Autism is often referred to as ASD or Autism Spectrum Disorder. ASD is characterised by three core traits:
- Impaired communication
- Impaired reciprocal social interaction
- Restricted, repetitive and stereotyped patterns of behaviours or interests (including sensory differences)
Although all people with ASD share certain traits, these traits typically present in different ways in boys and girls.
Why is autism more prevalent in boys?
Traditionally ASD has been thought to affect more boys than girls; however there is a growing body of research that indicates that autism presents differently in girls and therefore often goes unrecognised. With the diagnostic criteria for ASD based largely on how autism presents in males, girls can often ‘slip under the radar’ or get misdiagnosed.
How does ASD typically present in girls?
Girls with ASD often recognise on some level that they are different from their peers and as a result they consciously or unconsciously ‘mask’ or ‘camouflage’ their difficulties in order to fit in. Although this can appear to work in the short term, it can later lead to:
- Mental health difficulties e.g. social anxiety, depression
- Internalisation of their struggles and feelings
- Presenting as the ‘perfect student’ in school, but Parents often report a different presentation at home (e.g. meltdowns, anxiety)
- Loss of a own identity from imitating peers
Some of the ways that girls with ASD present differently are:
- Delayed or disordered language skills
- Advanced language skills for her age (e.g. use of vocabulary that would not typically be expected for a child of their age)
- Unusual pitch – falsetto quality/ high pitch, monotone, flat affect
- Repetitive or scripted language (e.g. use of language or phrases used by peers or heard on tv)
Impaired reciprocal social interaction
- Observe others intently
- Excellent imitators/ mimickers
- Very good at responding to direct questions; however they struggle to initiate interactions and conversations
- Can struggle to follow conversational leads or respond to ‘cliffhangers’ (e.g. “I rode on an elephant yesterday”)
- Often appears to look like they are playing appropriately; however they are often mimicking what their peers are doing
- Can be very attached to one particular peer (intense relationship) and often becomes very reliant on this peer e.g. ‘lost’ if that peer is not in school
- Good at appearing like they are having conversations with others by mimicking others’ language
Restricted, repetitive and stereotyped patterns of behaviours or interests (including sensory differences)
- Repetitive interests are often based on objects that girls their age like(e.g. polly pockets, teddies, dolls), so they are often missed; however it is the intensity of their interest and what they do with these objects that differs e.g. set up toys, but don’t play with them, repeat/ imitate play scenarios they have seen, collect items
- Typically demonstrate sensory differences from a young age (e.g. sensitivity to loud sounds, picky eater, sensitivity to fabrics/ tags/ colours of clothing). Girls will typically learn to cope with these difference as they get older; however this doesn’t mean that these sensory differences go away
It is important to note that some boys on the Autism Spectrum can also present with this more subtle presentation of ASD, in the same way that some girls with ASD can present with more overt traits.
If you are worried about your child’s social communication development please contact us at Sparking Speech for a FREE telephone consultation to discuss your concerns.
- ‘Women & Girls On the Autism Spectrum’ Training Course – https://www.autism.org.uk/professionals/training-consultancy/online/women-and-girls.aspx
- Hiller, R.M., Young, R.L. & Weber, N. (2014) Sex Differences in Autism Spectrum Disorder based on DSM-5 Criteria: Evidence from Clinician and Teacher Reporting. J Abnorm Child Psychol (2014) 42:1381-1393.
- Begeer, S., Mandell, D., Wijnker-Holmes, B., et al. (2013) Sex differences in the timing of identification among children and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders 43: 1151-1156.
- National Autistic Society – https://www.autism.org.uk/
- The Diagnostic and Statistical Manual of Mental Disorders (DSM–5)
- As I Am – https://asiam.ie/
- ASHA – https://www.asha.org/public/speech/disorders/Autism/
- RCSLT – https://www.rcslt.org/speech-and-language-therapy/clinical-information/autism