Autism in Girls – In recent years there has been a growing understanding that autism has been undiagnosed in girls. This is likely to be related to a number of factors, including differences in symptom presentation as well as diagnostic biases.
Autism in Girls – Coping Mechanisms
We now understand that autistic girls may be more likely to develop coping mechanisms that ‘mask’ or ‘camouflage’ their difficulties or differences. This can be done consciously or subconsciously and may mean that it is more difficult for others to recognise the underlying needs and to then provide appropriate support.
This type of coping mechanism can be extremely exhausting for girls and can lead to higher levels of stress and anxiety. Furthermore, they may then need to ‘let out’ their emotions when in the safety of their own homes. This means that their families may see their distress, whereas schools may not see this side of them.
Biological Brain Differences
Due to biological brain differences as well as different societal expectations, the average girl is more likely to be more socially motivated and showing more advanced language abilities than the average boy. These sex or gender-related strengths are likely to contribute to more ‘subtle’ presentations of autism in girls.
For example, there may be:
- a strong desire for social engagement but a lack of skills in maintaining relationships
- extensive vocabulary but struggles with the more subtle aspects of communication (e.g. understanding the non-verbal communication of others. Or grasping the subtle nuances of social communication, such as sarcasm or irony)
Autism in Girls – Special Interests
Another example is in terms of special interests. This is a common feature of autism, however it often presents differently in girls compared to boys.
Girls may show more ‘typical’ interests for their age (e.g. horses or a specific book series) whereas boys may present with more ‘stereotypical’ interests (e.g. trains or numbers) which may stand out more as an area of differences.
Societal Expectations
Societal expectations can also play a significant role. Autistic symptoms in girls may be more likely to be attributed to shyness or mental health difficulties such as anxiety disorders than those in boys.
Girls are also more likely to ‘internalise’ their anxiety whereas boys are more likely to ‘externalise’ anxiety. Moreover, this can lead to disruptive behaviour that is more likely to present as a challenge for families and schools. In other words, this means autistic boys may be more likely to be ‘picked up’ than autistic girls.
Diagnostic Tools
Diagnostic tools and criteria have also been primarily developed based on observations of autistic boys and these may therefore not always capture the presentation of autism in girls.
To conclude, autism presents differently in girls compared to boys. Autistic girls may:
- exhibit more subtle social communication difficulties or differences than boys
- demonstrate higher level language skills
- be more likely to have age appropriate or ‘typical’ interests
- use masking and social camouflaging more than boys.
It is important that professionals assessing girls for autism are aware of the complexity of this type of assessment to ensure that diagnoses are not missed as this may be detrimental to mental health and other life outcomes.
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