A Must-Read About Girls With ADHD

Understanding Girls with ADHD


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

Here are the first few lines of my review on Amazon.com—followed by a personal essay from co-author Kathleen Nadeau, PhD, a longtime preeminent expert on ADHD, sharing some of the new research findings that inform the book.

Gina writes on Amazon.com: 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 leading 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. Dr. Littman is also well-known as a longtime clinical ADHD expert, based in New York City.

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 blog.

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

I first focused on adult ADHD in the 80’s and early 90’s, when adult ADHD was 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 that focused on how to identify and help girls with ADHD, and what made them different from boys. At that time there was precious little research, but 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, and I’m glad to say that there is much more research to report.

A Personal Connection

My daughter was diagnosed with ADHD in 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, a lovely, bright, creative 10-year-old, who has been denied accommodations on a qualifying exam for a magnet program 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.

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.

Girls’ ADHD symptoms may 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.

Girls with ADHD 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 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:

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
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. 🙂


Gina Adds:

Are you the parent of a girl with ADHD, or a grandparent or any other concerned adult? Understanding Girls with ADHD, 2nd Edition is your guide to identifying, understanding, and helping.

Even after all these years, more advocacy work is needed to educate another generation of teachers.

Get a copy of Understanding Girls with ADHD, 2nd Edition for yourself and one for your daughter’s teacher!

Understanding Girls with ADHD


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

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

  2. 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.


  3. 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.

  4. 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!

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

  6. 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. 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!


  7. 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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