Are Girls Really Less Likely to Have Autism?

Many learning and attention difficulties, including ADHD and Autism Spectrum Disorder (ASD), are found more often in boys than in girls. When it comes to ADHD, figures vary, but it is estimated that boys are at least twice as likely to have ADHD than girls. In terms of ASD, a boy is four times as likely to have ASD than a girl.

These statistics point to a large number of potentially undiagnosed or misdiagnosed women and girls with ASD who are simply not being recognized and therefore will not receive the support and treatment they may need. This compelling issue is well described in the article “Invisible Girls” by Nancy Volkers.

Volkers argues that, since current ASD diagnostic tools were normed on boys, they often don’t identify some girls. Since the assessments were developed with boys in mind, they overlook the fact that the symptoms of ASD can look very different between genders.

Typically, girls are more socially motivated than boys, and this leads to vast differences in ASD symptoms. For example, one classic symptom of ASD is “restrictive interests.” This calls to mind a young child with ASD who is more interested in playing with the wheel of a car than pretending to drive the car. Girls are more likely to have socially acceptable interests, such as dolls or horses; however, Volkers notes, they are just as likely to engage in repetitive play with those toys.

Volkers also points out that girls are more likely to attempt to camouflage their symptoms in an attempt to fit in, hiding the behaviors that would typically lead to diagnosis. Volkers writes, “Some studies are finding that the girls try very hard to camouflage the social problem—they remember scripts, or pay a lot of attention to what other girls are doing…”

The risk for girls with ASD is high. Some will never be diagnosed, or they may be diagnosed as teenagers or adults after years of suffering in school and in their relationships with others. At times these girls are even misdiagnosed with other conditions, including anxiety disorders, eating disorders, or ADHD.

We need to learn to understand how ASD presents itself in women and girls so that we can provide early screening and early intervention. No one should be left to struggle in silence. In the words of Ami Klin, director of the Marcus Autism Center and professor and chief of the Division of Autism and Related Disorders in the Department of Pediatrics at Emory University School of Medicine, “Females are the orphans of the autism world.”

  • Michael Greschler, M.Ed., SMARTS Director