Autism in girls may look different, be less noticeable than in boys

Autism in girls can present differently than in boys, and research shows girls can be better at hiding symptoms of autism for a variety of reasons.

Autism in girls can present differently than in boys, and research shows girls can be better at hiding symptoms of autism for a variety of reasons.

For decades, boys have been four times more likely to be diagnosed with autism. Today, according to researchers, certain signs of autism in girls can look different or be less noticeable compared with some of the classic symptoms that are most often noticed in boys. Researchers say this disparity leaves many girls underdiagnosed, misdiagnosed or diagnosed later in life.

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“It’s important for parents to know and recognize the signs of autism in children, no matter their gender, so they can be screened by a professional,” said Grace M. Kuravackel, Ph.D., psychologist and clinical director of Norton Children’s Autism Center, affiliated with the UofL School of Medicine. “Early detection of autism is key — that way children can receive the support they need to thrive at school and among their peers.”

How is autism in girls different?

Girls often show differences in behaviors and social communication compared with boys, which can cause some signs of autism to be missed.

For example, girls with autism can be better at modeling or mimicking learned social interactions, called “masking” or “camouflaging.” Societal pressures may also play a role for females to conform to gender roles.  An autism diagnosis may be easily missed when certain behaviors overcompensate for other more “hidden” symptoms, such as difficulty with nonverbal communication, sensory processing and information processing.

Other signs of autism in girls may be seen as more “socially acceptable,” such as being overly conversational or having special interests. A girl who may not understand social cues may just be seen as “overly chatty.” It also may be less noticeable when a girl shows an intense special interest in a favorite movie character or a celebrity crush, since these behaviors are often seen as a typical sign of development among girls and teens and not a sign of cognitive rigidity.

Signs of autism may become more noticeable after a girl enters her teenage years, when social interactions become more complex, varied and demanding and social difficulties may become too great to manage their usual “masking” strategies. While “masking” can have some benefits in feeling accepted and fitting in, it can also cause more stress and anxiety. When faced with these challenges, it is important to reach out to a mental health professional for further evaluation and support.

Traditional signs of autism

Social Interaction and Communication

  • May appear not to hear you or fail to respond to their name
  • May have poor eye contact or few facial expressions
  • May not speak, or have delayed or limited speech
  • May have difficulty starting or maintaining a conversation
  • May speak in different tones or rhythms; may use a singsong voice or robot-like speech
  • May repeat words or phrases but have difficulty using them in context
  • May not appear to understand simple questions or directions
  • May have trouble expressing their feelings
  • May have trouble understanding the feelings of others and nonverbal cues, such as facial expressions, body language and tone of voice