Why is hyperactive-impulsive ADHD sometimes underdiagnosed in girls? 

Despite growing awareness, ADHD diagnosis in girls, especially those with hyperactive-impulsive traits, remains inconsistent. Many girls are overlooked or misdiagnosed because their symptoms don’t always match the stereotypical image of a disruptive, high-energy child. Instead, they may present as talkative, emotionally intense or socially impulsive, which can be mistaken for personality quirks rather than signs of hyperactive-impulsive ADHD . 

This underdiagnosis has lasting effects. Without support, many of these girls grow into women with undetected ADHD, only receiving a formal ADHD diagnosis in adulthood when stress, academic struggles or burnout become overwhelming. This delay in care can result in missed opportunities for intervention and support. 

Why symptoms in girls are often missed 

Understanding how ADHD in adults and girls presents differently helps reduce bias and leads to better outcomes: 

• Masking and compensation 
  Girls often work harder to hide symptoms by overcompensating or mimicking peers, which makes their challenges less visible. 

• Emphasis on emotional expression 
  Emotional intensity, mood swings, or sensitivity can be signs of hyperactive-impulsive ADHD. But without context, they may be misread as anxiety or just “being dramatic,” missing the need for proper behaviour strategies. 

• Social and academic expectations 
  Girls are more likely to be praised for compliance and punished for emotional expression. This dynamic can suppress signs of ADHD while increasing internal stress levels. 

• Late emergence of symptoms 
  Many girls don’t struggle until their coping skills are overwhelmed by life changes, especially during puberty, university or early career stages. These patterns often emerge in cases of ADHD in adults. 

Building awareness is the first step toward better screening and earlier care. Mindful observation, validated tools, and mindfulness techniques can all help girls manage symptoms and improve emotional regulation. Visit providers like ADHD Certify for assessments and strategies that recognise how ADHD appears across genders. 

For a deeper dive into the science, diagnosis and full treatment landscape, read our complete guide to Hyperactive‑Impulsive ADHD .