How ADHD Symptoms Differ in Boys and Girls

Think ADHD, and most of us picture a rambunctious boy fidgeting in his seat, interrupting the teacher, and disrupting classmates' play. It may be an accurate description, but it’s not the only one.

ADHD is the most common childhood neurodevelopmental disorder. An estimated 6 million American children between the ages of 2 and 17 have a current ADHD diagnosis. However, many don’t realize that the disorder can present in three distinct ways:

• Hyperactive and impulsive
• Inattentive
• A combination of inattentive, hyperactive, and impulsive

Girls are more likely to be inattentive rather than hyperactive and impulsive, which is why they frequently go undiagnosed and are left to struggle on their own. 

Board-certified pediatrician Murray Fershtman, MD, of Forest Pediatrics, with offices in The Woodlands and Montgomery, Texas, is an expert in ADHD evaluations and creating personalized treatment plans for both boys and girls.

Here’s what he wants parents to know about this disorder and how symptoms can differ between genders.

Common ADHD symptoms in boys

Boys are diagnosed with ADHD nearly twice as often as girls. This is largely because boys often display disruptive behaviors that teachers and other adults can’t ignore.

Typical symptoms in boys include:

• Physical impulsivity, such as running or climbing at inappropriate times.
• Frequent interruptions during conversations or lessons.
• Difficulty sitting still or constant fidgeting.
• Externalizing frustration through outbursts.

This disruptiveness leads to an earlier diagnosis and support.

Common ADHD symptoms in girls

Girls’ ADHD symptoms are more often internalized. Rather than physical hyperactivity, they are more likely to experience mental hyperactivity. This can look like daydreaming or trouble staying focused and is often chalked up to shyness or a lack of motivation.

Girls are more likely to struggle with:

• Difficulty following multi-step instructions.
• Frequent loss of personal items like homework or coats.
• Feeling overwhelmed by sensory input or social situations.
• Excessive talking or verbal impulsivity rather than physical movement.

Many girls adopt coping mechanisms to mask their symptoms. They might work doubly hard to appear organized, hiding their difficulties, which can cause high anxiety and exhaustion. 

The impact of late diagnosis

When ADHD goes undiagnosed, it can lead to long-term problems. If a girl or boy reaches adolescence without a diagnosis, they’re likely to struggle with low self-esteem or mood disorders. 

Dr. Fershtman's personalized treatment plans can greatly help kids with ADHD succeed in school and social settings. Each plan is individualized and may include a combination of cognitive and behavioral therapy, medications, and services to support their education. 

If you’re concerned about your child’s behavior, symptoms, or poor school performance, contact Dr. Freshtman at Forest Pediatrics today.