Currently, boys are diagnosed with ADHD at a ratio of 4:1 to girls, while the gender bias in regards to ASD diagnosis is similar if not slightly higher.
However, now there is increasing research which shows that these conditions are as likely to affect girls as boys. This has lead to the awareness that ADHD and ASD can actually present differently in girls.
Due to the differences in presentation, girls are more likely to be diagnosed with ADHD or ASD much later in life than boys.
ADHD in Girls
One reason ADHD is more likely to be picked up in males early is that boys are more likely to act out, be aggressive and hyperactive than girls. These problem behaviours bring their issues to the attention of teachers and parents sooner, which can lead to closer examination of causes and subsequent assessment.
Girls are more likely to show signs of “inattentive” ADHD. Symptoms are typically less obvious and may include:
- Low-self esteem
- Difficulties with school work
- Inattentiveness or tendency to daydream
- Being withdrawn
- Being excessively “chatty”
Many of these symptoms could be written off as a girl being flighty, immature or needing to “apply herself better” to her school work rather than there being a deeper underlying issue.
ASD in Girls
When thinking of someone with autism, the mind automatically jumps to a stereotypical character such as Sheldon on the Big Bang Theory, who exhibits social awkwardness and rigid behaviours.
However, girls are more likely to be better at masking their behaviours in order to fit in. This can lead to emotional strain with subsequent anxiety, depression or self-harming.Here are some other traits common in girls with ASD:
- A special interest in animals, music, art, and literature (might show signs of hyperlexia)
- Strong imagination, might escape into the worlds of nature or fiction
- A desire to arrange and organise objects
- Not identifying with or wanting to play cooperatively with female peers (e.g. might want to dictate the rules of play or prefer to play alone in order to maintain control)
- A tendency to “mimic” others in social situations in order to blend in
- Often displaying strong sensory sensitivities, especially to auditory and tactile input (e.g. clothing tags, socks) (source)
As with boys, there are shared traits in females across ASD and ADHD. This includes an ability to hold their emotions in check at school, but being prone to meltdowns or explosive behaviour at home. This can lead to parents being aware of problems but finding it hard to get evidence from school or other carers to support the need for diagnosis.
Mother of 2, Lynette shares her experience in trying to get a diagnosis for her daughter:
“I had always known my daughter was “different” – very talented at drawing, very smart at school (early teachers even threw around the term “gifted”) – but her problems in dealing with people, situations and seemingly innocuous things made me question whether there was something else going on. Visits to two different child psychologists (at ages 5 and 7) left me perplexed – I raised the possibility of autism and was told that as she could hold eye contact and have a conversation, she was not autistic. The best they could tell me was that she “angered easily” and had trouble regulating that, so I needed to keep her calm.
It wasn’t until she was 11 that a third, very savvy, psychologist said my daughter had very definite signs of high functioning ASD. Now, at the age of 12, we are finally halfway through getting a proper diagnosis.
She has always felt “different” – but now she can see that there is a reason. Hopefully an ASD diagnosis will give us the key for the door to help so her life isn’t such a struggle.”
Unfortunately, Lynette and her daughter’s experience isn’t an isolated case.
Hopefully the growing body of research around how ADHD and ASD presents in females will help change the lives of future generations of neurodiverse girls.