5 Signs A Child May Be Struggling With ADHD At School

A child psychiatrist has opened up about a pattern she sees routinely where a neurodivergent child will struggle at school, and the adults around them mistake their symptoms for poor behaviour or a bad attitude.

Dr Anya Ciobanca, consultant child and adolescent psychiatrist at The ADHD Centre, says children who appear disengaged, inconsistent or emotionally volatile at school may be experiencing something far more complex than just a bad attitude.

“Behaviour is never the whole story,” she says. “When we approach a child with curiosity rather than judgement, everything changes.”

Conditions such as attention deficit hyperactivity disorder (ADHD) can go undiagnosed for years because there are often misunderstandings over symptoms. For example, people might think kids who have it are just hyperactive, but there are also more subtle signs that can show up, like day-dreaming or emotional dysregulation.

Girls in particular are likely to remain undiagnosed until later life. Reviews suggest ADHD is identified more often in boys in childhood at a ratio of 3:1 (males to females), while the ratio appears to even out in adulthood at 1:1.

Experts previously told HuffPost UK this happens largely because there’s a gender divide in how ADHD symptoms are expressed (girls tend to demonstrate more inattentive symptoms), and social expectations on girls can lead to them keeping quiet, carrying on, and developing sophisticated masking strategies (sometimes at detriment to their mental health).

“There is a version of ADHD that looks, from the outside, like daydreaming or simply not caring,” says Dr Ciobanca. “But internally, that child may be working extraordinarily hard just to keep up. The effort of masking is immense, and it has a cost.”

In classrooms, children are often doing the best they can with a nervous system that’s working against them, but there are certain signs they might be fighting a hidden battle and need more support.

1. Avoidance of school or specific lessons – this might look like persistent reluctance or distress around certain subjects or transitions.
2. Difficulty starting or completing work – this is often mistaken for laziness, says Dr Ciobanca, but rooted in overwhelm or difficulties with executive function.
3. Emotional outbursts or withdrawal – this can look like frustration, tears or shutting down, particularly after school (also known as after-school restraint collapse).
4. Chronic tiredness or physical complaints of headaches, which can be linked to anxiety or sensory overload.
5. Low self-esteem, negative self-talk, and appearing to cope at school (masking) while falling apart at home.

One child Dr Chiobanca worked with had been labelled by her school as inconsistent and difficult to motivate. But in reality, she was overwhelmed and had developed a profound sense of shame around her difficulties.

Girls with undiagnosed ADHD are “more likely to blame themselves, turning their anger and pain inward”, according to the Child Mind Institute, which noted they’re also more likely to experience depression, anxiety and eating disorders than those without ADHD.

“Once we understood the underlying picture – the interaction between her ADHD, her anxiety and her environment – we could make meaningful changes,” says the psychiatrist. “She no longer had to spend every day just fighting to survive it. That freed up an enormous amount of energy for actually learning.”

With one in 20 children thought to have ADHD, Dr Ciobanca wants to see earlier intervention, more flexible teaching, and emotional wellbeing placed at the centre of education rather than its margins.

“Too much support comes too late. We cannot expect children to learn well when they do not feel safe,” she adds.

If you think your child might be neurodivergent (research suggests around 15-20% of people are), it’s worth exploring this subtly with your child. Dr Chiobanca advises parents to ask their children: “What’s the hardest part of your day?” as this can reveal more than questions about effort or behaviour.

It’s also worth speaking to your child’s school – specifically their class teacher or SENCO (a special educational needs coordinator) – if you notice a pattern of distress or avoidance. Months of avoidance or emotional dysregulation are a signal worth acting on, she notes.

The psychiatrist also urges parents to separate the behaviour from the child, as “struggling children often already feel like failures; they need to know you’re on their side”.

While NHS waiting times for diagnosis can stretch for months, it might also be worth considering a professional assessment. “ADHD and anxiety remain significantly underdiagnosed, particularly in girls,” says Dr Ciobanca.

Yet when children feel safe and understood, “they are far more able to learn and grow,” she adds. “That is the kind of education system worth working towards.”