Gender And ADHD Referrals

In a study by Joseph Biederman, et al. (2002), the impact of gender on the clinical features of ADHD was examined. The authors had previously showed that ADHD in girls displayed symptoms typical of the disorder, yet there still remained a large discrepancy between the male:female ratio of clinic-referred (10:1) and community (3:1) samples of children with ADHD. The group examined 140 boys with and 120 boys without ADHD, and 140 girls with and 122 girls without ADHD. All children were between 6-17 years of age.

The study differentiated between three types, or manifestations, of ADHD: Inattentive, Hyperactive/Impulsive, or Combined (both). The conclusions of the study showed that ADHD in girls was predominantly of the inattentive subtype, was less likely to be associated with a learning disability in reading or math, was less likely to be connected to problems in school, and was less likely to correlate to a lower out-of-school activity involvement. Their results show that although the majority of both boys and girls displayed the combined type of ADHD, "girls with ADHD were twice as likely as boys with ADHD to manifest the predominantly inattentive type of the disorder. Since symptoms of inattention are more covert t han those of hyperactivity and impulsivity, the higher rate of these symptoms in girls with ADHD than in boys with ADHD may … explain the markedly higher male-to-female ratios in groups of children who are clinically referred for ADHD than in children with the disorder who are not clinically referred" (39).

Overall, this study is important because it shows that gender does have an effect on the clinical presentation of ADHD. This means that teachers and other initial diagnosticians must be mindful of the differences in presentation that may result in disproportionate referrals based on gender.


Biederman, Joseph et al (2002). Influence of Gender on Attention Deficit Hyperactivity Disorder in Children Referred to a Psychiatric Clinic. American Journal of Psychiatry, 159, 36-42.

This page was created by Jimmy Sarakatsannis.