Here's a question. What if ADHD doesn't always look the way you think it does? What if in some pupils, the signs are so easy to miss that whole generations of children have slipped through the net and are 50% less likely to get the diagnosis and the support that they need? In today's episode of School Behaviour Secrets, I'll reveal why ADHD in girls is so often overlooked and what that means for the classroom. Hi there, my name's Simon Currigan and welcome to School Behaviour Secrets. I'm the kind of man who spends a lot of time weighing up the pros and cons of crinkle cut chips versus straight cut ones. I've got a decision matrix in everything. Today, we're diving into an issue that doesn't really get enough attention. ADHD in girls. For decades, ADHD has been stereotyped as a boy's problem. The kid who's bouncing off the walls, blurting out answers, fidgeting constantly, engaging in risky behaviours without considering the consequences and so on. And because of that stereotype, potentially too many girls with ADHD are being missed, misdiagnosed or misunderstood. And that's important because it means that they aren't getting the help they need to thrive in school and it affects the way they think about themselves, both personally and as a learner. So if you've ever taught a pupil, a girl who seems daydreamy, forgetful, disorganised or overly sensitive, but somehow doesn't fit the ADHD picture that you've been told to look for, then this episode is for you. And just before we get started, I've got just one re... Thank you. I really appreciate it. It really does make a difference. All right, let's jump into it. Here's the big picture. For girls, how ADHD looks and presents is different. And that difference means it often slips under the radar. In the US, the Centers for Disease Prevention and Control report that 15% of boys have received an ADHD diagnosis at some point, compared to only 8% of girls. Now that's nearly double the rate. That figure comes from the CDC's National Survey of Children's Health, which is a large parent-reported survey carried out every few years across the US. Parents are asked whether a doctor or a health professional has ever told them that their child has ADHD. So it's not based on clinical assessments, but on parents reporting previous diagnoses. It's reliable for spotting large-scale trends like the gender gap, but it can't catch undiagnosed cases. And in England, data shows that boys are diagnosed nearly four times as often as girls. And that number comes from a study of NHS population data, where the researchers looked at official medical records of how many kids were either given an ADHD diagnosis or prescribed ADHD medication. Both sets of data tell the same story. Girls are far less likely to get an ADHD diagnosis than boys, even when their difficulties are just as real. So does that mean boys simply have more ADHD? Are they more likely to have the condition? Well, no, not really. It means that the diagnostic system and the way those symptoms present are probably stacked against girls. You see, one of the biggest reasons that ADHD in girls get missed is history. The original diagnostic tools for ADHD were developed by observing how boys with the condition behaved. And when those scales and those diagnostic criteria, which are the things that doctors look for when they're diagnosing ADHD, when they were developed, the focus was on obvious hyperactive behaviours. Things like, you know, running around, climbing, shouting out, fidgeting. These became the yardstick. And because girls often present differently, usually more along the inattentive lines or having more internalised behaviour, more masked behaviours, those tools weren't built to pick them up. And that's a huge problem because it creates the illusion that ADHD is mostly a boy's condition. But here's the important bit. The latest research shows it's not that girls have lower rates of ADHD, it's that they're being missed, they're being underdiagnosed. How do we know? Well, in the UK Millennium Cohort Study, researchers compared children who met the actual ADHD symptom criteria with those who had been a formal diagnosis. And they found that boys with high levels of ADHD symptoms were way more likely to get diagnosed, but girls with the same level of symptoms were much more likely to slip through the net. So that means, right, if you put two kids side by side, one boy, one girl, same symptoms, the girl was half as likely to be diagnosed. Same struggle, completely different outcome. In other words, the difficulties were there in the girls, but they weren't being recognised as ADHD. And we also know that parents and teachers tend to underrate girls' hyperactive and impulsive behaviours when compared to boys, which means they're less likely to be flagged for assessment in the first place. And then, right, let's just chuck masking into the mix, which is where girls copy their peers, overcompensate with perfectionism, or just work incredibly hard to give the appearance that they're coping. And it's no wonder so many get missed. But the cost of that masking is huge to the individual girls. It results in real emotional damage. One study of 11 to 14 year old girls with conditions like ADHD found that those who masked were also the ones most likely to develop anxiety and depression. So the takeaway here is... it's not that ADHD is necessarily rarer in girls, it's that we're not seeing it because the way ADHD is diagnosed was built around how it shows up in boys and because girls with ADHD tend to hide or mask their struggles. And this really connects with a theme I'm quite preoccupied with right now. I'm writing a book on student dysregulation, how pupil behaviours are often misunderstood because we don't see the real pressures underneath that are driving student behaviour, and the book's still a work in progress, but this is exactly the kind of issue I'm going to tackle in it. So that's the state of the nation, but the first step to helping girls who have ADHD is to spot it. We have to know how ADHD for girls presents in the classroom. What does it actually look like? What do we look for? Not so we as teachers can diagnose it, but so we can get the right professionals involved and ask the question. Often a diagnosis starts with a teacher or a teaching assistant asking the question, well, what is driving this behaviour in class? So what does that mean for a practitioner in the classroom? Well, instead of the hyperactivity that you usually see in boys, not all the time, but usually, girls often present with the inattentive type of ADHD. So here's what that can look like in school, right? Daydreaming or zoning out in lessons, forgetting homework, PE kits or equipment, getting lost in the middle of a task, struggling to organise their work or their time or get the homework in in time, talking a lot and sometimes slightly oversharing socially with their friends and having high emotional sensitivity, things that it might look like overreacting to adults' constructive criticism or small comments from their schoolmates. And here's the kicker. Those behaviours often get labelled as personality traits instead of ADHD. We don't tend to look for an underlying cause for those behaviours, we tend to label them. We say she's just shy or she's a bit scatterbrained or she's too chatty or she's very touchy. So the underlying need never gets addressed, but we label the identity of the pupil in question. And here's where it gets serious, right? Because when ADHD in girls is missed... the consequences then snowball. There was a large Swedish study that found that girls are diagnosed with ADHD on average four years later than boys. And often by the time they're then diagnosed, they've already been treated for anxiety or depression. And that was because the underlying condition flew under the radar. In other words, the ADHD was there all along, but it was overlooked, overshadowed, and that then did emotional damage, resulting in the anxiety or depression. Now, think about what that means in real life for the girls in that study. Years of struggling academically. Years of being cast or thinking of yourself as lazy or stupid because you can't seem to stay on task or organised like everyone else. Years of eroded self. And those years matter because truth is, once a child believes I'm not good enough, it changes their relationship with school, their learning, their work, their peers and themselves. And just before we move into practical classroom strategies, I've got another quick request. If you're enjoying this episode or finding it helpful, please do me a favour, hit the subscribe button right now. And if you can, leave us a review for the podcast. It helps spread the word, spread the podcast to get this information into the hands of more educators that need to know about it. It really helps us. It's all we ask you to do. Thanks again. And by the way, if you're looking for more practical ideas and strategies to support children with SEND needs in your classroom around SEMH, social, emotional, mental health needs, we've put together something you'll find really useful. It's called the SEND Behaviour Handbook. Inside, you'll find simple bite-sized guides to common conditions like ADHD, autism, trauma and more, plus a behaviour analysis grid that helps you connect classroom behaviours to possible underlying needs like the ones we're talking about today. It's all about giving you simple, clear tools to spot difficulties early and put the right support in place. And the best part, you can download it completely free. I'll put a link to the handbook in the show notes. All you have to do is tap your podcast app and look at the episode description, scroll down and you'll see a link, or you can head directly to beaconschool.support.co.uk/send-hyphen handbook. That's beaconschoolsupport.co.uk/send-handbook to grab your copy. So let's talk solutions. What can we as teachers actually do about this? Well, first of all, we need to spot the masking. So here's a clue. If a girl always looks fine in class, but parents come to us and they say she's falling apart at home, well, that's a red flag. Kids who mask are often storing up, kind of holding back lots of emotional churn on the inside. And then when they get home, like a damn bursting, those emotions have to go somewhere when the child finally feels safe. So if a parent comes into school to tell you their daughter, when she gets home, just explodes or falls to pieces or becomes incredibly tearful or withdrawn, and you don't see that in the classroom or at school, don't just dismiss it. Listen to them because they could be sharing some useful information with you. The way she's behaving in school might be different. She might be masking her difficulties. And then that behavior looks different at home when all that emotional churn has to go somewhere. Secondly, if you do suspect a girl in your class is struggling because of undiagnosed ADHD, you don't have to wait for a label from the professionals. Now, I'm not saying go up to the girl and say, I think you've got ADHD. What I am talking about is start implementing ADHD friendly strategies for that child. So every child with ADHD is an individual. So you have to adapt what I'm going to say to the pupil in question. But for attentiveness, that might be things like reducing cognitive load. So things like simplifying instructions, stripping back the language, chunking bigger tasks into smaller steps, using visuals as reminders and repeating directions and instructions. Often what helps ADHD also helps every child in the room. And I think that's true more for ADHD than it is virtually any other condition. Thirdly, support emotional regulation. ADHD often comes with high heightened emotions. So the children that you're teaching, they kind of look like they're on a hair trigger emotionally. And that means offering predictability, safe spaces and validating their feelings rather than just dismissing them or saying the child is overreacting. And finally, build up your student's sense of self-worth.Give pupils with ADHD opportunities to shine, whether that's through responsibilities or creativity or a subject or a topic they love being able to share that subject or topic. Often, and this is true for all students with social, emotional and mental health needs actually, we tend to highlight where they're not so good, where the deficiencies are or highlight their negative behaviours or highlight the things that they've done wrong in school. But in terms of engagement and pride and success and resilience, recognition is often rocket fuel for these kids. So find a character strength they have, whether it's kindness or sharing or being supportive or an achievement that they're proud of in school or out of school or a positive action, a behaviour that you've seen your pupil engage in, like holding open a door and big that up so that they feel good about those behaviours in school or those achievements. So here's the big takeaway. ADHD in girls doesn't always look like ADHD in boys. It doesn't shout, it whispers. And if we're not listening carefully, there's a good chance that we will miss it in the classroom. But if we start spotting those signs early and we know what to look for, we can change literally the trajectory of a child's life for the good. So they experience more positive academic outcomes, social outcomes and emotional outcomes, which are key for learning success. So if today's episode gave you a new perspective on ADHD, here's my final request. Hit subscribe. Share this episode with a colleague. Because the more we understand ADHD in girls, the fewer children will slip through the cracks. And if you're working with or you know a colleague who's looking at a girl in their class and they're struggling to understand and support that child to reach their potential, they don't understand why the child keeps falling, you know, falling off task or having difficulty organizing themselves, then this might be the piece of information that they need to understand that behavior and look a little more deeply at what's going on. And don't forget to grab your free copy of our SEND Behavior Handbook. That link is in the show notes on your podcast app. Remember, all you've got to do is open the episode details and tap straight through to get your copy. That's it for today. My name's Simon Currigan. Thank you for listening and I'll see you in the next episode of School Behavior Secrets.

//otter.ai