Autism has always seemed to be a boy thing. Ask most people what they imagine when they think of an autistic person. The chances are that the mental image conjured up would be male. Indeed, that’s not surprising, as the majority of people diagnosed with autism are boys. Hans Asperger started studying autistic children in the 1940s. He did not think that girls were affected by the condition. He eventually changed his mind at a later point.
There is no official figure on the boy/girl ratio. At this time of writing, official estimates vary between 2:1 and 16:1.
But are there more autistic boys than girls? Or are girls just harder to diagnose?
A big part of the problem comes with the way that young boys and girls differ in their social patterns. A young autistic boy may display behaviours more commonly thought of as “classically autistic.” They might play alone and struggle with social cues and eye contact. A young autistic girl, however, may have a small friendship group. Although her behaviour may be passive, she is much better as imitating others to fit in. This behaviour is known as masking.
Problems may only be noticed when the girl is older, often in the teenage years. This when a lot of autistic girls finally get a diagnosis. There is generally a lot more awareness about female autism now than there was a few years ago. Practitioners are trained to spot the more subtle signs of female autism when considering a diagnosis.
Some Signs of Female Autism
1. Girls with autism may have an obsessive interest about a particular topic. This could be a certain movie, game or toy. A girl may spend a lot of time reading or researching about their subject of interest. She might only engage with others socially when talking about it. Autistic girls can be quiet and withdrawn when others talk about a different subject that doesn’t interest them.
2. Autistic girls may have very high anxiety levels, resulting in age-inappropriate meltdowns that can seem like tantrums. They may cry, shout and destroy objects as they feel completely overwhelmed.
3. Although they may have a friendship group, fall-outs can be common as an autistic girl may fail to understand social cues and nuances in speech.
4. Teachers may describe a girl as “quiet” or “shy” during classroom discussions. Whilst this is obviously not always a sign that someone is autistic, this trait is common in autistic girls.
5. Sensory issues can be common in autistic girls. Noises may be loud and overwhelming and they may not like being in crowded areas. Clothes may feel scratchy and uncomfortable and they may be picky eaters.
If you think your daughter or someone you know has autism, it is important to seek a diagnosis in order to get the appropriate help. Discussing concerns with a family doctor is the first stepping stone towards diagnosis.
Diagnostic pathways vary, but it is likely that a girl will be referred to CAMHS or another specialist service where they may undergo certain tests, interviews and observations in order to ascertain whether the issue is autism or another underlying condition. Practitioners may also interview parents and school staff to get a picture of how the patient behaves in certain situations and to get a complete family history.
If an autism diagnosis is made, it is likely that the parents will receive more information on the condition. Most areas run parent courses about autism. The girl may be eligible for extra help in school and the family may be able to claim certain government benefits like DLA and Carer’s allowance.
Conclusion: Autism in Girls
Practitioners now understand that the diagnostic criteria used to recognise autism in boys should not be used in cases of female autism, which can present very differently.
As we learn more about female autism and how it affects individuals, better care will result for those affected. Hopefully less children will “fall through the net.” Families need to feel supported and listened to. No girl with autism should be denied the help she needs.