Despite the fact that Autism Spectrum Disorder (ASD) affects both male and female children, an autism diagnosis is significantly more likely to be made for a boy. Why is this? Are boys truly more likely to be affected by ASD, or simply more likely to be diagnosed? Are girls more likely to be misdiagnosed?
These are all very serious questions, particularly if you’re the parent or guardian of a little girl you suspect is struggling with a developmental disorder like ASD. Let’s answer all of these questions right now.
Table of Contents
- Types of Autism
- How Common Is Autism in Girls?
- Why Is It Harder to Diagnose Females with Autism?
- How Can You Tell if a Girl Has Autism?
Types of Autism
One reason ASD can be difficult to diagnose, in both boys and girls, is that not all forms of autism affect a child in the same way. There are five different types of Autism. These are:
- Asperger’s Syndrome/Level 1 Autism Spectrum Disorder
- Rett Syndrome
- Childhood Disintegrative Disorder (CDD)
- Kanner’s Syndrome
- Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS)
Rett Syndrome is the only type of autism more likely to be diagnosed in girls.
How Common Is Autism in Girls?
Many more boys than girls are diagnosed on the autism spectrum: more than four boys for every autistic girl, according to the latest numbers from the Centers for Disease Control. Researchers point to genetic differences.
Females with autism may be better at hiding the signs, at least when they’re young. Even when girls’ presentation is clearer, they can be overlooked.
- One in 68 children in the U.S. is affected by autism—but new research suggests that current diagnostic methods overlook girls, meaning even more kids may be on the spectrum.
- Behavioral and preliminary neuroimaging findings suggest that girls with autism manifest it differently. Notably, females with autism may be closer to typically developing males in their social abilities than typical girls or boys with autism.
- Girls with autism may be harder to diagnose for several reasons, including criteria developed specifically around males and overlapping mental health diagnoses such as obsessive-compulsive disorder or anorexia.
Rates of children with autism suggest that boys are, on average, four times more likely to have autism than girls. But this figure may hide the true incidence of autism in girls and women, with some estimates ranging from 7:1 to as low as 2:1 (that is, 2 boys for every girl). Parents with daughters on the spectrum will often share frustrating tales of how difficult it was to get a proper diagnosis for their daughters, while many autistic women did not receive a diagnosis until adulthood.
Why Is It Harder to Diagnose Females with Autism?
Doctors may underdiagnosed autism in girls because they may not exhibit the “common” behaviors associated with autism or are better at hiding their symptoms.
Today, clinicians and researchers have come to realize that many “higher functioning” autistic girls are simply missed. Particularly older girls with milder forms of autism attempt to hide their symptoms and work harder than their peers to “fit in” at school. They’ve been termed the “lost girls” or “hiding in plain sight” because they’re overlooked or diagnosed late. They don’t fit the stereotypes or their symptoms are misinterpreted as something else.
Being female does appear to protect the brain from many developmental disabilities, not just autism. There is emerging evidence that girls with autism need more extreme genetic mutations than boys to develop autism. However, there is a growing body of work that indicates that autism just presents differently in girls and therefore often goes unrecognized, especially in verbally fluent girls with normal intelligence. Girls with autism also appear to be better at ‘camouflaging’ their autism symptoms in order to fit in, like maintaining eye contact because they taught themself to do so.
With the diagnostic criteria for ASD based largely on how autism presents in males, girls can often ‘slip under the radar’ or get misdiagnosed. Girls with ASD seem to have less restricted and repetitive behaviors than boys, but it’s also possible that some of these behaviors go unrecognized — for example, an obsessive interest in collecting dolls may be misinterpreted as pretend play.
How Can You Tell if a Girl Has Autism?
Although every child with autism is different, here are some common signs of autism for girls:
- A special interest in animals, music, art, and literature
- A strong imagination (might escape into the worlds of nature or fiction)
- A desire to arrange and organize objects
- Poor social skills, like not wanting to play cooperatively with female peers (for example, wanting to dictate the rules of play or preferring to play alone to maintain control)
- A tendency to ‘mimic’ others in social situations in order to blend in
- An ability to hold their emotions in check at school, but be prone to meltdowns or explosive behavior at home
- Strong sensory sensitivities, especially to sounds and touch (for example; clothing tags, socks or even deodorant).
While girls with ASD are less likely than boys to also be diagnosed with ADHD and conduct problems, they are more vulnerable to internalizing problems, such as anxiety, depression, and eating disorders. As we learn more about autism in females, we appreciate just how important timely diagnosis, effective support, and understanding can be.
Keep Learning More with BM Behavioral Center
The symptoms of autism tend to be different for boys and girls, and people with autism are different from one another- even two girls. Individual symptoms can vary as autism affects people differently. If you suspect your child, either male or female, is struggling with ASD and you’re in Northern California, we can help through ABA therapy. Children on the Autism spectrum may need special care and support, above and beyond what parents, grandparents, and loving family members can provide.