ADHD Masking in Girls: The Cost of Being “Fine”

ADHD masking in girls can make symptoms difficult to recognize, delaying diagnosis and support. In this personal story, one military mom shares how teachers and providers viewed her daughter as “fine,” causing her struggles to go unnoticed for years

From preschool on, teachers described our daughter the same way: bright, busy, magnetic. At every conference we heard, “She’s wonderful,” “She’s so helpful,” “She’s a joy to have in class.” She thrived socially and creatively, often singing, dancing, inventing games, and doing science experiments. As a baby and toddler, we would often get comments about her keeping up with her older brother.

When the pandemic pushed her into online learning, she struggled. Long Zoom sessions and muted interaction understandably frustrated her, and she often quit online Kindergarten to play outside. Still, with the blessing/ curse of having a Kindergarten teacher for a mom, she entered first grade academically prepared.

A Difficult Transition

In 2021, we moved to Japan for the second time. We were excited for our children to attend a DODEA school. I had gone to one myself and believed in its quality. But almost immediately, our daughter began to struggle.

She resisted going to school, became sensitive to noise, and cried over homework. When we raised concerns, her teacher reassured us: “She’s fine here. I never see her unhappy.” We assumed it was the stress of an international PCS.

The Disconnect Between School and Home

As the year went on, things worsened at home. She came home exhausted, often melting down by mid-afternoon. She fixated on perfection, saying things like, “It isn’t my best,” and “This has to be perfect.” Her teacher again dismissed concerns: “She’s doing great. If she chatted less, she’d be at the top of the class.”

By the third quarter, her behavior had escalated into screaming fits, aggression toward siblings, and emotional outbursts that felt completely out of character. School staff suggested that her behavior was related to her father’s deployment or something happening at home. The school referred us to the MFLC, where staff conveyed the same message: she would likely “return to normal” once her father returned.

But even after he returned, nothing improved.

“No Concerns at School”

My son’s ADHD diagnosis led me to recognize many of the same symptoms in myself, and I soon received my own diagnoses of ADHD and anxiety. Through therapy, I learned that I was constantly stressed and anxious because I was masking—the effort of suppressing behaviors to meet expectations. It was the lightbulb moment. Our daughter was holding it together all day, then releasing everything once she felt safe at home.

We asked her teacher to complete an ADHD evaluation. It came back with all zeros. “She’s chatty, but girls usually are,” the teacher wrote. And noted she had no concerns at school. Our pediatricians echoed this: without symptoms at school, it couldn’t be ADHD—this must be a family issue. Providers also told us she was too young to receive an anxiety diagnosis.

Meanwhile, we faced long waitlists for mental health services on base and limited options off base due to language barriers and a lack of Tricare-approved providers. By the end of the school year, we had met with three pediatricians, trying to explain that this wasn’t typical behavior for our child.

Finally Being Heard

Eventually, we met with a child psychiatrist on base. The experience was initially dismissive and patronizing, with questions implying a lack of structure at home. I knew we were doing everything possible to help her, thanks in part to my background in early childhood education. I think of other parents without the training and experience that I have, and imagine there are many who simply take the passivity of doctors and continue in survival mode. I knew I needed to push for answers, and eventually someone listened. It is safe to say that many don’t know what questions to ask or what services to request, and there doesn’t seem to be a lot of focus on how females with ADHD present.

With persistence (and by ignoring the people who continued to say nothing was wrong), we finally obtained a diagnosis of ADHD Inattentive Type and Pathological Demand Avoidance (PDA) for our daughter.

A Tale of Two Children

The contrast with our son’s diagnosis two years earlier was stark. A provider diagnosed his ADHD within 48 hours. His teacher immediately recognized the signs, completed the paperwork quickly, and put support systems in place, including a 504 Plan, within weeks. His impulsivity and hyperactive behaviors disrupted the classroom, so intervention benefited everyone.

Our daughter’s experience was the opposite. Because she wasn’t often disruptive, her struggles were invisible in the classroom.

After her diagnosis, I formally requested a 504 Plan before second grade began. Weeks passed with no response. When school started, the process had to begin again from scratch because the school had not collected data despite my formal request months earlier. Even with a supportive teacher and a structured classroom, our daughter continued to fall apart at home, crying, lashing out, unable to quiet her mind at night.

At school, she was excelling. At home, she was unraveling.

Limited Resources, Constant Advocacy

Diagnosis didn’t magically fix anything. She started meds (many are banned in some countries, so research that thoroughly!), which helped. Unfortunately, in Japan, our access to help like occupational therapy, psychiatry, and other common ADHD resources was scarce. We adapted as best we could. We built sensory supports at home. I researched ADHD therapies, took classes, read books, incorporated movement-based strategies from my oldest child’s OT appointments, and purchased equipment out of pocket because Tricare doesn’t cover much, and families cannot use services like ECHO overseas. Thankfully, she began seeing an amazing therapist online and started talking about her frustrations.

Still, progress with the school was slow. Data collection began months late. Finally, by the end of the third quarter of second grade—nearly two years after we first raised concerns—the school approved her 504 Plan and provided accommodations.

The Difference Isn’t Severity—It’s Visibility

The difference between our children’s diagnoses and support experiences seemed contingent not on the severity of their needs, but on how those needs presented.

Our son’s ADHD was more external. They were visible, disruptive, and impossible to ignore. Our daughter was mainly internal—masked, people-pleasing, and therefore overlooked. She worked tirelessly to meet expectations, only to collapse under the weight of that effort at home when she felt safer.

And for our daughter, that difference, combined with systemic biases, delayed both her diagnosis and school support. Our daughter wasn’t “fine.” She was coping the only way she knew how, by becoming exactly what everyone expected her to be, until she had nothing left.

As I look back on my own childhood, I see I didn’t fit the stereotype, just like my daughter. Instead of obvious hyperactivity, we may show hypervigilance, perfectionism, excessive talking, or quiet inattention. Many are labeled as “good students,” even while struggling intensely beneath the surface. 

Many ADHD girls are labeled “gifted students,” even while struggling intensely beneath the surface. High achievement often masking stress fractures that cause daily, invisible pain.

Don’t Wait for the System to Catch Up

If I can impart one piece of advice for other military parents, especially overseas, it’s not to wait for the school or medical system to validate what you’re seeing. A child who is “fine” at school but falling apart at home may be masking just to get through the day. Trust your instincts, document everything, put requests in writing, and follow up relentlessly. It’s okay to seek second opinions, learn your rights, and push for support even when systems move slowly. In environments where visibility often determines who gets help, quiet struggles are the easiest to miss—but our children cannot afford to be overlooked.

About the Author – Becca Kofonow

Becca Kofonow has been an early childhood and elementary educator for over two decades. She also runs many military community peer support groups in Japan, including several that assist military- connected children and parents. Currently, she teaches at a DODEA school in Japan and volunteers for the school and base community. She is also a certified Military Lactation Counselor, a Naval Service Family Line – COMPASS Mentor, a certified Mental Health First Responder, and a founding member of The Beyond Sleep Training Project. She enjoys traveling and experiencing the world with her spouse and children. She is an avid reader, Japanese convenience store, and vending machine aficionado.

Becca is a former military child and has been married to a USN sailor (also a military child) for nearly 20 years. They now have three military children of their own who are 13, 11, and six years old. Her oldest was diagnosed with ADHD in 2018, which began her journey into the world of neurodivergence. She discovered her own ADHD after her son was diagnosed, and this led to her passion for helping other neurodivergent families struggling with visibility and acceptance.