Autism spectrum disorder (ASD), also known as autism, is a neurological condition characterized by a wide range of developmental differences, including unique styles of social interaction, communication, and behavior. Although ASD affects both genders, research suggests autism is about four-times more common in boys. This gender gap, however, may not entirely be due to a true difference in prevalence, but rather the way autism manifests in girls, often resulting in delayed or missed diagnoses. Early diagnosis helps children with ASD receive the appropriate support and interventions for their growth and development. 

A mom and young child playing with building blocks.

How Autism Might Look in Girls 

Autism in girls often presents with characteristics different from boys, making it less noticeable and, consequently, more challenging to diagnose. Those differences may relate to  

  • Social Skills: Autistic girls tend to develop better social skills than boys with autism, which can mask their difficulties. They might have a greater ability to form friendships and engage in play with peers, although these relationships could be more one-sided or superficial. Girls with autism may be more inclined to observe social interactions before participating, allowing them to learn and mimic expected behaviors. 

  • Special Interests: Autistic girls may have intense interests, like boys with autism, but these interests often revolve around subjects that are more socially accepted or mainstream. For example, a girl with autism might become deeply engrossed in a popular book series, fashion, or animals, making her interests seem more typical compared to a boy who may have a highly specific interest in train schedules or electrical circuits. 

  • Emotional Expression: Autistic girls may appear more emotionally expressive than boys with autism, but this expression may not always reflect their true feelings. They may develop the ability to mimic emotions they observe in others, which can make it difficult for parents and professionals to recognize their underlying emotional struggles. 

  • Language Skills: Autistic girls can sometimes have better language skills compared to autistic boys, which may disguise their communication difficulties. They may excel at using scripted language or engage in long conversations about their special interests, making it challenging for professionals to identify challenges in conversational skills. 

  • Co-occurring Conditions: Autistic girls often have co-occurring conditions such as anxiety, depression, eating disorders, or ADHD, which can complicate the diagnostic process. These conditions can overshadow the symptoms of autism, leading to missed or delayed diagnoses. 

  • Sensory Issues: These may be less pronounced or may present in different ways than they do in boys. 

The differences in how autism looks in girls can make it more challenging for healthcare professionals to recognize the symptoms and provide a timely diagnosis. A greater understanding of these nuances is essential for ensuring that girls with autism receive the appropriate support and interventions they need.  

The Challenges of Diagnosing Autism in Girls 

Stereotypes and misconceptions surrounding autism often lead to girls being overlooked or misdiagnosed. The current diagnostic criteria for ASD were largely developed based on studies of boys, contributing to a gender bias in diagnosis. In addition, many girls with autism engage in camouflaging or masking their symptoms, which makes it even more challenging for healthcare professionals to recognize their autism. 

 Late Diagnosis of Autism in Girls 

Late diagnosis of autism in girls can have a significant impact on their mental health and overall well-being. Without support and understanding, girls may develop unhealthy coping mechanisms, leading to anxiety, depression, or other mental health issues. Seeking support and connecting with others who have experienced similar challenges can be an invaluable source of strength and encouragement. 

A child and a physician giving a high five.

What to Do If You Suspect Your Daughter May Have Autism 

If you suspect your daughter may have undiagnosed autism, consult with a healthcare professional expertise in diagnosing ASD in girls. When seeking a professional to evaluate your daughter, it's important to choose someone with experience diagnosing ASD in girls, as they will be more attuned to the unique presentation of autism in females. You may want to ask for recommendations from your primary care physician, local autism support groups, or other parents who have gone through the diagnostic process. 

In addition to seeking a professional diagnosis, consider connecting with advocacy and support groups that focus on girls with autism. These groups can provide valuable resources, information, and emotional support for both you and your daughter as you navigate the challenges and triumphs of living with autism. Early intervention and understanding are essential to ensuring that girls with autism receive the support they need to thrive. 

Understanding the unique ways autism manifests in girls is vital for ensuring timely diagnoses and appropriate support. By raising awareness of these differences and advocating for improved diagnostic criteria, we can help bridge the girl gap and ensure that all children with autism receive the support they need to live fulfilling lives.