Which girls and which women come to the doctor for ADHD?

ADHD in females will often present itself in different ways than in males.  Recognizing and knowing the differences between each type of ADHD can help it to be correctly identified in children and adults whether they are male or female. Let me share with you some of my experiences.

Elementary School Years

Young girls in elementary school are more often quiet and inattentive than their counterpart boys. ADHD in boys is often more noticeable because they are disruptive. By age ten or eleven, in later elementary school grades, problems surface because homework now becomes a struggle; i.e. two or more hours to finish a twenty-minute assignment is fraught with yelling and tears. Even if the child is getting an average grade on tests and the teacher does not see a problem, a trend is developing that sets the tone for more difficulties ahead in middle school. Sustained attention has become a problem.

Middle School Years

By middle school the gap between girls with ADHD and their counterpart widens. With multiple classes, more activities in and out of school, the teen girl’s ability to manage time efficiently and to keep organized may worsen. As a girl’s appearance outwardly changes and menstruation begins, an inward spiral towards mood control worsens.  Time management, running late, organizational problems, losing things such as homework, shirts, shoes, cell phones, etc. become more apparent. Self image, confidence and esteem start trending down. Family members might observe a more angry and irritable girl and explain this as an adjustment to hormone changing. Reaching a correct diagnosis of ADHD requires a broad assessment from open minded and informed parents, teachers along with optimal measuring tools; rating forms and testing.

High School Years

High school girls may present with a decline in grades from middle school. Some that were “A” students may become “C” students. This may be the first time school performance becomes difficult. Why?  Some girls are more distracted in class. Some prioritize things other than schoolwork such as boys. Some refuse to follow good sleep habits and go to school exhausted and unable to learn. At this point in their life some girls willingly want medicine to improve their attention and academics. These girls may be open-minded to work with a doctor to find the best medication with the least side effects and best benefit for problems of attention, focus, distraction, impulse control, etc.

During their teenage years many girls wander into murky waters, tying their self-esteem to sexuality and peer group rules. Untreated girls with ADHD often lack the self-esteem that allows for good decision making. Impulsive decisions may lead to poor consequences. For this reason teenagers with ADHD/ADD have been found to be the most high-risk drivers on the road. A motor vehicle accident may occur if attention is diverted.

College Years

In college a common concern is difficulty completing assignments on time. Here, the school setting is so different from home or high school.  Students must work within a schedule and adjust to changes efficiently. Poor time management skills go hand in hand with impulsive behavior. For students with ADHD activities of high interest take priority over activities of importance; i.e. dorm parties or late night pizza with friends and drinking alcohol. This kind of behavior prevents completing course work successfully. In college, it is unlikely professors will reach out to students and suggest that they get evaluated for ADHD. A girl with a strong sense of self-esteem is more decisive with her behavior including her sexuality, dating, and school performance. Managing time efficiently, wise decision making and preventing complications from impulsive behavior are benefits that come from proper treatment of ADHD.


As women advance into a career, in the home or out, they are faced with managing more and more responsibilities and choices. Untreated ADHD can present itself as either multiple failures to manage a job, romance or family. Life becomes an exhausting task of “working twice as hard for half as much” even if you can keep every responsibility in order. Romance fades, intimacy is lost, parenting, marriage and career become more and more difficult to maintain.

Anxiety and a sense of inadequacy may evolve into depression. The decision to begin antidepressant treatment may overlook the root cause of ADHD. A step wise approach to making a better treatment plan must begin with a clear history; one that identifies the core features of selective difficulties with attention, motivation and impulse control. Most women never present with hyperactivity and exclude themselves from conveying important information that helps the doctor make a correct diagnosis.

Women with ADHD often display common core features of ADHD over the development from childhood to adulthood. Each person is unique and because of that each person with ADHD will present it slightly differently depending on his or her personality and experiences in life. This can make ADHD difficult to properly diagnose in some cases. One tool that myself and many other doctors around the country are using to accurately test for ADHD in our patients is the Quotient® ADHD System. It is an objective, non-invasive, computer-based test and is the first FDA-cleared objective test for ADHD. The Quotient test takes 15 minutes for children under 13 or 20 minutes for adolescents and adults, and is conducted right in the doctor’s office.

If you are a female and any of the stories I have shared in this article sound familiar you should seriously consider getting tested for ADHD.  To find out more about the Quotient ADHD System and the doctors who are using it visit my website at www.drrobertkohn.com or visit BioBDx.com.

adhdRobert G. Kohn D. O.

Kohn Integrated Medical Group

McHenry, IL


Dr. Kohn is trained in adult psychiatry and neurology since 1993.  He is board certified in adult neurology completing training through West Virginia University, University of Missouri-Columbia and Chicago Medical School. He has trained in Brain SPECT imaging through a mini fellowship at the University of Illinois-Chicago. He is subspecialty certified in Behavioral Neurology and Neuropsychiatry and frequently lectures locally and regionally on ADHD and Traumatic Brain Injury. He is an associate clinical professor of radiology at UIC.

His outpatient practice evaluates children and adults using a comprehensive integrative bio-psychological-social model. He includes quantitative behavioral-based computerized testing with the Quotient ADHD System in his evaluation for ADHD.

He shares his private outpatient practice in the Chicago suburb of McHenry with his wife and cranial -Osteopath, Dr. Bernadette Kohn. They are the proud parents of five children.