5 Strategies to Help Clinicians Spot ADHD in Girls and Women

Attention-deficit/hyperactivity disorder (ADHD) is identified in girls and women less often than it is in boys and men. Many researchers think we may be missing diagnostic opportunities; here are 5 ways you can improve the accuracy of your ADHD evaluations for girls and women. 

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Effective ADHD Detection in Girls and Women: 5 Strategies for Clinicians

1. LOOK FOR SIGNS OF INATTENTION.
   
   1. Girls and women tend to have the inattentive type of ADHD rather than hyperactivity. They may appear to be distracted, disorganized, unmotivated, or forgetful.
   2. Daydreaming and procrastination aren’t usually disruptive in a classroom setting, so they may be easier to overlook, and harder to diagnose.
   3. Inattention can affect classroom learning and test-taking skills. For example, overlooked test items or text details can lead to errors.
2. PAY ATTENTION TO DISRUPTED SOCIAL RELATIONSHIPS.
   
   1. Some girls and women with ADHD find it comes with social communication challenges like missed social cues, a persistent sense of isolation, or social awkwardness. 
   2. Bullying can be a part of the lived experiences of girls and women with ADHD.
   3. Difficulties may increase during times of social or educational transition (Young et al., 2020).
3. BE AWARE OF INTERNALIZING SYMPTOMS.
   
   1. Internalized symptoms like low self-esteem, anxiety, and depression are a common experience and may “overshadow” ADHD characteristics, leading to  “missed diagnoses and therefore inappropriate treatment” (Morley & Tyrrell, 2023). 
   2. For some, ADHD brings higher stress, worry, and feelings of anxiety.
   3. Emotional dysregulation can also be a key feature of ADHD for girls and women.
4. EXPLORE CO-OCCURRING CONDITIONS.
   
   1. ADHD often occurs alongside other neurodevelopmental differences, and overlapping symptoms can make it harder to identify ADHD.
   2. In addition to anxiety and depression, autism, dyslexia, fibromyalgia, chronic fatigue, and eating disorders frequently co-occur in girls and women with ADHD (Young et al., 2020).
5. NOTICE POSSIBLE COMPENSATORY STRATEGIES.
   
   1. Girls and women with ADHD may use coping methods to camouflage, or mask, differences or to deal with day-to-day difficulties.
   2. Some girls and women develop highly effective workarounds that support their academic and personal success. 
   3. Others may try to self-soothe with substance use, self-harm, or risky behaviors (French et al., 2023). Asking questions about such strategies may help you identify ADHD sooner.