Like many girls with autism, Pauline Campos’s 9-year-old daughter’s situation often escapes notice from unsuspecting people:
My daughter has high-functioning autism, which is the diagnostic term doctors now use for what was formerly known as Asperger’s syndrome. Many of the typical behaviors that we associate with this condition, such as hand-flapping and rocking, don’t apply to her.
That’s because most of the public’s understanding of the condition applies primarily to boys and men.
Girls and boys on the autism spectrum very often present with different signs and symptoms:
“Compared to their male counterparts, high-functioning girls on the spectrum are often misdiagnosed with social ‘difficulties’ instead of ‘disabilities,’” said Judith Zenna-Valgento, a clinical psychologist and director of Brightmont Academy in Arizona, a private school that caters to children who need one-on-one instruction, including many with autism.
“Females on the spectrum can exhibit social skills and strategies at a higher level than male peers. They can also exhibit imaginative play and can appear to have less obsessions than males. For example, a female who is fixated on dogs will be less suspect than a male fixated on the pattern of a ceiling fan or floor tiles.”
The differences between males and females with autism can be striking. According to the CDC, males are 4.5 times more likely to be diagnosed with autism spectrum disorder than females. In the United States in 2017, 1 in 68 children have been diagnosed with autism. Broken down by gender, it’s 1 in 42 males and 1 in 189 females. Campos explains how autistic girls can fly under the radar and escape formal diagnosis:
Generally speaking, girls on the higher-functioning end of autism spectrum disorder may attempt to direct their “restricted interest” ― fixations commonly associated with autism thanks to longstanding research based almost entirely on observing white men and boys ― to something less obvious so they can blend in.
Many researchers have acknowledged that current diagnostic criteria based on the male brain misses how autism affects and presents in the female brain. This translates into girls and women being diagnosed less often or later in life.
Girls with autism are often diagnosed with eating disorders, ADHD or anxiety and have been known to harm themselves. Many also report fear of change and a rigid preference for what is already known and comfortable, which was one of the main reasons my husband and I kept pushing for an autism evaluation for our daughter. (This isn’t to say that girls and women with autism cannot or do not present with “typical” symptoms; just that those who don’t present with these symptoms are less likely to be diagnosed.)
Campos says current research into these gender differences of how autism presents in children finds girls to be more emotional and socially introverted, quieter and less demonstrative than boys:
Girls with autism don’t only often differ from boys in terms of their social skills. Boys are also more likely to provide a visual clue that they have the disorder, another “extreme male brain” sign (like the aforementioned flapping and fixations on ceiling fans).
That’s because of gender differences in sensory processing and emotional expression, says pediatric occupational therapist Amy Baez and founder of Playapy, a Miami-based therapy resource for parents.
“Boys tend to have more repetitive and restricted behaviors compared to girls,” said Baez. “My experience shows that girls tend to internalize their feelings and boys externalize. Hence, boys are noticed more because those feelings become more disruptive to others.”
Interested in learning more about autism? This Saturday, August 12 at 1 pm, Pediatric Alliance will be presenting a program entitled “It Takes A Village: Autism/Learning Disabilities,” hosted by The Woodlands Foundation (134 Shenot Road, Wexford, PA). Come join us and listen to the following lineup of speakers:
A Significant Difficulty – Autism Spectrum Disorder: A discussion with a focus on early diagnosis, new research, socialization, and other therapies — presented by Michael Petrosky, MD, FAAP, Pediatric Alliance — Wexford.
Executive Functioning: This encompasses cognitive, behavioral, and emotional regulation — presented by Dr. Erika Buchanan, Licensed Psychologist and Certified School Psychologist from the Center for Pediatric Neuropsychology.
Learning Disabilities and Navigating School Based Services — presented by Damian Ternullo, MD, FAAP, Pediatric Alliance — St. Clair.
Guest speaker: Kristin C. Weidus, Esq., Ruder Law – Advocates for the rights of children in public schools.
The Woodlands Foundation: Enrichment for people of all ages living with disabilities and chronic illness, while providing respite for families — presented by Jesse Solomon, Director of Programs.
Local resources will be available with materials and additional information following Q&A.
Learn more about “It Takes A Village: Autism/Learning Disabilities” and register for the class here.