ADHD Weekly, January 15, 2026

Ask the ADHD Information Team

Question: My daughter struggles with executive functioning. She’s bright, but her grades don’t reflect her abilities. She often falls behind at school, becomes overwhelmed, and shuts down under stress—especially during exam weeks when everything is due at once. I’ve long suspected ADHD, but the most her doctor says is that her difficulties are from anxiety because she doesn’t act like her brother, who was hyperactive and impulsive and received a diagnosis at age six. I’ve read that ADHD looks different in girls and that this affects diagnosis rates. Can you explain why?

Difference in symptoms

Information Team: You are right that girls sometimes go many years, and often until their teens or adulthood, without a diagnosis. A national survey of parents found that 11.4 percent of children in the United States had ever been diagnosed with ADHD. The diagnosis rate was higher for boys (15 percent) than girls (8 percent).

This may be because boys are more likely to show hyperactive or impulsive symptoms that are easy to see, such as jumping off playground equipment or blurting out answers in class. Girls often have the inattentive type, exhibiting symptoms like poor working memory, inattention, and poor time management, which can go unnoticed by teachers and parents. Because inattentive symptoms are internalized and less disruptive, girls may silently struggle in school and often work twice as hard to keep up with their peers.

An ADHD research expert weighs in

The research on the gender gap, and what we have learned from it, is important to understand. We talked with Margaret H. Sibley, PhD, a member of CHADD’s professional advisory board who has focused much of her work on teens and young adults who have ADHD. She is an associate professor of psychiatry and behavioral sciences at the University of Washington School of Medicine and Seattle Children’s Research Institute.

Dr. Sibley: You are right to point out that one differential diagnostic question [making sure the right condition is identified] might be ADHD versus anxiety in a child who is presenting with executive functioning overload relative to the demands being placed on them by their school—particularly in a child who seems adequately motivated and invested in doing well. Providers also may be assessing whether the demands placed on your daughter by the school are a good developmental fit.

However, given the genetic risk in your family, it is possible that ADHD symptoms that are independent of anxiety are also contributing to the executive functioning challenges you are noticing in your daughter.

You’re correct that ADHD historically has been diagnosed at lower rates in girls than boys. Because girls have historically been underrepresented in ADHD research, there is still limited evidence about which behaviors or experiences best indicate ADHD in girls. Some doctors without specialized training in recognizing the inattentive subtype of ADHD may fail to catch girls (as well as inattentive boys) who are struggling. But girls and women may have later-onset impairments. This means that some women who later receive an ADHD diagnosis did not experience or show difficulties challenging enough to qualify for diagnosis until young adulthood (even if they showed some early signs).

The trouble is the majority of kids with some signs of ADHD do not go on to meet criteria for the diagnosis when carefully evaluated. Families should also know that research suggests that genetic risk for ADHD may show itself differently in females, with some protective effects that can influence when and how symptoms emerge. This means that some girls and women with ADHD will have the same ADHD-risk genes as their brothers, but won’t ever show a diagnosable version of ADHD.

There is a meaningful portion of the population that has some ADHD-like tendencies without meeting criteria for the clinical diagnosis. As a field, the medical community has to be careful not to over pathologize [treat as a medical problem] lower levels of everyday human traits, like how well one pays attention or how organized they are with their stuff.

Ultimately, the most important thing is that your daughter gets the support she needs to live a happy and healthy life. Working with a mental health provider who can help her apply organization, task management, and planning strategies, as well as making sure she is in a school that is the right fit for her, could be beneficial regardless of whether she has a formal diagnosis (and whether that diagnosis is ADHD, anxiety, or both).

Do you have a question about ADHD or are you looking to find support from professionals or peers? Call CHADD’s ADHD Helpline, Monday-Friday, 1-5 PM ET, at 866-200-8098. Or email us at Customer_Service@CHADD.org, subject line For Health Information Team.

Read more about girls and women with ADHD

• ADHD in Women and Girls
• Girls With ADHD Internalize Struggles
• How the Gender Gap Leaves Girls and Women Undertreated for ADHD
• Principles for Parenting a Girl with ADHD