Girls with autism - Evolve Psychology %

According to Autism in Pink autism in women and girls is “often overlooked or diagnosed late”.

Here we will explore why more boys than girls are assessed and diagnosed for ASD, how girls are masking their traits and the impact of masking and the signs of autism in girls and women.

Source: Autism Diagnostic Service | NHS GGC

Why are less girls diagnosed with autism?

Masking ASD

There is some evidence that there are biological factors which explain why fewer girls and women receive a diagnosis for ASD. Another argument is that women with autism simply don’t fit into the standard ASD profile (signs and traits).

We know that parents can be reluctant to seek a diagnostic assessment for their child because the child is coping or the parent is unaware of the full impact on the child.

If their daughter appears to be coping reasonably well then any changes in behaviour can easily be explained away by puberty, shifting social pressures, school transitions and academic pressures. It may appear to be a leap to thinking any behaviour or symptom could be the result of ASC.

Teacher likewise often under report traits in girls because the child is masking the full extent of their traits effectively. Clinicians similarly may hesitant to commit themselves to a diagnosis unless the signs are significantly different from “a normal range” of behaviour and abilities.

How are girls and women masking autism?

Our clients will often have their own personal strategies to mask or camouflage their difficulties.

They have worked out how to act, what to say and what expression to give. This may be by basing behaviour on mirroring from another scenario or research. The masking can be exhausting (as you’d imagine) because they have to actively manage their inner anxiety whilst appearing calm and confident on the outside. At school the child may be managing to appear social in the play ground at lunchtime and then and a model student in the classroom, but as soon as they get home they collapse. They crave some down time and if they are put into another ‘pressured situation’ then it can be too much. After school clubs for example may sound like a great idea but to someone on thee spectrum it may feel like another performance that they don’t want to do.

Successfully masking means constantly prove oneself and in effect being ‘fake’ . This can lead to feeling misunderstood and that in itself can lead to feelings of frustration.

Coming up with ingenious and creative ideas to imitate, model and camouflage difficulties can include developing ‘social scripts’ for real-life situations. They prepare themselves for a social situation, like an actor learning a part. They think about all the permutations that may appear, understanding what they could say, how they could act and what may be expected of them.

Here the Art of Masking shows what impact this masking can have on the individual.

Girls masking autistic traits

Source The Art of Masking: Autistic Women who Mask | Tiimo (tiimoapp.com)

What are the signs of Autism in girls?

11 signs of Autism in girls

Verywell / JR Bee

You can read more about autism in our other blog but when we are talking about girls with autism these points are important to note:

Create imaginary friends
Girls can use these imaginary friends or play with dolls to substitute for real people. This make believe can help them experience some sort of connection without the social pressures.
Fascinated with a subject
Whether it’s history, literature, or a subject girls can become very educated and interested in a specific subject.
Tone of voice
This can resemble a much younger person and have a childlike quality.
Different to their friends
They may not hold the same values as their friends and can then feel different.

How can we better support girls with autism?

We hear client’s saying “I don’t came across as autistic” but wish they had the confidence to stand up and say “I am actually autistic.”

Many girls, young women and adults we have spoken to, wish friends and family knew the ‘real them’ and that their struggles and differences were understood and accepted.

If this sounds familiar and you are looking for some help and support than a good starting place maybe an assessment. We assess children and adults for neurodevelopmental conditions and you can find out more here Autism Assessments