Understanding autism in girls

Understanding autism in girls

Autism in girls has not had the same attention as in boys.

Research focused on Autism prevalence has historically been on Autism in boys.

If you read up on Autism prevalence rates, male to female ratios can vary from 16:1 to 2:1.

There are many reasons as to why girls have historically flown under the radar of an Autism diagnosis, such as:

  • The gendered presentation of Autism (ie Autism being known as a ‘male’ condition)
  • A lack of knowledge in those diagnosing as to how Autism may present differently in girls and women
  • The tools and testing used to diagnose Autism have been developed based on how identification of how Autism presents in boys.

Factors such as

  • Intelligence,
  • Differing repetitive behaviours and
  • Intense, special interests and
  • The use of ‘masking’ or camouflaging have all been offered as potential reasons that an Autism diagnosis may be harder to confirm or even missed altogether in a girl.

It is not uncommon to hear a specialist say that they are ‘not convinced’ that a girl is Autistic, when her family is pursuing a diagnosis, and the journey to diagnosis may be longer than that to diagnose a boy that has a more ‘textbook’ presentation of Autism.


Intelligence may influence Autism diagnosis in a number of distinct ways.

Autistic girls with a lower IQ may be misdiagnosed as having a learning disorder or a Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS).

In contrast, girls with strong verbal skills and a higher IQ who may meet the criteria for an Autism diagnosis may be less likely to be diagnosed or diagnosed a lot later as a result of their verbal skills and intelligence.

For many girls, Autism diagnoses increase with age and as they are able to articulate their inner experience more as they get older.

Many girls are not diagnosed until adolescence or even into adulthood.

Often many may initially be referred for or misdiagnosed as having an Eating Disorder, Borderline Personality Disorder, an Anxiety or Depressive Disorder or ADHD, before they actually receive an Autism diagnosis.

Repetitive behaviours and special interests

Repetitive behaviours and intense special interests are almost always part of an Autistic girl’s experience, but these may differ to those stereotypically demonstrated by an Autistic boy.

An example of what a repetitive behaviour or intense special interest in an Autistic girl might look like, is a girl who carries a few much loved books around with her everywhere, reading instead of socialising whenever she has the opportunity.

Another example is the girl who has to handle her dolls a certain way, insisting on sameness for the routine of putting the doll to bed and how the doll house is arranged. Both are potential repetitive behaviours that could easily not be described as ‘atypical’.


Research has also found that Autistic girls and women may be effective at superficial social skills which may help them ‘mask’ or ‘camouflage’ their Autistic characteristics. This greater ability to imitate social behaviour that is considered ‘socially acceptable’ can also impact on the correct identification and diagnosis of Autism.

Autistic girls may appear to have stronger social and communication skills, the ability to pretend play and focus for extended periods, and have fewer behaviour problems than Autistic boys, but again, this is often due to their ability to ‘mask’ their internal experience.

The outlook

The good news is that the awareness of how Autism may present in girls is increasing, with those that are tasked with diagnosing our girls now being much more likely to understand the differences in how Autism looks in girls.

Some fantastic research is being done in Australia on topics such as the Female Autism Phenotype, Autistic Burnout and also complementary medicine use in Autistic children and adults.

Affirmative, experienced practitioners are available at The Paediatric Naturopath to support Autistic children and adolescents, children and adolescents with ADHD and other Neurodivergence and children diagnosed with developmental delays and their families seeking dietary and lifestyle support. Make an appointment today.

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