Autism is often thought of as a disorder of the extreme male brain, which means the signs are more easily identified in boys. Your daughter on the spectrum may be harder to diagnose based on the assumption that it is more prevalent among males than females, however, this gap is closing. Although psychologists used to believe the ratio was 10:1, recent research suggests males are four times more likely to be diagnosed. The gender gap may be explained by gender role expectations and neurological differences.

Understanding the Gender Gap

According to neuropsychologist Susan Epstein, “the model that we have for a classic autism diagnosis has really turned out to be a male model. That’s not to say that girls don’t ever fit it, but girls tend to have a quieter presentation, with not necessarily as much of the repetitive and restricted behavior, or it shows up in a different way.” Some people have tried to create a separate female model that acknowledges just how different it can appear, although it is based on the same core principles of sensory issues, social problems, sense of self, and learning differences.
Common features of Autism in girls include:

  • Difficulty making and keeping friends
  • Conversation is limited to topics of interest, which are usually passionate and specific
  • Relies on other children to guide and speak for her
  • Unusual anxiety, depression, and moodiness
  • Difficulty regulating emotions
  • Unusual passivity, quietness, and shyness
  • Difficulty with social communication increases with age
  • Sensory difficulties

Many social problems experienced by people on the Spectrum are considered normative for girls, such as being sensitive, anxious, shy, and passive. Some reasons girls are more likely to be misdiagnosed or overlooked for an Autism Spectrum Disorder diagnosis may include:

  • Girls are socialized more intensely. Girls are encouraged to play in groups, while boys are given more freedom to explore or do things on their own. Mothers play a large role in teaching them social scripts and how to show affection. Even if your daughter struggles to read other people, she may have picked up on how to recognize some social cues or things to say in certain situations that boys are less likely to have been taught. Girls are more likely to value intimacy in relationships, while boys are more likely to value recreation. 
  • Girls are seen as more emotionally intelligent. Girls are assumed to be social creatures and are taught to empathize with others at a young age. They are generally better at identifying and communicating their emotions while boys are more likely to detach from or externalize their emotions. Girls may have more coping skills and social support that leads professionals think they’re managing fine without a diagnosis.
  • Girls are more likely to display signs of emotional distress. In boys, autism is often misdiagnosed as a learning disability or ADHD, however girls are more likely to be diagnosed with depression and anxiety before considering it could be associated with neurodevelopmental issues. They may be diagnosed with eating disorders rather recognizing the link between food and sensory issues or restrictive behaviors. Friend problems are as a normative issue for young girls who typically care more intensely about how they are perceived, but girls on the spectrum may feel particularly hopeless about their ability to maintain relationships.
  • Girls are more likely to struggle with adaptive skills. Girls have more difficulty planning things and staying organized. Boys are more likely to know what they want and be single-focused, while girls may be more indecisive and doubt their own abilities. Girls also tend to higher levels of debilitating anxiety and may express more worry about completing tasks the right way.
  • Girls’ interests may seem more normative. Whereas boys may be obsessed with reptiles or ceiling fans, girls are more likely to be interested in dolls or unicorns. Their interests may seem more age-appropriate and may be celebrated as more creative and imaginative. Girls may play with dolls as imaginary friends, but this is seen as more socially acceptable than boys who might personify an action figure they bring with them everywhere. Boys tend to have more specific interests and are more rigid about protecting them, which can make them feel more isolated or targeted in a social setting.
  • Girls are diagnosed later than boys. Girls are more motivated learners in elementary school and are more likely to overcompensate for difficulties with executive functioning by appearing confident and working harder. They may only start to struggle to catch up in middle or high school. While most boys are diagnosed by their teenage years, it is not uncommon for girls to be diagnosed in middle adulthood.

One of the main reasons girls are overlooked for spectrum diagnoses is that there is much less research on autistic girls and by autistic girls. As it is more prevalent in males, most of the research follows assumptions of the male model. It is also harder to isolate the effects of ASD on female behavior as by the time they are diagnosed, they have often developed depression or anxiety. They are also more likely to experience traumatic events or perceive events as traumatic.
Seven Stars is a co-ed residential treatment center for teenagers, ages 13 through 18, who are struggling with neurodevelopmental issues including autism and aspergers, executive function deficits and learning disorders. We recognize the prevalence of autism in girls and how it may look different from autism in boys and apply a greater emphasis on building self-esteem and adaptive skills. Our goal is to help students learn conflict resolution, problem solving, social skills, academic skills, self-efficacy and prosocial behaviors. At Seven Stars, we strive to help our students develop the skills necessary to live full, productive lives.
For more information about how Seven Stars can help your daughter on the spectrum, contact us today at 844-601-1167.

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