Why Do Girls With Autism Have Difficulty Getting Diagnosed?

When people think about Autism Spectrum Disorder (ASD), it is often associated with a discrete set of hallmark traits. Some of these include social difficulties, hand flapping, meltdowns, and extreme interests in uncommon things. Recent research has uncovered differences among boys and girls in their presentation and experiences of ASD. Understanding of what was previously assumed to be a male-dominant diagnosis, has now broadened, uncovering unique signs and symptoms of ASD for boys and girls. It is possible that several girls with an ASD diagnosis have flown under the radar due to limited understanding of female ASD experiences. As such, it is important that parents and practitioners be aware of the signs of Autism in a female population.
Boys and girls with ASD present differently from as early as preschool. Both boys and girls experience similar problems with understanding social situations, though specific behaviours and skills are more found more consistently in certain genders. Generally speaking, girls’ symptoms tend to be less obvious than boys’ symptoms of the same diagnosis. However, it is important to note that the presentation of an ASD diagnosis varies significantly between each person, and no unique set of symptoms will describe all individuals with an ASD diagnosis.


For boys, common characteristics of Autism include:
• Social withdrawal and isolation
• Difficulties making and maintaining friendships
• Struggles with social skills
• Disruptive behaviours in the classroom
• Frequent tantrums and meltdowns at home as well as in public places
• Sensory sensitivities
• High levels of obsessive interests and repetitive behaviours

The presentation of ASD in girls is quite different, and at times may appear to contrast some of the signs we commonly expect in boys.
• Girls with ASD tend to achieve some social success by imitation or by avoiding engagement in interpersonal situations. This may be attributed to the fact that girls with ASD possess a strong desire to fit in with others. On some level, girls escape into an imaginative fantasy in settings beyond the home, emulating and mimicking others in social situations.
• Girls with ASD are better able to manage the use of gestures and maintain conversations than boys.
• Girls with ASD tend to experience their tantrums and meltdowns in the home, as a result of built up tension throughout the day.
• Girls with ASD also tend to experience lethargy and irritability to a greater extent than boys with ASD, potentially as a result of this accumulated tension.
Obsessive interests in girls tend to be less than that of boys, and generally surround topics that are typical of young girls (e.g. reading, dolls, horses, colouring, fashion, appearance). These interests are often overlooked given how ordinary these interests appear. Yet, though not uncommon, these are pursued with autistic intensity.
• Girls with ASD tend to obsess over their friendships. Generally, a small number of friendships are formed and these tend to be intense one on one friendships.


Top Tip

If parents, carers or educators have concerns for an ASD diagnosis in young girls, some early signs in the preschool years that parents should look out for are:
• Intense emotions (particularly distress)
• An inability to be comforted by affection
• Resistance to change, auditory and tactile sensitivity
• Unusual language characteristics
• Not identifying with or wanting to play cooperatively with female peers
• Determination to organise toys rather than play with and share them
• Intense interests in reading resulting in an extensive vocabulary
If these concerns have been raised and have appeared consistently, consult our psychologist for more information, and a standardised assessment of ASD.

Helpful Resource

“I’m an Aspie Girl” by Danuta Bulhak-Paterson is a great book for girls on the autism spectrum over the age of 5. This book may be used as a tool for preparing girls for education about their diagnosis. In this book, Lizzie talks about the things that she and other girls on the spectrum have difficulties with, as well as the things that are special about them. These ideas are presented clearly and simply, and provide a platform for discussion for parents and practitioners to explore with girls.

aspie girl book


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