The hidden gender. Identifying and supporting girls with autism

Is autism being missed in girls? Misdiagnosed, misunderstood or missed altogether, many girls with autism struggle to get the help they need. The autism spectrum has been reported as more prevalent in males since the initial studies by Asperger in the 1940’s and this reported gender bias has had various impacts upon research and clinical practice.  It is reported that 3 times as many boys are diagnosed with autism than girls, while many girls are either misdiagnosed through mental health services or never referred for a diagnosis.  Here, our latest blog investigates the key differences surrounding autism in girls. 

Social interaction

One of the main points of difference between girls and boys with autism is that girls tend to demonstrate a level of ‘superficial sociability’, giving the appearance of better social integration skills.  Social characteristics more often present in girls than boys include:

• a greater awareness of the need for social interaction
• a desire to interact with others
• passivity (a ‘loner’) often perceived as ‘just being shy’
• a tendency to imitate (copy, mimic or mask) others in social interactions, which may be exhausting
• a tendency to imitate social scripts, e.g. TV soap operas, ‘masking’ their behaviours / or developing compensatory strategies
• one or few close friendships
• appearing more able to concentrate than boys, who become distracted more easily and can be disruptive
• a better imagination (escape into pretend play, but prone to being nonreciprocal, scripted and overly controlled)

Special interests 

On the surface, the special interests of girls with autism may seem to differ less from those of other girls, than those of boys with autism. Girls have also been observed to have fewer repetitive, ritualistic behaviours.

In the research on Gender differences and Autism, Gould and Ashton-Smith, 2012, said:

“It is not the special interests that differentiate them from their peers, but the quality and intensity of these interests and the length of time spent on these… So, careful questioning on interests and routines is important…”

For example, girls’ interests may have a more nurturing and social focus and boys may be more likely to focus on the technical. For both, however, there is a tendency to objectify, collect and systematise. Restricted interests for girls tend to involve people and animals rather than objects, e.g. animals, soap operas, celebrities, pop music, fashion, horses, pets and literature.

All of the above are stereotypical female interests, which is why girls with autism may not seem that different to girls who are not on the spectrum. The key is the intensity and quality of these special interests, i.e. exclusive, all-consuming and experienced in detail.

Timely diagnosis

Often, the differences in girls come to light at secondary school where changes to routine, crowded corridors and noisy screams in playgrounds can lead to anxiety. 

For girls at this age, it is understood that underlying autism can often be overshadowed by secondary symptoms, such as mental health disorders (eating, anxiety, obsessive-compulsive, paranoia, depressive, personality or sleep disorders). It is often here that girls are misdiagnosed, so it’s important for schools to be prepared and to have a knowledge of ASD indicators in girls.

If autism is suspected, teachers and SENCOs can adopt evidence-based learning, social and environmental support strategies to help their students. There are many steps that schools can take:  including:

• using visual timetables, or other visual aids, to underpin communication and increase predictability
• buddying individual girls with ASD and older volunteer children in school, who can offer social support and advice about social interactions
• structuring breaks and lunchtimes for girls with ASD
• Increasing teachers’ awareness of the need for highly structured lessons, e.g. not presenting a test without warning, and to support children with ASD during unstructured time.
• carefully positioning children with ASD in the class, away from distracting children
• giving warning of sensory stimuli that are to be introduced into the classroom
• liaising closely with parents to discuss behaviours in school, and to understand if any elements of school are causing anxiety

Remember, a timely diagnosis is essential. Early identification gives girls with autism the best chance to succeed throughout their school years. For more help and support try our Autism Spectrum Disorder course. 

Autism Spectrum Disorder course
Teachers and teaching professionals looking to develop their understanding of ASD can learn more by enrolling on our Autism Spectrum Disorder course. 

About the author
Jacqui is a Director of OnLineTraining. Contact Jacqui at training@oltinternational.net or on Facebook

About the author

Jacqui is a Director of OnLineTraining. Contact Jacqui at training@oltinternational.net or on Twitter @Team_OLT.