Autism in Girls

**The following is my opinion, perspective, and general impressions from nearly 15 years of working with children on the autism spectrum and should not be construed as clinical advice.

According to the Centers for Disease Control, on the whole, females receive an autism diagnosis about a year later than their male counterparts.

Why is this?

From my perspective, there is a lot at play in this disparity. Clinical definitions for autism have historically centered on a male-centric perspective across a wide range of diagnoses, including autism. Boys with autism tend to exhibit more overt and stereotypical behaviors, often aligning with the conventional understanding of autism spectrum disorder. These may include repetitive movements, intense fixations, and challenges in social communication and interaction. Such recognizable (and often “disruptive”) behaviors often facilitate the early identification of autism in boys.

Conversely, girls are not as likely to exhibit outward “disruptive” signs that signal an urgent need for clinical attention, and girls with autism may display symptoms in a more nuanced manner. They might excel in mimicking social behaviors, a phenomenon commonly referred to as "masking." Girls on the spectrum might also have different interests or obsessions that are more socially acceptable or similar to those of their peers, which can make their symptoms less conspicuous.

In my clinical experience, girls on the autism spectrum are often able to coast along socially in elementary grades, until the social demands exceed their ability to mask or camouflage their social challenges, around the time of middle school. This is when I typically see an uptick in autism referrals at the secondary level. Indeed, for ANY child, the social demands of middle school are daunting. Add in autism, and the underlying anxiety and social communication differences that brings to girls, and you have a recipe for a very challenging few years.

So what can be done?

Increased research and understanding about autism in females is still needed. Those that work with children on the autism spectrum need to continue to seek continued opportunities for growth and expansion of clinical skills as new information comes available.

On the whole, the psychological community is getting better about listening to autistic girls and women, expanding clinical understanding, and addressing gender differences in diagnosis. However, we still have a long way to go in order to reach equity in diagnosis, treatment, and intervention assistance.

If you think your child may need an autism evaluation, Grounded Roots of Abilene has openings for assessment services.