Autism in Females
Before we begin our discussion about Autism Spectrum Disorder (ASD) in females, we would like to start with a description of the diagnostic criteria. ASD is a neurodevelopmental condition characterized by difficulties with social communication/interaction skills and the presence of repetitive and restrictive interests/behavior (RRB’s). Examples of RRB’s include hand flapping, spinning/rocking, lining up items, an intense interest in a particular topic/hobby, and/or difficulty tolerating changes in routine. Sensory sensitivities are another component of restrictive behavior and includes over-or under-sensitivity to sensory experiences. ASD is considered a spectrum because presentation varies widely across the lifespan and between males and females.
Women/girls are much less likely to be diagnosed with ASD than men/boys. One explanation for this disparity is researchers have disproportionately included males in research groups. This approach shaped how characteristics of ASD were defined, assessed, and what interventions were found to be effective. It also contributed to the misconception that males are more likely to meet criteria for a diagnosis of ASD. Unfortunately, this led to incorrect or missed diagnoses among females. In recent years there has been an increased demand for research focused on female ASD characteristics and their life experiences. Despite these changes, there remains a lot of work to be done to expand the traditional definition of ASD.
Research suggests late and missed diagnoses are more likely to occur among females because their behavior may appear more “socially appropriate” when compared to males. For example, females with ASD often display more motivation to engage with others and their intense interests are viewed as “typical” for their gender (e.g., art, animals, celebrities). Additionally, males are more likely to engage in observable/external behavior (e.g., tantrums, aggression) and females experience internal symptoms (e.g., anxiety, depression), which are less likely to attract attention from caregivers/professionals. Being aware of the characteristics associated with a diagnosis of ASD in females is key to an early and accurate diagnosis. Here is a brief list of some possible signs of ASD among females:
- Difficulties tolerating certain sensory experiences (e.g., being a “picky” eater, bothered by certain smells, strong reaction to wearing certain types of fabrics/clothing)
- Appears “bossy” in their peer interactions by trying to control the relationship/how they play
- May be described as shy if she doesn’t actively seek out social interactions with peers
- Engages in “masking” to control her behavior and hide social difficulties (e.g., hiding “stimming” behavior, mirroring the facial/verbal expressions of others, imitating actions/interactions seen on television/movies)
- Prefers engaging with 1-2 peers at time instead of a group
- Rehearses or practices how to initiate/respond to social interactions ahead of time
- Arranges/dresses up dolls/stuffed animals without engaging in imaginative play
- May not recognize non-verbal communication (e.g., body language, tone of voice)
Once a female has been diagnosed with ASD, there are a variety of therapies and interventions that may be beneficial depending on individual preference and level of need. Working with a mental health provider can help reduce internalizing symptoms by processing difficult or stressful experiences in a compassionate, nonjudgmental setting. Research has suggested it can be helpful for females to join groups specifically for neurodivergent individuals because it offers a safe place to be their authentic selves. There are also a variety of resources/services available in educational and employment settings, such as a Section 504 Accommodation Plan, Individualized Education Plan (IEP), or other support plan. Social skills groups targeting friendship skills can also help females feel more confident navigating social interactions. This is not an exhaustive list and every person with ASD demonstrates different symptoms and needs. If you, or someone you love, is looking for support/resources, speak with a mental health provider (e.g., psychologist, therapist, social worker) who is knowledgeable about ASD in females.
Our understanding of ASD in females continues to expand, but there is more work to be done. An early diagnosis allows for a deeper understanding of one’s identity and why they experience the world differently than others. A delayed or incorrect diagnosis is also a barrier to receiving services, accommodations, and/or therapy. At Wasatch Learning & Wellness our mission is to provide accurate diagnoses through comprehensive evaluations individualized to the needs of each client. If you believe you, or your child, might meet criteria for an ASD diagnosis, please complete our free, no-obligation intake process. We are here to help you find your path.
To learn more, please contact us via phone at (385) 645-4947 or via email at support@wasatchlearningandwellness.com. You can also complete our evaluation inquiry form by clicking here.