Diagnosis of Autism in Girls and Women

Published on May 29, 2024

What are the classic signs of Autism?

Autism, or as its officially called, Autistic Spectrum Disorder (ASD) is

  1. Deficits in social communication and social interactions in a variety of situations and places.
  2. Restricted, repetitive patterns of behaviour, interests or activities.
  3. The presence of symptoms beginning early in life.
  4. The presence of symptoms that lead to clinically significant difficulties with social, educational, occupational or other important areas of functioning.

What are the issues when diagnosing ASD in males versus females?

When Autism assessments are conduct, ASD is diagnosed at a rate more than four times the rate for females. The disorder is thus more common in males. However, this likely is the result of females often not fitting the stereotyped image of someone with Autism. As a result, many girls and women go undiagnosed.

To be more specific, clinicians and researchers have come to realise that many “high functioning” females with Autism are simply missed. “High functioning” refers to those whose intellectual functioning or IQ is not impaired or low. These girls and women have often been called “lost girls” or “hiding in plain sight” because they’re overlooked or diagnosed late. They don’t fit the stereotypes, or their symptoms are misinterpreted as something else. And they may be better at hiding the signs, at least when they’re young.

Let’s look at this in more detail:

  1. Girls’ and women’s symptoms are often less obvious. Unlike males with Autism, who may express frustration by being disruptive or aggressive, females are trained to be cooperative, so they’re not as likely to be referred for an Autism assessment.
  1. Although boys with ASD may be intensely focused on things like trains or computer games, girls with ASD often have special interests that seem typical for girls their age, like Disney movies or animals, so they don’t stand out. A 2005 study at Stanford University found that girls with Autism demonstrate fewer repetitive and restricted behaviours than do boys. The study also found brain differences between autistic boys and girls that may help explain this discrepancy.
  2. Because they are better at imitating what they see around them, girls and women tend to have better eye contact or social interactions than do males with Autism. So even though they’re struggling with social communication and relationships, females are more likely to “pass” as typical until as late as middle school and do not receive an Autism assessment. They often engage in what we call “masking.”
  3. Although not written about or researched, girls and women with ASD are often very private about their thoughts, feelings and relationships, and often become distressed easily when asked about them.

#Autism #Autistic Spectrusm Disorder #ASD


Category(s):Adult psychological development, Anxiety, Asperger's Syndrome, Autism spectrum disorders

Written by:

Andrew Adler, Ph.D.

Andrew Adler, Ph.D. is the director of the Adler Family Centre and the Honorary Consultant (Psychology) at OUHK-LiPACE. He is a licensed psychologist in New York State (US) and has specialised in evaluating and treating a wide range of psychological difficulties for the past 20 years. He earned doctoral and master degrees in clinical psychology from Yale University after graduating Magna Cum Laude with a bachelor’s degree from Brandeis University. He taught at Yale University and supervised medical students as an Assistant Professor of Clinical Psychiatry at New York Medical College. In his work in hospitals, clinics and private practice, Dr. Adler has evaluated and treated the full range of psychological difficulties experienced by children, adolescents, adults and their families. Prior to moving to Hong Kong, he was a psychologist in Shanghai for three years, treating and assessing children and adolescents, both expats and local residents.