By Seana Smith, co-author of the Australian Autism Handbook, Edition 1
It’s well known that autism spectrum disorder (ASD) affects more boys than girls with figures of 1 in 42 for boys and 1 in 189 for girls.
Could part of this difference be that ASD in girls is simply not so well diagnosed? Perhaps girls are better at masking their symptoms or their symptoms are less severe?
Well yes, this does seem to be the case and many autism researchers are now making efforts to better understand how ASD manifests in girls and how to diagnose girls earlier and create effective treatments for them.
Let’s start by looking at some signs and symptoms more often seen in girls than boys. Some of these tend to be seen in older preschoolers, school-aged children and adults.
Signs of autism in girls
Copying the behaviour of others especially at school or preschool. This is a clever way of blending in with other children.
- Pronounced sensitivities to sensory stimulation like touch, smells and noise.
- Passionate interest and expertise in animals and creative activities like drawing and painting and music.
- Very active and colourful imaginations, may escape into imaginary worlds.
- Tendency to obsessive compulsory disorder, wanting everything to be carefully arranged and in perfect order.
- Girls may be able to manage in social settings and appear very similar to their peers, however, this can cause enormous stress which is acted out at home and in other ‘safe’ settings.
- Depression, anxiety and eating disorders are common co-morbid conditions with girls and women.
Symptoms of autism in all young children
The early signs of autism in children apply equally to girls and to boys. If you have a very young daughter and are concerned about her development then do look out for these:
- Lack of interest in others
- Avoiding the gaze of other people
- Not pointing or showing people objects
- Not turning their head when their name is called
- Being very placid
- Not showing emotions
- Lack of response to social approaches
- Repetitive behaviour with objects
- Staring at objects and being hard to distract
- Watching hands and fingers closely
- Insensitive or oversensitive to sound, pain and temperature
Many girls on the spectrum really do want to be sociable and make great efforts to fit in. Boys may often be more socially isolated and content to be so.
Being more social, girls may not be sent for assessment, even when they are showing many of the symptoms described above as being common in young children.
The restricted and repetitive behaviours of girls may also seem more like real play. For example, an obsession with pets or Barbie dolls may seem more typical of normal play.
Girls’ Symptoms and Current Diagnostic Guidelines
Undoubtedly more research has been conducted with boys than with girls on the spectrum and the current diagnostic guidelines have been created using research done mostly with males.
Research does indicate that there has been unintended bias, with girls being diagnosed less frequently than boys even when they have shown the same level of autism traits. This is especially true for the less severe end of the autism spectrum.
Girls with good language skills and a normal IQ may fly under the radar, with many becoming experts at hiding their differences whilst they mimic the behaviour of their peers.
Girls on the spectrum may often be skilled actresses because they have been acting as if neurotypical all their lives. Girls may wear an emotional disguise whilst feeling highly distressed inside.
In the past, many girls and women with autism spectrum have been misdiagnosed with other conditions and have only received the correct diagnosis and treatment in adulthood. This has often led to decades of harm and distress.
Let’s be aware of the sometimes milder and often different symptoms of autism in both young girls and women, and aim to ensure that all people receive the correct diagnosis as early as is possible.
Seana Smith is a Scottish-born writer, blogger, autism parent and co-author of the first edition of the ‘Australian Autism Handbook’.