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How does Autism Manifest Differently in Females?

Statistics provided by the Centers for Disease Control and Prevention (CDC) suggest that Autism Spectrum Disorders (ASD) are diagnosed in males more than 4% compared to females. With surveys such as these, it is typically hard to decipher whether there are more cases or more registration of cases. The question in this particular case is furthered by the fact that autism in girls presents itself more subtly than it does in males. In fact, an article by Marina Sarris highlights that most studies on autism are based on case studies of male patients. Females with autism do not exhibit symptoms commonly aligned with the condition, and are able to mask the social deficits associated with ASD so well that they may not seem to require a prognosis.

Sarris notes research by Interactive Autism Network concludes that there are a number of female cases which are either diagnosed fairly late- enough to delay intervention- and some which remain undiagnosed throughout.

The Signs and Symptoms of Autism Spectrum Disorder in Females

The signs and symptoms that manifest in females with Autism Spectrum Disorder are less noticeable as compared to those identified in males. This is a major reason why the condition is generally overlooked in girls, keeping them from effective reinforcement and therapies. The intensity of the various possible signs and symptoms of autism in females may vary with each individual.

Signs and Symptoms in Female Toddlers

Signs of autism in toddler girls are identified as being similar to those of toddler boys, including:

  • Rejecting physical contact, like hugs and cuddles;
  • Losing certain skills, like linguistic capabilities;
  • Not being able to respond to their name by their first birthday;
  • Avoiding eye contact.

However, with the association of specific traits with the female stereotype, these signs and symptoms are largely overlooked. For instance, an obsessive interest in toy trucks or automobile trivia is categorized as a sign of autism in boys. Conversely, a girl with no such interest may show more subtle signs, for example dressing dolls or arranging toys in a certain manner.

Signs and Symptoms in Adolescent Girls

At the 16th Annual International Meeting for Autism Research (IMFAR) in San Francisco, Dr. William Mandy presented his research team’s findings on individuals with Autism Spectrum Disorder. They concluded that tell-tale signs of autism collectively display in girls in their pre-teen and teenage years; whereas boys tend to exhibit consistent and similar tendencies throughout their adolescence. A marked elevation in autism driven social deficits can be noted in girls between ages 10 and 16.

Mandy admitted to having expected a decrease in symptoms of ASD, instead of an increase. However, he relates the research findings to a quote from Hans Asperger who claimed a possible reason for the lack of apparent autistic characteristics in girls may be “because these traits don’t show onset until adolescence with females.”

It is useful to note that one or two signs of autism in well-adjusting girls may not necessarily indicate they have the developmental condition. Therefore, it is more appropriate to categorize the following autistic tendencies in adolescent girls as possible markers of Autism Spectrum Disorder:

  • They may come across as unnaturally shy, depending on others, typically girls, to guide or speak up for them or guide them at school. Some studies suggest that girls with high-functioning autism may employ methods to cope with relevant deficits and mask the symptoms.
  • They can have focused and limited interests, like fixating over a television show’s actors, props, locations, etc. without information on the storyline. Their conversation is also normally restricted to their restricted fascinations.
  • Autistic girls may suffer from hypersensitivity to external stimuli, such as loud noises, strong smells, bright lights, etc.
  • They may be seen as quiet in social situations or uncommonly passive, due to receptive and/or expressive difficulties. This also poses a struggle with moderating feelings, getting highly agitated when faced with normatively minor frustrations.
  • Autism is associated with obsessive-compulsive and mood disorders. Girls suffering from ASD, thus, can experience an atypical extent of anxiety, depression or moodiness from time to time. Moreover, they may go through separation anxiety from their parents or caregivers.
  • Girls can find it hard to establish or maintain friendships. This could possibly be the cause of unawareness of social cues and norms, or for being incapable of meta-representation. They can often be seen playing alone, or preferring to play with boys rather than with female peers.
  • They may also suffer from seizures, being more prone to epileptic episodes than boys with autism.

Signs and Symptoms in Older Female Children

As highlighted by the Autism in Girls Checklist provided by the Staffordshire County Council, the signs of autism in teenage girls afford the affected with both strengths and weaknesses. It is perhaps this duality that restricts diagnoses among girls, restricting them from social inclusion and Autism Therapy.

  • Girls may find themselves copying social mannerisms and behaviors, for lack of formulating their own personal or gender identity. This can help mask social deficits, until they face a situation they have not yet scripted.
  • They can be hypersensitive to external stimulus, or hyposensitive. The latter commonly causes problem behaviors in the individual, like picking their skin, or may pace around, rub their hands or clear their throats to relieve sensory frustrations. Sensory processing struggles may also trigger eating disorders, and can be the reason behind poor personal hygiene.
  • It is possible for them to be seen as immature, as they may show affiliation towards a certain object (e.g. a special blanket, or stuffed toy) or may have an imaginary friend to gain a sense of comfort. They may also prefer to play with either, children far younger, or older than them.
  • Girls with autism may appear to suffer from learning difficulties for their forgetful impression, disinterest in homework, and problems with starting work in lessons or giving up on incomplete work. However, it is actually associated with perfectionist tendencies, as they have a mentally exhausting fear of failure.
  • They may be unable to comprehend social hierarchy, conducting themselves inappropriately with those in authoritative positions. This can include correcting adults and peers, misbehaving with teachers, and not acting their own age.
  • Autistic girls can come across as bossy, as they may display an unnaturally strict adherence to rules; so much so that they may tell on themselves if they feel they did not conform to regulations. They may also feel an aggravated need to be right, seeming highly opinionated.

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