Understanding and supporting neurodivergent girls

This blog post was written by Shipei Wang, University of Edinburgh

When we think of ADHD or autism, there has long been a tendency to see them as conditions that primarily affect boys. Neurodivergent girls have, in the past, been overlooked in both clinical and everyday settings. Although awareness of neurodivergence in girls has improved substantially in recent years, many neurodivergent girls still experience delayed diagnosis or are not diagnosed at all.

Delayed diagnosis and being overlooked

Current systems used to diagnose, and expectations people commonly have, are often based on how neurodevelopmental conditions present in boys. For example, the diagnosis of ADHD focuses on disruptive behaviours such as hyperactivity and impulsivity, which are more common in boys. In contrast, girls with ADHD are more likely to experience difficulties that are more internal to themselves such as anxiety, low mood, and challenges in regulating emotions. A similar pattern can be seen in autism. Autistic boys are more likely to show noticeable restricted interests and repetitive behaviours. Autistic girls often show fewer of these behaviours and frequently show relatively strong language skills and social motivation in early development. However, they are more likely to experience higher levels of symptoms that are internal like low mood, as well as increased compulsive behaviours and self-harm. This sometimes means that neurodivergent girls are first thought to have mental health conditions, rather than them being recognised as showing signs of ADHD or autism.

Many neurodivergent girls also actively mask or compensate for their difficulties in order to fit in socially, which is a process referred to as ‘camouflaging’. We have talked about this in previous blog posts. This may involve copying peers, suppressing behaviours, or putting in extra effort to meet expectations. While this can help them navigate social environments in the short term, it also makes their difficulties less visible, increasing the likelihood of delayed or missed diagnosis.

Emotional difficulties in neurodivergent girls

Neurodivergent girls are more likely to experience emotional difficulties than boys. A study we recently published, that followed children from their childhood to early adolescence, showed that levels of emotional symptoms tend to significantly increase over time in girls with ADHD, while remaining relatively stable in boys.

Camouflaging, or masking, plays an important role in this increased difficulty with emotions. To meet social expectations and blend in, neurodivergent girls frequently hide their natural traits and mimic their neurotypical peers’ behaviours. However, keeping this masking going requires a lot of psychological effort. Over time, this can become exhausting. Anxiety can really impact emotional reserves, making these young people highly vulnerable to emotional difficulties and burnout.

The transition into adolescence and puberty may further contribute to this increase in emotional difficulties among neurodivergent girls. Puberty brings dramatic hormonal fluctuations, particularly in oestrogen, which can disrupt emotion regulation abilities and increase sensitivity to stress. At the same time, this time is associated with increased complex social, academic, and environmental demands. As children move to high school the expectations are that they will be more independent. Now they have lots of teachers not just one main teacher. For neurodivergent girls who are already investing substantial effort to manage these demands, this time period may be associated with increased emotional difficulties and stress compared with neurotypical girls and neurodivergent boys.

Moving forward

Neurodivergent girls need to be seen, understood, and consistently supported. Parents and teachers looking beyond the direct behaviours they see and paying close attention to more subtle signs of emotional experience and coping is highly supportive. Neurodivergent girls may not always show disruptive behaviours, but may instead have unexplained physical complaints (such as stomach aches), excessive worrying, or quiet exhaustion—particularly during puberty. Environments, where girls feel safe to be themselves and not always needing to mask or hide their differences, both at home and in school, are important. Early recognition and responsive support can make a meaningful difference in helping neurodivergent girls feel understood and supported as they grow.