6 Reasons It Is Difficult To Identify Autism In Girls

Identifying autism in girls can be challenging for several reasons. Traditionally, autism spectrum disorder (ASD) has been studied and diagnosed primarily in boys, leading to a male-centric understanding of the condition. However, research has shown that autism presents differently in girls, and there are several factors contributing to the difficulty in identification:

1. Presentation of Symptoms: Girls with autism often exhibit different patterns of behavior compared to boys. While boys may display more noticeable and stereotypical symptoms, such as repetitive behaviors and intense focus on specific topics, girls may camouflage their symptoms by imitating social behaviors or appearing more socially adept. Watch this video example:
   
   
   
   
   
2. Social Masking: Girls with autism may engage in social masking, wherein they imitate or copy the social behaviors of their peers to fit in. This social camouflaging can make it challenging for observers, including parents, teachers, and clinicians, to recognize the underlying social difficulties characteristic of autism.
   
   
3. Societal Expectations: Societal expectations and stereotypes about gender roles can influence the perception of autism. There may be a tendency to overlook or dismiss certain behaviors in girls that might be considered atypical because they don't conform to traditional stereotypes of autism.
   
   
4. Diagnostic Criteria: The diagnostic criteria for autism have historically been based on studies primarily involving boys. As a result, the criteria may not fully capture the range of ways autism manifests in girls. The criteria are evolving, but there is still a need for greater awareness and understanding of the unique presentation of autism in girls.
   
   
5. Co-occurring Conditions: Girls with autism often have co-occurring conditions, such as anxiety or depression, which may mask the core symptoms of autism. These co-occurring conditions can complicate the diagnostic process and contribute to the challenges of identifying autism in girls. VIDEO EXAMPLE
   
   
   
   
   
6. Communication Differences: Girls with autism may have more developed language and communication skills than boys with autism. This can lead to the assumption that their social difficulties are related to shyness or other factors rather than an underlying developmental condition.

Despite the more developed language skills, girls with autism may display a degree of idiosyncratic behaviors that are typically observed in boys with autism. For example, girls may perseverate on specific topics, use a flat tone of voice, misunderstand jokes and sarcasm, use scripted speech, or walk on their toes.

To improve the identification of autism in girls, there is a growing recognition of the need for more inclusive research, increased awareness among healthcare professionals and educators, and a consideration of gender-specific differences in the presentation of autism spectrum disorder. Early and accurate diagnosis is crucial for providing appropriate support and intervention for individuals with autism.

Research Articles Milner V, McIntosh H, Colvert E, Happé F. A Qualitative Exploration of the Female Experience of Autism Spectrum Disorder (ASD). J Autism Dev Disord. 2019 Jun;49(6):2389-2402. doi: 10.1007/s10803-019-03906-4. PMID: 30790191; PMCID: PMC6546643.
Ratto AB, Kenworthy L, Yerys BE, Bascom J, Wieckowski AT, White SW, Wallace GL, Pugliese C, Schultz RT, Ollendick TH, Scarpa A, Seese S, Register-Brown K, Martin A, Anthony LG. What About the Girls? Sex-Based Differences in Autistic Traits and Adaptive Skills. J Autism Dev Disord. 2018 May;48(5):1698-1711. doi: 10.1007/s10803-017-3413-9. PMID: 29204929; PMCID: PMC5925757.