'Symptoms' of autism in females and girls

The diagnosis of autism has historically been based on boys, with diagnosis rates being considerably higher for males than females.

This means too many girls are missed and the discovery of autism is made too late. Many girls are diagnosed with various mental health difficulties before autism is considered or diagnosed.

But things are changing...

We are learning more and more about autistic girls and getting better at diagnosing and supporting them earlier.

Find out about assessments

Teenage girl playing with rainbow pop-it fidget toy while studying at home. Teen kid with trendy stress and anxiety relief fidgeting game. Popping the dimples of sensory silicone toy.

Why are so many girls missed for diagnosis?

Girls are more able to hide, mask and camouflage their differences to others, particularly at school.
Girls often internalise their differences, often seeing extremely shy or anxious.
Girls don't tend to be a 'problem' in the classroom. They are less likely to show externalised behaviours that are disruptive to others.
Repetitive interests and routines tend to be different in girls to boys. Their interests are very 'age appropriate' but the intensity and focus is often different to their peers.
Girls tend to remain 'under the radar' at school, though typically differences become more apparent during adolescent where their internal resources and ability to maintain the mask becomes untenable.
Girls seem to be able to develop their own, often complex, coping strategies for dealing with the social confusion of the social world and the anxiety this triggers. They may take more of a role in social situations, as the 'mother' or the helper for example.
Our diagnostic tools are too often based on males and are therefore less sensitive to noticing differences in females.

How might I know if my daughter is autistic?

A 'perfect' student

A master of disguise

The autistic girl can be the master of disguise and deception. She has learnt how to mask and camouflage her differences to the world around her. She can copy and imitate others, she can mimic the behaviour of other social able girls at school. She can adopt their language and mannerisms as if viewed through a mirror. She may also try to mend social mistakes or difficulties, even if they are not her own. She may quickly say sorry for every social issue, regardless if the mistake is hers, because social unrest is too overwhelming to cope with.

Socially exhausted

The autistic girl can often be exhausted and overwhelmed by the high level of masking and camouflage she is engaged in. She can often be exhausted when she gets home from school and needs to withdraw to reset and recharge. As time goes on, the time she needs to recharge increases and her level of exhaustion becomes unmanageable. She may withdraw from after school activities in favour of needing to recover from the levels of masking.

Anxiety and mental health

Lack of sense of self and identity

An enjoyment for role play and re-enacting

Many girls enjoy re-enacting what has happened during their day through play and role play, as if processing and then rehearsing how to cope with it. Many autistic girls loved playing schools when they were younger, over and over again, where they would be the teacher.

An autistic girl may show other differences in her play such as enjoying organising and arranging her toys, rather than playing imaginatively.

Many autistic girls can have an incredible imagination and use it as a coping mechanism. We have met many autistic girls with a prolific imaginative world in their head which they can escape to when they are feeling overwhelmed. It may look to others like she is distracted and not concentrating, but in fact she is concentrating intensely on her fantasy world.

High levels of empathy

Rosie King is an autistic woman who advocates for the strengths and abilities associated with a diagnosis.

This clip is a great resource to learn more about autism and girls.

What should I do if I think my daughter is autistic?

Talk to your daughter about their experience of the world. Be curious about what school is like for them, and the areas that they are finding more challenging.

Talk to your daughters school about their understanding of your daughter. Are they aware of any differences? Can they offer any additional support? Don't be surprised if your child's school does not pick up on autism in girls, it can be challenging to spot, especially if they present as the 'perfect' pupil and are not a problem to their teacher.

We can offer a 'screening' appointment to meet you and your daughter and discuss autism in more detail. We will find out more about the differences, and explore areas that your daughter might be finding hard. Importantly, we will get to know her, exploring her perception of her identity and possible neurodivergence. We can then recommend if a diagnostic assessment would be helpful.