Autism in girls is quite prevalent despite diagnostic skews toward autistic manifestations in boys and men. Symptoms of autism often present differently in females than males but can include similar social, sensory processing, and behavioral challenges. Support options can help autistic girls improve communication skills, emotional regulation, and anxiety often associated with autism.
What Is Autism?
Autism, formally known as autism spectrum disorder, is a neurological condition affecting how an individual experiences the world around them. Autism can contribute to social, behavioral, and emotional differences that influence how one interacts and behaves with others. Every autistic person reports different symptoms and experiences, and neurodiversity exists on a spectrum.
How Common Is Autism in Girls?
Researchers are just beginning to understand how prevalent misdiagnoses are for autistic women. Professionals diagnose autism in girls at a lower rate than in males, at around a 4:1 ratio.1 However, new evidence suggests the rate may be much higher at 3:1.
Autism in Girls Vs. Boys
Female autism often differs from male presentations because girls may be more skilled at camouflaging their autistic traits and blending in with others. Autistic girls often imitate others to cope with social differences or go unnoticed.2 Girls are also socialized to be more polite and present “socially acceptable” behaviors.
In other words, professionals may miss autism symptoms in girls because society expects women to socialize well with others. These influences may explain why autism symptoms in girls sometimes do not present with similar language or communication deficits seen in autistic men.
Signs & Symptoms of Autism in Girls
Signs of autism in girls may be more subtle than those observed in males. Female autistic traits may appear as “quirkiness,” shyness, or heightened literacy. While these traits can also apply to boys and gender-diverse individuals, they generally fall outside the accepted autistic stereotype.
Below are common signs and symptoms of autism in girls and women:3,4,5,6,7
1. Social & Communication Differences
Social and communication issues may present differently in autistic girls. For example, signs of autism in teen girls may include difficulties with forming or maintaining friendships despite the desire for social connections. Other autistic traits in girls may manifest as copying or mimicking social behaviors, and some may rehearse certain situations before engaging with others.
Below are common social differences seen in autistic girls:
- Difficulty forming friendships or maintaining them
- Periods of isolation, where one might appear shy
- A more “chameleon” type of approach where they move from one social group to the next
- Rehearsing social situations
- Copying or mimicking others during social interactions
- Scripting, “cutting and pasting” lines from TV, movies, or other people
- Appearing uncaring or unable to make decisions
- Hyperverbal behavior or speech/language delays
- Using echolalia in conversation
- Over-use of eye contact
- Hypersensitivity to criticism or rejection from peers
2. Sensory Issues
Autism often presents with sensory issues. For example, autistic girls may feel over-stimulation by loud sounds, bright lights, or specific textures. These sensory issues may persist into adulthood, with some women limiting exposure to certain places based on the intensity of symptoms.
3. Special Interests
Females with autism sometimes have special interests that may appear unique or intense to neurotypical individuals. They may hold these interests in high regard, investing much time and energy in educating themselves about various aspects of each topic. For instance, some autistic girls may lean toward art, literature, science, or technology.
4. Behavioral Differences
Autistic girls may present as “quirky” because of stimming behaviors or special interests outsiders consider otherwise “odd.” Signs of autism in females can also include frequent autistic burnout symptoms, as many struggle with constantly masking or overstimulating environments.
Additionally, autistic females often lean toward rigidity. They thrive with and rely on schedules, becoming anxious when they experience change. Overwhelming stress from unforeseen interruptions or obstacles can result in distressful and debilitating meltdowns. Unfortunately, outsiders may not understand these challenges, leaving many autistic girls feeling additional pressure to conform to societal expectations.
5. Masking Behaviors
Girls on the spectrum may engage in masking behaviors to cope with symptoms of autism. For example, some autistic girls might rehearse or copy peers in social situations. In general, masking can feel overwhelming or exhausting for autistic individuals.
Why Does Autism in Girls Go Unnoticed?
Professionals created the diagnostic criteria for autism with boys in mind, meaning girls on the spectrum often go unidentified until adolescence, even into adulthood.2 Presently, the ratio of diagnosis of boys to girls is four to one. However, this ratio would likely change dramatically if more girls received accurate diagnoses.3 Unfortunately, autistic girls are often misdiagnosed with social anxiety, anxiety, borderline personality disorder, or a comorbid eating disorder.3
Discerning autistic female traits can be difficult for the individual, those around them, and sometimes professionals. For example, high-functioning females with autism can display relatively good communication skills and social competency that overall mask the diagnosis.8 They tend to have an increased ability for self-control and can even develop pretty complex empathy skills that would deter a diagnosis.8
Impacts of Masking on Autistic Girls
In general, camouflaging may lead to overall exhaustion, confusion about identity, suicidal ideation, anxiety, and depression in autistic females.8 Masking can also delay diagnosis, meaning many autistic girls do not receive helpful resources or accommodations. Some research suggests masking is an adaptive coping skill. Regardless, the accompanying negative impacts can significantly impact overall well-being and mental health.8
Impacts of Late Diagnosis of Autism in Girls
A late diagnosis of autism can impede autistic females. Many women tend to internalize symptoms, meaning they are more likely to hide anxiety or depression rather than display disruptive behaviors at work or school.
Without education about autism, peers may misunderstand and ostracize autistic girls. One study found autistic participants reported being negatively labeled by peers pre-diagnosis.9 Once receiving a diagnosis, they could find more like-minded individuals, leading to a sense of belonging and positive self-esteem.9
Are There Tests for Female Autism?
Autism tests for girls generally include gathering information from the parent, meeting with the child, and direct observations. The clinician will note things like eye contact, how the child engages in conversation, facial expressions, gestures, and imaginative play.
During an autism assessment, the autism diagnostic observation schedule (ADOS) test facilitates situations where the clinician can observe characteristic traits. However, the ADOS can easily miss autism in girls unless the assessor thoroughly understands how girls and women exhibit (or mask) autistic traits.
Assessing autism in adult women typically includes a meeting and interview with the client where the assessor asks questions and gathers information about present and past traits. Sometimes, the clinician will also meet with parents or other close relatives present throughout childhood to gather additional history and information.
Testing and diagnosis have long revolved around the male model of autism and can be rooted in outdated stereotypes. Because autism in girls manifests differently, obtaining an accurate diagnosis can be difficult. Access to proper diagnosis remains a challenge, but the increase in autistic clinicians and researchers may shift the tide toward increasing understanding of the nuances and diversity of presentations within the autism spectrum.
Autism in Girls Throughout the Lifespan
As autistic girls mature, navigating social relationships becomes more complicated and challenging. Many may struggle with sociality in middle or high school. Over time, autistic individuals may learn strategies to manage these difficulties or to mask their traits. However, they may find camouflaging impossible in stressful or overwhelming situations.10
Autism in Teen Girls
Puberty and adolescence can be incredibly difficult for girls on the autism spectrum due to physical and hormonal changes and the growing complexity of social relationships. Previously unnoticed autistic traits might become more pronounced as life becomes more complicated or overwhelming. Emotionality may grow stronger, possibly increasing sensory, mental, or emotional overwhelm.
Autism in Adult Women
As autistic girls reach adulthood, sensory issues may become difficult to manage. The cost of masking or camouflaging autistic traits can accumulate over the years, leading to autistic burnout, sometimes known as “regression.”
Receiving an autism diagnosis in adulthood is not uncommon, as many women may seek professional support during an autistic burnout. Late diagnosis of autism often occurs when life stressors increase and an individual can no longer spare time, energy, or rest to cope with these struggles.
Also, women with children on the autism spectrum or who are otherwise neurodivergent may notice and identify with the characteristics their children possess. Mothers are more commonly seeking diagnoses after learning their children are autistic.
Support Options for Autism in Girls
Autism in girls is not a disease that individuals should seek to “cure,” correct, or change. Not everyone wants or needs support, but individual therapy can help many cope with challenges associated with autism, like comorbid anxiety or depression. In some cases, medications for these conditions can help alleviate stress and provide additional support.
Therapy
Autism does not automatically require therapy or intervention. Many autistic girls thrive without support when allowed to be themselves and follow their interests. Still, professional help can benefit children or adults struggling in specific areas.
The best therapy offers non-judgmental support, understanding, and unconditional positive regard. Consider finding a neurodiversity-affirming therapist who can offer practical, personal, and empathetic insight to autistic clients.
Therapy options for autism in girls may include:
- Occupational therapy: Occupational therapy can help manage sensory differences, challenges with emotional regulation, or activities of daily living.
- Language and speech therapy: Speech therapy can be helpful for girls with communication challenges. Therapists can help individuals choose a communication method that suits their needs, whether spoken speech, sign language, or typing.
- Individual therapy: Psychotherapy and counseling can help autistic girls and women manage stress, anxiety, depression, pathological demand avoidance, or complex feelings.
- Expressive arts therapy: Communicating feelings through words can be challenging for girls on the spectrum. Expressive art therapies, such as music therapy, art therapy, drama, and movement, can be helpful modalities.
- Support groups: Group therapy provides mutual support, connection, and understanding from other autistic or neurodivergent peers.
- Equine therapy: Horses are a common special interest for girls on the autism spectrum. Equine therapy offers opportunities to care for horses and can be incredibly therapeutic.
Medication
Autism does not require treatment with medication. However, comorbid conditions commonly coexist with autism, such as autism and a sleep disorder, anxiety, depression, or ADHD. Medications can help reduce symptoms of these conditions and improve overall well-being. Individuals should seek medical advice and take medications as prescribed.
Supporting an Autistic Girl in Your Life
Supporting girls on the spectrum means loving, accepting, and encouraging them. Help them locate available resources or accommodations (if they ask), and allow them to explore their gifts and interests openly and proudly.
Below are tips for supporting an autistic girl in your life:
- Seek out resources: Understand that social school environments may feel confusing, exhausting, or unpleasant for your autistic loved one. Ensure to provide a welcoming, understanding, and sensory-friendly space. Consider an IEP or 504 plan if your child needs additional support or accommodations in the school environment.
- Encourage creativity: Drama, theater, and the arts can help facilitate self-expression and communication. Art may be a more comfortable and preferred method of communication than the spoken word. Allow and encourage the individual to engage in creative activities and expression.
- Find a neurodiversity-affirming community: Facilitate connection with peers who may also be autistic or neurodivergent. People within the neurodiverse community often find understanding, communicating, and forging friendships easier when surrounded by like-minded individuals.
- Support their interests: Special interests can be a great source of joy and pave the way for potential career paths and opportunities in adulthood. Women on the autism spectrum often excel in the arts, psychology, and helping professions. Autistic women can be brilliant psychologists and psychotherapists because of their deep empathy and ability to recognize patterns and systems.1
- Provide alone time: Many autistic people require solitude to recharge their energy and recover from school or social situations. Follow her lead if she needs time alone.
- Create a safe environment: Girls can be experts at masking or camouflaging their autistic traits. Masking is extremely taxing and exhausting, so create a space where she can feel free to unmask and be her genuine self.
Final Thoughts
The most important thing to remember is that autism is just a different neurotype with unique strengths and challenges. Accepting each autistic girl in your life as they are, supporting them, and fostering their gifts can be invaluable in their personal growth and success.
For Further Reading
Autism in Girls Infographics
