Autism Spectrum Disorder is a neurodevelopmental condition impacting social communication, social reciprocity, sensory processing and flexibility, across the life span. The rate of diagnoses amongst males has always exceeded that of females. Females also tend to receive their diagnosis later than males, even when concern has been raised at similar ages. Girls who present with similar autistic traits to males, are also less likely to receive a diagnosis. The research has found that the girls need to face more significant difficulties to receive a diagnosis.
As a result, women and girls often go undiagnosed and not having access to the early supports that come with receiving a diagnosis. Girls who have not been diagnosed report experiencing social isolation, feeling misunderstood or not fitting in. Access to intervention and community supports builds an individual’s understanding of what it means to be autistic and have more positive autistic identity. It also supports them to develop a sense of belonging to the autistic community.
It is felt that girls and women go undiagnosed or receive misdiagnosis, due to a lack of understanding of the female autism phenotype. While many of the characteristic of autism are similar for both genders, the current literature has identified four key features that present especially in autistic girls and women.
- Autistic females show higher social motivation in comparison to autistic males. They often build close relationships with one or two peers, significant challenges maintaining these relationships when things go wrong.
- Camouflaging or masking of autistics traits is more prevalent amongst females. This may include the use of practiced phrases or gestures, remembering topics for conversation or forcing eye contact.
- Autistic females are more likely to internalise their emotions, often appearing to cope in environments that are actually challenging and fatiguing. This contributes to poor mental health.
- For males, restrictive and repetitive behaviours often focus on mechanics or mathematics, while autistic female’s interests are more socially focused e.g. novels, animals or celebrities. These interests are more commonly shared by neurotypical people.
Increasing awareness of the female autism phenotype, will allow more women and girls to access the necessary supports that come with receiving a diagnosis, contributing to greater long-term outcomes.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders ( 5th ed.). Washington, DC: American Psychiatric Association.
Begeer, S., Mandell, D., Wijnker-Holmes, B., Venderbosch, S., Rem, D., Stekelenburg, F., & Koot, H. M. (2013). Sex differences in the timing of identification among children and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(5), 1151– 1156.
Giles, D. C. (2014). ‘DSM-V is taking away our identity’: The reaction of the online community to the proposed changes in the diagnosis of Asperger’s disorder. Health, 18(2), 179– 195.
Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M., & Mandy, W. (2017). “Putting on my best normal”: Social camouflaging in adults with Autism Spectrum Conditions. Journal of Autism and Developmental Disorders, 47(8), 2519– 2534.
Parsloe, S. M. (2015). Discourses of disability, narratives of community: Reclaiming an autistic identity online. Journal of Applied Communication Research, 43(3), 336– 356.
Hull, L., Mandy, W., Lai, M. C., Baron-Cohen, S., Allison, C., Smith, P., & Petrides, K. V. (2019). Development and validation of the camouflaging autistic traits questionnaire (CAT-Q). Journal of Autism and Developmental Disorders, 49(3), 819– 833.
