Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental conditions, affecting approximately 5–10% of children and adolescents. Yet, when we picture ADHD, many people still imagine a young boy who can’t sit still in class. This stereotype has contributed to a longstanding gender gap in diagnosis, leaving many girls misunderstood, unsupported, or misdiagnosed well into adulthood. Within the therapy space, teen girls report spending years wondering why focusing feels harder for them than it seems to be for their peers. Their struggles are real, but they are often hidden beneath layers of coping strategies, anxiety, and perfectionism.

Understanding how ADHD presents differently in girls is key to offering them the help and compassion they deserve.

ADHD in Teen Girls: A Hidden Presentation

ADHD is not a one-size-fits-all diagnosis. It exists along a spectrum and manifests differently depending on biology, personality, environment, and gender socialisation. For teen girls, ADHD symptoms often fly under the radar because they tend to be less overtly disruptive and have developed compensatory strategies.

Common signs of ADHD in teen girls include:

Inattention and distractibility, rather than obvious hyperactivity
Daydreaming or appearing “spaced out” in class
Forgetfulness, such as losing track of assignments, items, or plans
Emotional or rejection sensitivity and mood dysregulation
Overwhelm from balancing academic, social, and family expectations
Perfectionism and overcompensation by trying to “mask” their struggles

Because many girls with ADHD internalise their difficulties, teachers and parents may interpret their struggles as anxiety, depression, or simply “not trying hard enough.” While these conditions can co-occur, the root cause, ADHD, may go unnoticed.

Why ADHD Looks Different in Boys and Girls

Diagnostic Bias for Girls and Boys

ADHD diagnostic criteria were historically developed based on research on boys, particularly those displaying hyperactive and impulsive behaviours. As a result, girls, who are more likely to show inattentive symptoms, often don’t meet the classic diagnostic picture.

Socialisation Differences

From a young age, girls are socialised to be quiet, organised, and compliant. When they struggle with these expectations, they often turn their frustration inward, leading to low self-esteem or anxiety. Boys, on the other hand, are more likely to externalise their frustration through impulsivity or disruptive behaviour, drawing the attention of parents and educators, which may lead to earlier diagnosis and supports.

Presentation Patterns in Girls and Boys

Symptom Type	Boys	Girls
Hyperactivity	Overt – fidgeting, running, interrupting	Subtle – restlessness, talkativeness, internal agitation
Impulsivity	Acting out, blurting answers	Excessive talking, emotional impulsivity
Inattention	Distracted by the environment	Distracted by internal thoughts or emotions
Academic impact	More behavioural referrals	More quiet underachievement or “hidden” effort
Emotional expression	External frustration	Internalised shame, anxiety, and perfectionism

The Impact of Late ADHD Diagnosis for Girls

Teen girls with undiagnosed ADHD may carry deep feelings of inadequacy. They may ask themselves:

“Why can’t I focus like everyone else?”
“Why do I always forget things?”
“Why am I so emotional all the time?”

Without understanding their brain’s wiring, they may interpret their struggles as personal failures. Over time, this self-criticism can lead to burnout and anxiety. When they finally receive a diagnosis, many describe it as a moment of relief, an explanation that replaces shame with self-understanding.

Assessment and Diagnosis for Teen Girls: What to Expect

Identifying ADHD in teen girls requires a comprehensive and nuanced assessment. Because girls often present with subtler symptoms, it’s important for clinicians to look beyond surface behaviours and consider the full context of emotional, academic, and social functioning.

A thorough clinical interview
A skilled clinician will gather information about the girl’s developmental history, academic performance, behaviour at home and school, and emotional well-being. The goal is to identify patterns of inattention, impulsivity, or hyperactivity that have been present since childhood.
Multiple sources of information
Input from parents, teachers, and the teen herself is essential. Teachers may not notice internal struggles like anxiety or daydreaming, while parents may see the emotional toll at home. Combining these perspectives provides a more accurate picture.
Use of standardised rating scales
Clinicians often use validated questionnaires such as the Conners Rating Scales (teacher report, parent report, and self-report), or the Behaviour Assessment System for Children (BASC) to measure attention-related behaviours and compare them to age-appropriate norms.
Cognitive and academic testing
Psychoeducational assessments can help identify strengths and weaknesses in areas like working memory, processing speed, and executive functioning. This data is especially useful for school accommodations and understanding the girl’s learning profile.
Screening for co-occurring conditions
Because ADHD in girls frequently overlaps with anxiety, depression, or learning disorders, a comprehensive evaluation should explore these areas to ensure a complete and accurate diagnosis.
Collaborative feedback and next steps
A strong assessment process doesn’t end with a label; it includes feedback that empowers the teen and her family to understand how ADHD affects her daily life, and outlines practical supports, treatment options, and school recommendations.

Supporting Teen Girls with ADHD at Home and School

Awareness is the first step, but support must follow. Here are several ways parents, teachers, and clinicians can help:

Encourage self-awareness: Help girls understand their ADHD as a difference, not a defect.
Provide structure: Consistent routines and visual reminders can help manage time and tasks.
Focus on strengths: ADHD often comes with creativity, empathy, and problem-solving talents, which should be celebrated.
Address emotional health: Validate their feelings and consider therapy to build self-esteem and coping strategies.
Tailor academic supports: Adjustments such as extended time, use of visual and verbal instructions, or flexible seating can make a meaningful difference.

Empowering Teen Girls to Thrive with ADHD

Empowerment is not just about managing ADHD; it’s about helping girls see themselves as capable, resilient, and worthy just as they are. With the right tools and mindset, ADHD can become a source of strength rather than a difficulty.

Reframe the narrative
Teach girls to view ADHD through a strengths-based lens. Their divergent thinking, creativity, and high energy can be incredible assets in problem-solving, leadership, and innovation. Language matters, replace “disorganised” with “creative thinker,” or “distracted” with “multi-focused.”
Build self-advocacy skills
Encourage girls to speak up about their needs in school, friendships, and family life. Learning how to request accommodations or explain how their brain works can cultivate confidence and independence. Self-advocacy is a lifelong skill that promotes empowerment and self-respect.
Connect with the community
Support groups, online communities, and mentorship from older women with ADHD can help girls feel less alone. Representation matters; seeing other successful women with ADHD can reshape what’s possible.
Encourage mindful self-compassion
Girls with ADHD are often their harshest critics. Teaching self-compassion, through mindfulness, journaling, or therapy, can help them replace self-criticism with understanding and acceptance.
Celebrate small wins
Recognise effort, not just outcomes. Completing a project, keeping a planner updated, or even getting through a tough day are all successes worth celebrating. Validation reinforces motivation and self-worth.

Final Thoughts

ADHD in teen girls is not rare, it’s just under-recognised. The quieter, more internal presentation can mask profound struggles, leaving many young women feeling unseen. As awareness grows, so does our responsibility to notice, listen, and advocate.

By understanding how ADHD looks in girls, and by empowering them to embrace their unique strengths, we can help a generation of teens move from self-doubt to self-acceptance, from coping to thriving.

Is your teen struggling with focus, anxiety, or emotional overwhelm?

At Moi Clinic, our therapists specialise in supporting girls and young women with ADHD. Learn more about our adolescent therapy services or request an intake today.