a boy with ADHD.
For girls, as they are stereotypically perceived to be more subtle, they most commonly
experience the inattentive type. Because this behavior is not considered to be “disruptive” like the hyperactivity type, it is much easier to overlook. When a girl may be perceived as just sweetly daydreaming all the time, it may actually be that she is struggling internally with attention deficits.
In addition, girls with hyperactive or impulsive behaviors may be perceived as having an
overly emotional or pushy personality, especially as they get older.
These stereotypes affect how we see, perceive, and recognize ADHD symptoms in
children. By having expectations for how girls and boys should act in society, we are more
inclined to believe common diagnoses or let some children go undiagnosed. These societal expectations can place boys and girls in boxes and impact their future in big ways.
Then are there actually differences in symptom presentations?
The answer is yes, but it is important to keep in mind that societal expectations and
standards for boys and girls have impacted the way they behave. Naturally, this has shaped
behaviors and presentations for centuries, and because of this, symptoms often do reflect these stereotypes.
For boys in early childhood, symptoms can include constant movement, difficulty sitting
still, inattention, and impulsiveness, such as acting before fully processing thoughts. As they get older, this may look like difficulty following instructions, emotional dysregulation or outbursts, oppositional behavior, and interrupting. Into and throughout adolescence, social and emotional issues and risky behaviors may develop.
For girls in early childhood, they may be more likely to be verbally aggressive rather than
physically, have low self-esteem, pick at their skin or twirl their hair, or be either “spacey” or
“chatty.” As they get older, this may develop into internalizing behaviors, like anxiety or
depression, or a greater inability to emotionally regulate. Symptoms may present in ways such as psychological disorders, academic underachievement, and social difficulties, especially if undiagnosed or untreated.
So, what should I do for my child?
There is a growing awareness among healthcare and mental health professionals of the
impacts of sex on ADHD in girls and boys. Because of this, there is also a growing body of
research to help us better understand how to recognize patterns and support our children when they need us most.
Being aware of the differences in both societal expectations and symptom presentations
for boys and girls is a big first step. Be curious about your child! Try to see challenges from a different perspective rather than the one that’s always been known.
If your child may be presenting symptoms indicative of ADHD, reach out to your
pediatrician and mental health personnel. Together we can meet your child where they are and continue the journey toward a bright future.
References
Bloomington Meadows Hospital. (n.d.). ADHD in boys: Symptoms at different ages.
Cleveland Clinic. (2024, January 10). How are ADHD symptoms different in boys and girls?
Cleveland Clinic. https://health.clevelandclinic.org/adhd-symptoms-boys-vs-girls
Duke Center for Girls & Women with ADHD. (n.d.). FAQs about ADHD in girls and women.
Duke Department of Psychiatry & Behavioral Sciences. https://psychiatry.duke.edu/duke-center-
girls-women-adhd/about-us/faqs-about-adhd-girls-and-women
Kear, N. C. (2026, September, 16). New research: Sex differences impact ADHD symptoms,
treatment efficacy. ADDitude. https://www.additudemag.com/adhd-symptoms-in-girls-vs-boys-
research/?ecd=wnl_additude_261004_cons_adhd_pro&goal=0_a767e6fc3c-ea6dac1858-
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