Girl Autism

Studies have consistently shown that when verbal girls with ASD (who often present as higher-functioning) seek professional help, their symptoms are often played down, misinterpreted, or misdiagnosed with a variety of other disorders (e.g., anxiety, mood disorders, disruptive behaviors). Therefore, there is a real risk that females with ASD will not get the help or support that they need. Research by autism expert Dr. Cathy Lord have noted that girls with ASD often appear to fare better than boys at an early age as they tend to be less disruptive, imitate typical kids, and seek out social contact, albeit in more idiosyncratic ways. While these girls are motivated to interact, their behaviors may seem more exaggerated, which in turn isolates them further from peers. Yet by middle childhood, few of the girls had developed reciprocal friendships, and a subset of them were struck by significant anxiety because of the rising demands of social interactions that comes in middle school when girls’ social networks become more intricate, demanding, and usually hinge on attention to feelings and more rapid and nuanced communication. Further, these girls were often subjected to notable social difficulties such as bullying, teasing, and exclusion by their peers, which further contributed to their distress and symptoms.

Some researchers also theorize that girls may be more effective at masking and compensating for their symptoms, especially during structured one-to-one interactions with adults such as psychologists, school personnel, and other healthcare professionals. Adults are oftentimes viewed as safer social partners for many individuals with ASD because they are typically willing to accommodate their social challenges – unlike similar-aged peers in actual social situations that are less structured and predictable. Further, most autism screening and diagnostic tools were developed based on male samples. As a result, many clinicians may still be overlooking the girls whose symptoms do not match the “prototypical” presentation of ASD seen in most boys. Until standardized assessment tools are improved to better detect ASD in females, clinicians may need to gather evidence though other means, such as observing girls in their natural social settings (e.g., schools, playgrounds, play/peer dates) and comparing their presentations to girls unaffected with ASD. This approach can help generate better ways to reliably assess the milder impairments in social communication and interaction as well as restricted interests and repetitive behaviors in girls with ASD.

Earlier studies on sex differences in ASD was dedicated to studying girls who had lower intellectual abilities and more severe symptoms, especially when there was a co-occurring yet rare genetic disorder of Rett Syndrome. As Rett Syndrome is no longer under the umbrella of Autism Spectrum Disorders (ASD’s) or what was previously referred to as Pervasive Developmental Disorders (PDDs), there is an explosion of studies aimed at investigating higher-functioning females with ASD who were overlooked in previous research. Current studies are now investigating the less severe symptomatology of impairments in social communication and interaction as well as restricted interests and repetitive behaviors in comparison to males, who are more impacted by ASD symptoms. It is hoped that with this new research, more girls and women will be able to be identified at earlier ages and access diagnostic-specific interventions.