By Lauren Polster, M.S., CCC-SLP
Approximately four boys for every one girl are diagnosed with autism spectrum disorder (ASD). Therefore, scientists have focused their research on boys, and we have had little information about how autism might present differently in girls.
New research suggests that methods currently used to diagnose autism can overlook girls. More research is showing that girls with autism might differ from the typical diagnostic criterion outlined in the DSM (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition). Here are some examples:
- Boys showed more repetitive and stereotyped behavior than girls (Van Wijngaarden-Cremers, 2014).
- Girls with autism were more socially motivated and reported friendships that were more intimate than those of boys with autism (Sedgewick, 2016)
- Girls with ASD are more likely to internalize their feelings (instead of tantrums, hyperactivity, etc.) and might present as shy or quiet. Internalizing could lead to anxiety or depression (Solomon, 2012).
Clinical observations suggest that girls with ASD may “socially camouflage” and superficially demonstrate social and emotional skills to help them fit in or not be noticed.
Ami Klin, director of the Marcus Autism Center at Emory University School of Medicine, and other experts advise teams to look for:
- More age-appropriate intense interests.
- “Pretend play” that is actually repetitive or strict.
- Possibly at-age or above-age language use, but perhaps echolalia or differences in receptive/expressive language.
- Less obvious self-stimulation behavior, as the girl may have replaced her natural self-stimulation with something more socially acceptable.
- Exhaustion after social stimulation (school, playgroups).
- Sensory issues—intolerance of crowds or of certain sounds or textures, for example.
- Difficulty with conversation skills and social engagement—turn-taking, staying on topic, initiating and contributing to the conversation.
Sedgewick, et al., J Autism Dev Disord. 2016; 46: 1297–1306.
Gender Differences in the Social Motivation and Friendship Experiences of Autistic and Non-autistic Adolescents
Solomon, et al., J Autism Dev Disord. 2012 Jan; 42(1): 48–59.
Autism Symptoms and Internalizing Psychopathology in Girls and Boys with Autism Spectrum Disorders
Volkers, ASHA Leader. 2018 April; 48-55.
Van Wijngaarden-Cremers, et al., J Autism Dev Disord. 2014 Mar;44(3):627-35.
Gender and age differences in the core triad of impairments in autism spectrum disorders: a systematic review and meta-analysis.