Updated: Oct 5, 2019
By: Dr Miriam Kirby, Clinical Psychologist
One of the first things I learned about autism was that there was a higher incidence in boys compared to girls. However, there is an emerging body of research and advocacy supporting the idea that autism may be under-diagnosed in girls because of differences in how the features manifest.
In practice, I have met and assessed many girls and women from late-childhood through to adulthood who have accessed a seemingly revolving door of mental health services trying to assess and treat features that are typically described as difficulties managing emotions, heightened anxiety, and often showing behavioural difficulties at home but not at school. The possibility of autism can be overlooked in girls because the social and behavioural features aren’t as overt or obvious compared to some of the common assumptions about autism.
For example (and subject to individual variation!):
Difficulties with social interaction- girls can mask their social symptoms observing and copying the social behaviours of significant others or characters in movies and on TV.
Lack of pretend and imaginative play skills- younger girls or adolescents may seem to enjoy imaginative games but may be going deep into a fantasy life that is somewhat scripted or has repetitive themes.
Lack of interest in making friends– girls may develop a “best” friendship but the intense level of connection and interest that they engage with can become overwhelming for their friends. As girls enter late primary school and into high school, the gap between their social and emotional maturity compared to their peers often starts to widen. While many girls like to talk in groups, girls on the autism spectrum are less likely to be interested in or feel competent in this sphere, and find it difficult to understand the social nuances, manage the emotional states of their peers and their emerging interests in romantic relationships.
Unusual interests- girls on the autism spectrum can often have age appropriate and typical interests (e.g., animals, dolls) but can become overly preoccupied and maintain their interest beyond same aged peers. An interest in collecting, arranging, or maintaining these items in a certain order can highlight an unusual level of interest.
Helping girls and women discover themselves on the autism spectrum can open the door to self-acceptance and shared understanding.