Many more boys are diagnosed as autistic compared to girls. According to the CDC, the figure is around more than four boys for every girl diagnosed with autism. While past researchers put it down to genetic differences, recently, clinicians and researchers have realised that girls tend to have ‘higher functioning’ traits that are simply missed. Many girls are diagnosed late or completely overlooked for this reason, since they do not fit the stereotypes, or the signs of autism in these girls are mistaken for something else. And, some professionals believe that girls might be better than boys at hiding the signs of autism, at least in childhood.
Not ‘Fitting the Model’
Autism is a developmental disorder that is marked by deficits in communication and social skills along with repetitive or restricted behaviours. Children with autism may also have sensory processing issues. However, clinicians say that the model that we currently have for an autism diagnosis is largely a male model. While girls will sometimes fit it, many girls with autism have a quieter presentation and may not display as much of the repetitive or restrictive behaviour compared to boys. Or, it may show up in a different way that is overlooked – for example, while boys with autism might have an interest in something rather stereotypical like train schedules, girls might be obsessively interested in unicorns, which isn’t quite unexpected, making it not quite as obvious to the untrained eye.
Misdiagnosis
Another reason why more girls with autism tend to be misdiagnosed, overlooked, or diagnosed later in life compared to boys is that girls that are struggling with undiagnosed autism are often more likely to develop self-esteem problems, anxiety or depression as a result. Clinicians may be more focused on treating these issues and fail to look any deeper to understand the root problem. A lot of girls who meet the criteria for autism when they are younger are also misdiagnosed with ADHD, especially when symptoms show up as more hyperactive and there is a different level or type of social impairment. If you have a girl who you believe may be autistic, it’s worth taking the Child Autism Test from Psymplicity, a mental health support service covering a range of disorders and conditions in children and adults. Tests are available for parents to take after observing their child to get a better idea of whether the signs could be autism-related.
Passing and Masking
Neurodiverse people learn to ‘mask’ in social settings from a young age. They will often observe the behaviour of neurotypical people around them and begin to copy it. This behaviour is often more prevalent in girls with autism compared to boys, and the fact that more girls can ‘pass’ as neurotypical may be just another reason why so many girls continue to go undiagnosed with autism. For this reason, the signs of autism in girls might not begin to become apparent or cause problems until their teen or even adult years, when masking may become more difficult.
It’s more important than ever for parents and clinicians to learn about how autism can show up differently in girls. Undiagnosed girls with autism are often left wondering what is wrong with them, which can lead to mental health problems and burnout from working so hard to fit in.