A Must-Read About Girls With ADHD

Understanding Girls with ADHD Nadeau Quinn Littman book

Do I recommend the new revision of Understanding Girls with ADHD: How They Feel and Why They Do What They Do

Consider the opening  lines of my review on Amazon.com. After, you’ll find a personal essay from co-author Kathleen Nadeau, PhD. This longtime prominent expert on ADHD shares some of the research findings that inform the book.

This is the definitive guide from the definitive experts. A newly revised edition of the classic, brimming with expert insights and guidance.

Buy this book. Read it. Read it again. Buy another copy for anyone else who could benefit from a more in-depth understanding of the girl in your life who has ADHD (maybe the girl that was you, maybe your daughter or grand-daughter).

My female friends who’ve read this book rave about it, too, typically saying, “If only my parents had this book when I was growing up.

I had asked the book’s co-authors if I might share an excerpt of this must-read book. Dr. Nadeau responded with something even better: a personal essay.

Drs. Nadeau and Quinn rank in my Top Five of ADHD experts. I greatly respect both of these professionals not only for their tireless efforts in placing “ADHD in Females” on the map but also for being pioneering and prolific authors on ADHD in general. Ellen Littman, PhD is also well-known as a longtime clinical ADHD expert, based in New York State.

By Kathleen Nadeau, PhD

Kathleen Nadeau, PhD
Kathleen Nadeau, PhD

I was thrilled when Gina Pera, a pioneer in helping all of us to understand couples affected by ADHD, invited me to submit a posting to her wonderful ADHD Roller Coaster blog.

As an ADHD specialist, my mission has been to write about those with ADHD whose struggles go ignored.

I first focused on adult ADHD in the 80’s and early 90’s, when adult ADHD went largely unrecognized. Then, a few years later, my colleagues Ellen Littman, Ph.D., and Patricia Quinn, MD, and I came together to write Understanding Girls with ADHD.

Ours was the first book to focus on how to identify and help girls with ADHD, and what made them different from boys. At that time there was precious little research. Yet, Stephen Hinshaw, Ph.D., was in the early stages of his ground-breaking research on girls with ADHD, and more research was on the way.

Now, in 2015, we’ve written a revised and updated edition of Understanding Girls with ADHD. I’m glad to say that there is much more research to report.

A Personal Connection

My daughter received her ADHD diagnosis n 1980. She was distractible, restless, and unfocused in school, but made good enough grades to be denied any accommodations. There was no recognition of “gifted ADHD” as there was of “gifted LD.”

Now, in 2015, I have a granddaughter just diagnosed with ADHD. She’s a lovely, bright, creative 10-year-old who has been denied accommodations on a qualifying exam for a magnet program. Why?  Because like her mother, she is doing very well in elementary school thanks to her above-average IQ. There is no recognition that her ADHD will likely prevent her from acceptance into the magnet program – the very type of program that she would thrive in – because she won’t receive accommodations on the entrance exam.

So, just at the time of the publication of our second edition of Understanding Girls with ADHD, it’s clear that there is more work to be done. Due to my granddaughter’s issues, I continue to have a very personal stake in helping educators and other professionals to better understand girls with ADHD.

A Review Of Recent Research On Girls

How are girls different? Let’s take a look at what research over the past decade tells us.

Girls With ADHD:

—Have differences in brain structure compared to boys

  • The parts of the brain associated with hyperactivity were larger in girls than in boys, helping to explain why hyperactivity is less pronounced among girls.
  • The part of the brain associated with emotional regulation (the amygdala) is smaller in girls, offering some understanding of why anxiety and depression seem to be more intense in girls with ADHD.

—Show differences in brain development compared to boys

  • Girls’ brains develop earlier than do boys’ brains, leading to better executive functioning in girls than in boys around the time of puberty.
  • But because boys’ brains continue to develop after puberty, there is more opportunity for improvement in adolescence for boys than for girls.

—May find symptoms worsen at puberty, just at the time when boys’ symptoms of hyperactivity are improving

  • Because the female brain is sensitive to low estrogen states, the hormonal fluctuations that occur at puberty and during the premenstrual week post-puberty can worsen ADHD symptoms in girls.

—May be more at risk for serious mental health problems in early adulthood than are boys:

  • Research in Scandinavia, and more recently in California, demonstrates that girls with ADHD are at risk for self-injurious behavior, and later at risk for suicide attempts.
  • Females with ADHD also show a pattern of higher levels of serious psychiatric disorders in their 20’s and 30’s than males with ADHD

—Girls with ADHD tend to be overlooked if:

  • They are well-behaved and fall into the predominantly inattentive category
  • Their anxiety drives them to work hard to compensate for their ADHD
  • A high IQ allows them to easily compensate for ADHD in elementary school

Even girls showing ADHD symptoms similar to boys, are still often overlooked by a teacher; studies show that:

  • Parents and the girls themselves report significantly higher levels of ADHD than are reported by teachers
  • When girls and boys demonstrate exactly the same symptoms, boys are more likely to be referred for evaluation and support by teachers
  • Girls are much less disruptive in the classroom than are boys with ADHD, and that their symptoms are more likely to be misinterpreted as signs of anxiety or as evidence that they “aren’t trying”

Bottom line About Girls with ADHD

Research shows that girls often continue to be overlooked due to less obvious symptoms in the classroom. Yet, they are actually at greater risk than boys if their ADHD goes untreated as they pass through their teen years into adulthood. It’s up to all of us to educate those professionals that can make such a difference to our daughters with ADHD.

 —Kathleen Nadeau, Ph.D.

Director, Chesapeake ADHD Center of Maryland, Silver Spring, MD

Patricia Quinn, MD, is retired.

Ellen Littman, PhD, practices in New York City


Patricia Quinn, MD
Co-author Dr. Patricia Quinn, with Gina at CHADD’s “Lunch with Luminaries,” in 2013. Notice the brightly illuminated wall sconce by Dr. Quinn’s head; that’s how luminous she is. 🙂


Link to the Book and First-Person Essay

  1. Are you the parent of a girl with ADHD, a grandparent, or any other concerned adult? Understanding Girls with ADHD, 2nd Edition is your guide to identifying, understanding, and helping.
  2. Head here to read the candid memories of girlhood by a woman diagnosed with ADHD in her 30s.  The Late Diagnosis of an American Girl




18 thoughts on “A Must-Read About Girls With ADHD”

  1. Vanessa d’Ambrosio

    Ugh! The despair i feel…the struggle never ends, for us to understand and be compassionate with our ADHD loved ones.
    My daughter will be 30 next Monday and received her diagnosis when she was 26, while going through her own difficult divorce. It nearly broke her. Watching her struggle was devastating and triggered my own emotional responses, dealing with her ADHD father.
    The sadness i feel from not having the bandwidth to help her, as I was enduring an extremely difficult life with her ADHD father; determined to fight at every turn and leave me in a continuous state of exhaustion.
    Even though, i met Gina and was exposed to this group fifteen years ago….for me that time was like having someone throw books at you, while you’re in the middle of a category 5 – Tornado, desperately looking for something to grab onto and land safely with the hope to survive, watching the books open and the pages being ripped and strewn about by the treacherous winds swirling about me.
    I’m rushing over to pick up copies of this book, hoping to gain insight into understanding my daughter’s plight and hopefully help to ease her plight moving forward.
    Thanks for this timely article!

    1. I hear you, Vanessa. Sometimes folks are just trying to keep their heads above water.

      It shouldn’t take supreme effort to get competent ADHD treatment but the fact is: It does.

      I hope you can work with her to maximize treatment strategies. Education is important, but so is action with medication when all else has failed


  2. Pingback: The Late ADHD Diagnosis of An American Girl - ADHD Roller Coaster with Gina Pera

  3. Great to find this tonight. As my 8yo girl is taking tests at school and feel happy that her teacher push admin to give her more time with her ADHD history. Need to continue to advocate for her and spread the word.

    1. Hi Corinna,

      Good for you. Reading that book will be a great investment in your child’s future.

      Please remember that it’s not only about “advocating for” your child but also making sure your child has the tools and strategies needed to thrive in all of life, not just as school. And, that might include medication.


  4. It’s really hard to detect ADHD in girls. While boys may exhibit ADHD through their hyperactive behavior, this is not the case with girls. They may be quiet and reserved but deep inside them is equally with ADHD.

  5. Although it may have felt dismissive for the doctor to hand you a pamphlet, Ashley, they may have actually done you a favor, in a way – I mean, if their own expertise in this area is not high, you should see a psychiatrist anyway! General practitioners aren’t specialists. They know a little about a lot of common ailments, but it’s not really their trade to know a lot about every possible medical issue. If they didn’t give you a referral to a specific psychiatrist, try asking for one. Otherwise…you’re probably best off trying out a psychiatrist anyway, so shop around until you find one that you like, and who doesn’t just hand you pamphlets!

  6. Pingback: Comprender a las niñas con TDAH | Dra. Elena Díaz de Guereñu

  7. Hi Ashley,

    You were brave to self-advocate. I wish your doctor had known more and so could have been more encouraging.

    At least your doctor didn’t dismiss the idea of ADHD.

    One survey showed that most family physicians (GPs) are uncomfortable talking with patients about ADHD, because they don’t fully understand it. It falls out of their expertise.

    Some, though, make it their business to learn enough—and to try to identify psychiatrists in the community—so that they can steer patients in a helpful direction.

    Please know that anti-depressants, taken alone and without a stimulant, can actually worsen ADHD symptoms.

    I see you are in the UK. Please check out the excellent charity ADDISS, which advocates for people with ADHD. Here is their website:


    You deserve help! I’m sorry you might have to fight for it. But please try.


    1. Hi Ali,

      I bet the Kindle version will be out soon. But I’m not sure about that.


    1. Ha! Thank you, Sandra, my lovely big sister.

      I cannot take credit for this, as Dr. Kathleen Nadeau wrote this post.

      I wrote only the intro.

      We are lucky to have these remarkable women in ADHD’s corner!


  8. Hello Dr. Nadeau! I would love to meet you someday–I live just a few minutes from you now! 😀 😀 😀 I trust Gina to relate my “secret identity” to you. 😀

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