Why girls with ADHD are often missed

By: The Neuroverse

When you think of ADHD, you might imagine a loud, energetic boy who can’t sit still. But that image often leaves girls with ADHD invisible, quietly struggling under the radar. Girls are more likely to internalise symptoms, masking their challenges as daydreaming, shyness or perfectionism. Because of this, many girls with ADHD are misdiagnosed or not diagnosed at all until much later.

Isn’t it wild to realise that most women with ADHD don’t get a proper diagnosis until they’re in their late 30s or even 40s?

Why is it that so many girls* with ADHD are either missed entirely or only diagnosed much later than boys? There are several contributing factors to keep in mind if you’re raising a daughter who might be neurodivergent.

Note: In this article, we use the word ‘girl’ to refer to individuals who were assigned female at birth.

How symptoms show up

ADHD can look quite different in girls compared to boys. While boys often present with clear signs of hyperactivity and impulsivity, girls may seem distracted, overly chatty, disorganised, emotionally sensitive or frequently lost in thought. These subtler signs are often brushed off or misunderstood.

The pressure to “be good”

Cultural expectations play a big part. Girls are typically expected to be tidy, polite and well-behaved. When they don’t meet these standards, their behaviours might be labelled as laziness, moodiness or personality traits rather than signs of ADHD.

Masking and overcompensating

Many girls with ADHD work extra hard to hide their struggles. They might put in hours of effort to stay on top of schoolwork or behave “appropriately” in social settings, which makes it harder for others to see what’s going on beneath the surface.

Less obvious subtypes

Girls are more likely to have the inattentive type of ADHD rather than the hyperactive-impulsive kind that is more noticeable in classroom environments. Because they’re not disruptive, their difficulties may go unnoticed or be dismissed as daydreaming or lack of focus. They may even be straight A students.

Other diagnoses first

It’s common for girls with ADHD also to experience conditions like anxiety or depression. These often get identified and treated first, leaving the underlying ADHD unrecognised and unsupported.

Gaps in awareness

Many teachers and parents are more familiar with the “classic” signs of ADHD, usually seen in boys. This means that girls who aren’t acting out or causing disruption might not raise any red flags.

Keeping it all in

Instead of acting out, girls with ADHD often internalise their difficulties. This can lead to low self-esteem, perfectionism and emotional overwhelm, none of which are typically linked back to ADHD unless someone is looking closely.

Reluctance to speak up

Girls may be less likely to share how much they’re struggling. Whether it’s embarrassment, fear of being judged or not knowing their experiences are unusual, this can lead to underreporting and delays in getting help.

The bottom line

Parents, educators and medical professionals need to understand that ADHD doesn’t have a one-size-fits-all presentation, especially when it comes to girls. If your daughter is facing ongoing academic, social or emotional difficulties, it’s worth considering whether ADHD might be a factor.

A proper assessment from a knowledgeable healthcare provider is key. With the proper support in place, children with ADHD can thrive, and the earlier the support begins, the better the long-term outcomes.

For more information on this topic, an interactive workshop focusing on Neurodiversity Parenting, sponsored by Old Mutual in partnership with The Neuroverse and Nutripaeds, will take place at The Forum, The Campus (Johannesburg) on Saturday, 13 September 2025. Tickets are R650 and include snacks and a light lunch, goodie bags and a chance to win practical prizes.

To book your tickets, visit www.babyyumyum.com or buy them directly on Quicket.