Symptoms10 October 2026 · 16 min read

ADHD in girls: signs, why it can be missed and next steps

ADHD is thought to be recognised less often in girls than boys. What the sources say about signs, why it may be missed and how to raise it in each UK nation.

Written and maintained by the ADHD Private editorial team, drawing on the sources listed at the end of this article. This is general information, not medical advice.

The NHS says ADHD is “thought to be recognised less often in girls than boys”, possibly because girls with ADHD more commonly have inattentive symptoms and these can be harder to recognise. The authors of a UK consensus statement say it is not known how often females with ADHD are missed or misdiagnosed. This guide covers what the sources say, what is not known, and how to raise a concern in each UK nation.

It is general information, not medical advice. If someone’s life is at risk, call 999 or go to A&E. Urgent help lines, including for children and young people, are under “Getting urgent help” near the end.

What can ADHD look like in girls?

The NHS’s list of signs is for children and young people in general. It says symptoms usually start before the age of 12, and that most children and young people with ADHD have symptoms of both the inattentive and hyperactive-impulsive type, while some show signs of only one.

A UK expert consensus statement (Young and colleagues, 2020) describes how ADHD may present in females. Its authors say the report provides a selective review of the research literature, plus guidance developed at a 2018 consensus meeting hosted by the UK ADHD Partnership “according to the clinical expertise and knowledge among attendees”. The authors say the meeting was funded by the UK ADHD Partnership, which has received unrestricted educational donations from a pharmaceutical company. They write that “much of the scientific literature indicates an overlap in the clinical presentation of males and females with ADHD”, but that “the available evidence often draws on predominantly male samples”.

The statement says females present with both inattentive and hyperactive-impulsive symptoms, and that inattention in girls and women may present as being easily distracted, disorganised, overwhelmed and lacking in effort or motivation. It says school reports “may comment more on attentional problems (daydreaming, distracted, disorganised, lacking in motivation and effort)” in girls with ADHD.

On 10 October 2026 we searched the NHS website, NHS 111 Wales and NHS inform pages on ADHD in children and young people, and nidirect’s ADHD page, for “girl”. The NHS website and NHS 111 Wales mention girls in two sentences; NHS inform (Scotland) and nidirect (Northern Ireland) had no match.

NHS inform says: “There isn’t a single test or checklist that can confirm if a child has ADHD or not.” NICE (England and Wales) says ADHD should not be diagnosed solely from rating scale or observational data. This guide does not include a checklist. For adult women, see our guide to ADHD in women.

Why can ADHD be missed in girls?

NICE guidelines are for health and care in England and Wales. NICE’s ADHD guideline says: “Be aware that ADHD is thought to be under-recognised in girls and women”. It then lists three points: girls and women “are less likely to be referred for assessment for ADHD”, “may be more likely to have undiagnosed ADHD”, and “may be more likely to receive an incorrect diagnosis of another mental health or neurodevelopmental condition”.

Its rationale says “no evidence was found on the increased risk of missing a diagnosis of ADHD in girls”, but that the committee “discussed the different symptoms often found in this group” and agreed to make a recommendation to raise awareness.

Other UK sources offer possible reasons for the difference in diagnosis. The NICE Clinical Knowledge Summaries site says ADHD is more commonly diagnosed in boys than girls and that this sex difference “may be due to the fact that boys present more often with disruptive behaviour that prompts referral, whereas girls more commonly have the inattentive subtype”.

The Royal College of Psychiatrists says girls “may be more likely to cover or mask their difficulties, such as by becoming withdrawn or anxious”, which “can make it more difficult to diagnose ADHD in girls”. The UK consensus statement says compensatory behaviours “may mask behaviour and impairments, and delay time to referral”.

In a UK twin-study sample of children identified as at risk for ADHD (Mowlem and colleagues, 2019; twin pairs born in the UK between 1994 and 1996), 153 children aged 7 to 12 (21% girls) met research diagnostic criteria on an investigator-rated parental interview. In that group, parents tended to rate girls’ hyperactive and impulsive symptoms lower, and boys’ higher, than the interview did. The authors say it is important to replicate the findings in non-twin samples.

How common is an ADHD diagnosis in girls?

McKechnie and colleagues, who analysed UK primary-care records, say their study captures “administrative prevalence (the prevalence of coded ADHD diagnoses)”, not “the community prevalence of symptoms meeting the ADHD diagnostic criteria”. Two primary-care studies give recorded figures for people under 18, with different databases, age ranges and definitions, so they are not a trend and not directly comparable.

UK primary care, IQVIA Medical Research Data (McKechnie and colleagues, 2023): for children aged 3 to 17, the abstract reports that by 2018 a coded ADHD diagnosis was recorded for 255 per 10,000 boys and 67.7 per 10,000 girls.
England primary care, CPRD Aurum (John and colleagues, 2026): on 30 June 2025, 2.91% of males and 1.18% of females under 18 had at least one ADHD diagnosis code or at least one prescription code for an ADHD medication.

A 2012 meta-analysis of population-based samples of children and adolescents (studies published 1994 to 2010, from several regions of the world) gives male-to-female ratios for an overall DSM-IV ADHD diagnosis from 1.9:1 to 3.2:1, depending on the diagnostic algorithm, with a higher prevalence in males under every algorithm in its table (Willcutt, 2012).

In a UK birth-cohort study (Barclay and colleagues, 2025; children born September 2000 to January 2002), girls were 20.2% of the 524 children whose parents reported that a doctor or health professional had told them the child had ADHD, and 38.7% of the 1,138 children with a high ADHD symptom score on a parent-completed questionnaire but no reported diagnosis at any timepoint up to age 14.

The authors call the second group “unrecognised ADHD”, say its lower male-to-female ratio suggests “relatively more males are being recognised”, and note that the questionnaire gave only “a broad index of probable ADHD”, so some of the group may not meet diagnostic criteria.

ADHD in teenage girls

The UK consensus statement says ADHD symptoms “may become more obvious later in females, often during periods of social or educational transition”. It adds that young people of both sexes “may be particularly vulnerable at times of transition”, and that the increased demands of the move to secondary school “may lead them to feel overwhelmed”.

In UK primary-care records from 2000 to 2018, rates of new ADHD diagnoses were “approximately four times higher in males than in females” at ages 3 to 15, falling to an approximate 2:1 ratio at ages 16 to 29 (McKechnie and colleagues, 2023).

In the abstract of a study of Welsh health records (Martin and colleagues, 2024), the mean age at first recorded ADHD diagnosis among 16,458 people born between 1989 and 2013 and living in Wales between 2000 and 2019, of whom 20.3% were female, was 10.9 years for males and 12.6 for females. That describes people with a diagnosis in Welsh health records, not girls in general or the other nations.

On hormones and puberty, we searched the NHS website and NHS inform pages on ADHD in children and young people, nidirect’s ADHD page, and the recommendations and rationale pages of NICE’s ADHD guideline, for “hormon”, “menstru” and “puberty” on 10 October 2026. None of them contains any of the three; the consensus statement above does mention puberty and hormonal changes.

Could it be something else, or as well?

The NHS says the doctor at a GP appointment “may consider other conditions that could cause these symptoms, such as autism, Tourette’s or anxiety”. NHS inform lists problems that can occur alongside ADHD in children and young people, including dyslexia and dyspraxia, anxiety, depression, autism and sleep problems, and says “difficulties concentrating can be a symptom of depression but can also be a symptom of ADHD”. Our guides to AuDHD and to ADHD and sleep cover two of these overlaps.

NHS inform (Scotland) also says a child’s symptoms and their impact “will need to be considered as part of a full assessment of their mental health”, and that this “helps to rule out other conditions which could be mistaken for ADHD”.

In the Welsh records study, females were more likely than males to receive a diagnosis of anxiety, depression or another mental health condition before their ADHD diagnosis. Its authors say the study adds to the evidence that females with ADHD are experiencing later recognition and treatment, and that this “may be partly because of diagnostic overshadowing from other mental health conditions, such as anxiety and depression, or initial misdiagnosis”.

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Raising it at school

The NHS website says to talk to one of the child’s teachers if you are worried that ADHD may be affecting them, and that an older child or teenager may choose to speak to a teacher themselves. The teacher will usually make a referral to the school’s special educational needs co-ordinator (SENCO), who can discuss support in the classroom or with homework, or help with building confidence and friendships. The NHS 111 Wales page carries these sentences too.

In Wales, a Senedd Research briefing (July 2026) says the Additional Learning Needs (ALN) system replaced the previous Special Educational Needs system. For Scotland, NHS inform says: “It may be helpful to have a conversation with your child’s school about identifying and meeting their support needs.” For Northern Ireland, nidirect’s general page on a child’s mental health, not its ADHD page, says the school “may be able to help sort out problems, provide extra support and make allowances for your child”.

On support before a diagnosis, the NHS website (England) says that while waiting for a referral or assessment, the child or young person should continue to get support at home and in school. The Senedd Research briefing on services in Wales says children and young people “should not need a diagnosis in order to begin getting support through their school or further education institution”.

In England and Wales, NICE says universal screening for ADHD should not be undertaken in nursery, primary and secondary schools, and that observations (for example, at school) “are useful when there is doubt about symptoms”. The NHS website and NHS 111 Wales say an ADHD specialist will usually contact a SENCO or teacher, or both, to see how the child is doing at school.

Raising it with a GP, nation by nation

The table sets out what the pages named in its first column say.

Nation and pages read	Where the pages say to start	Referral and assessment
England: NHS website (page reviewed 19 March 2025)	A teacher, who will usually refer to the school’s SENCO. If you are still worried or think your child needs additional support, you may want to make an appointment with a GP.	If support at home and at school is not helping, you may want to ask for an ADHD assessment: speak to a GP or SENCO about how to request a referral.
Wales: NHS 111 Wales (updated 4 July 2025); Senedd Research briefing (July 2026)	NHS 111 Wales, whose page says it was adapted from the NHS website: a teacher; if you are still worried or think your child needs additional support, you may want to make an appointment with a GP.	NHS 111 Wales says to speak to a GP or SENCO to request a referral. Senedd Research says children under 18 can access the all-Wales Neurodevelopmental pathway, and that a referral from a GP or education professional is generally required.
Scotland: NHS inform (updated 18 June 2026)	It may help to speak to the child’s teachers before seeing a GP.	There is no standard approach to assess ADHD in Scotland, and how a child is assessed depends on the area they live in. A GP cannot formally diagnose ADHD but can discuss concerns and next steps.
Northern Ireland: nidirect (no date shown)	Tell your doctor your concerns.	If the doctor thinks your child has ADHD, they may refer the child to a specialist, who may want to speak to you and to the child’s teachers.

NICE’s guideline (England and Wales) says only “a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in diagnosing ADHD” should diagnose it, and that primary care practitioners should not make the initial diagnosis in children or young people with suspected ADHD.

The guideline says to consider a period of watchful waiting of up to 10 weeks, and offering parents or carers a referral to group-based ADHD-focused support (“this should not wait for a formal diagnosis of ADHD”), if behavioural and/or attention problems suggestive of ADHD are having an adverse impact on a child’s or young person’s development or family life. If the problems persist with at least moderate impairment, it says the child or young person should be referred to secondary care (a child psychiatrist, paediatrician or specialist ADHD CAMHS) for assessment, or directly if the impairment is severe.

Private assessments. NHS inform (Scotland) says your local NHS health board or GP “may not accept the outcome of a private assessment”, and advises making sure, before you get an assessment from another provider, that they will accept it. Senedd Research (Wales) says getting a private diagnosis “also does not guarantee that someone will be able to access treatment or medication through the NHS”. The Royal College of Psychiatrists says to make sure your local NHS ADHD team or child and adolescent mental health service will accept the assessment, and that how this works “does vary between services”.

Getting urgent help

The NHS page on ADHD in children and young people says: “People with ADHD may be more likely to have mental health issues, such as anxiety or depression. They are also at higher risk of suicide.” It also says: “If you’re concerned about a child or young person, help and support is available right now if they need it. They do not have to struggle with difficult feelings alone.” We read the pages behind these routes on 10 October 2026:

England: call 111 and select the mental health option, use 111 online, or ask for an urgent GP appointment. An NHS England announcement from August 2024 says people of all ages, including children, who are in crisis, and their concerned family and loved ones, can call 111 and select the mental health option.
Wales: for urgent mental health support, call 111 and press option 2. The Welsh Government says the service is for people of all ages, open 24 hours a day, 7 days a week, and free to call from a landline or mobile.
Scotland: phone NHS 24 on 111 and choose the mental health option; NHS inform says the NHS 24 Mental Health Hub is open to all ages. For a child or young person in your care, it says to phone your GP practice or their usual mental health team if they are open, and if not, NHS 24 on 111.
Northern Ireland: call Lifeline on 0808 808 8000. Lifeline describes itself as Northern Ireland’s crisis response helpline, free and open 24 hours a day, 7 days a week, and says it provides support to people of every age.
If you are under 19, anywhere in the UK: call Childline on 0800 1111, or use its 1-2-1 chat. The NHS lists Childline for people under 19. Childline says it is open 24 hours a day, 7 days a week, and that calling is free from most landlines and mobiles in the UK and does not show up on the phone bill. It also says it can take longer to get through at night, and that if it is difficult to get through and you feel you need urgent help you can also call 999.
Anywhere in the UK: call Samaritans on 116 123, free from any phone, at any time.
Anywhere in the UK: call 999 or go to A&E if someone’s life is at risk.

The NHS website says a mental health emergency should be taken as seriously as a physical one: “You will not be wasting anyone’s time.” Another NHS page says that if you have serious concerns about how your child is feeling or acting, you may find it helpful as a first step to speak to someone you trust at school or college (for example a teacher, school nurse, mental health lead or SENCO) or a GP.

Finding a clinic

If you are thinking about an assessment for a child or young person, see our children’s clinics page.

In England, Right to Choose is one NHS route. The NHS says you can ask for an NHS appointment at a clinic, including a private clinic, if it provides ADHD services for the NHS in England. It starts with a referral: NHS England’s patient choice guidance says, “The legal rights do not extend to self-referrals or any referral other than from or on behalf of a GP, Dentist, or Optometrist.” Our Right to Choose guide explains the steps.

Sources

Sources checked on 10 October 2026.