1 in 189: How Autism Effects Girls Differently
by Olivia Gauthier
With the number of diagnoses increasing each year, Autism has moved more and more into the public eye as medical professionals and scientific researchers struggle to determine what causes this neurodevelopmental disorder. It’s also become more and more of a visible disability in our culture, with influencers discussing their challenges, and others wearing autism pins. In an unexplained phenomenon, boys are approximately nine times more likely to have the disorder compared to girls with 1 in 42 boys being diagnosed compared to 1 in 189 girls. However, recent studies show that more girls have Autism than is believed – they are just able to mask their symptoms well into adulthood. Why is this? Why does Autism manifest differently in boys than it does in girls?
Autism is a general terms for a number of complex brain development disorders. The term “Autism” was coined by psychologist Eugen Bleuler in 1908. As he meant it, Autism meant “morbid self-admiration and withdrawal within self.” The leading trailblazers in Autism research were Leo Kanner and Hans Asperger. Kanner focused on more acute cases where as Asperger focused on more able children (thus, leading to the name “Asperger Syndrome” to describe high-functioning Autism). While we know that autism is hereditary, little progress has been made on its underlying cause. Theories range from chemical imbalances and triggered genes to poor mothering and vaccinations. A solid cause has yet to be determined.
Recognizing signs of Autism is difficult because all cases are different, girls socialize differently than boys, and most importantly, autism screening and diagnostic tools were created based on behaviors displayed by boys. Because of this, researchers are unaware of what symptoms to look into for girls. In the past, Autism research in girls was limited in scope to girls with more severe cases and lower intelligent quotients. As a result, girls with high functioning Autism and higher IQ’s were overlooked.
The symptoms of Autism vary widely across three core areas: characterized social-interaction difficulties, communication challenges and a tendency to engage in repetitive behaviors. Researchers believe that girls with Autism are able to mask their symptoms better than their male counterparts. In a study conducted by psychologist Rachel Hiller, it was found that girls were more likely to mimic those around them in social situations when compared to boys. Girls also showed more of a desire to "fit-in" with their peers. In a school setting, girls control their emotions more and teachers are less likely to focus on their behaviors compared to boys. Researchers found that ASD girls are more socially on par with neurotypical boys than girls. They experience the same social challenges as neurotypical girls do but find it harder to cope with these problems because they feel no emotional connection, to begin with.
So why does Autism express itself differently between the sexes? Researchers have yet to figure this out. Figuring out the reason could lead to insight on the cause of Autism and vice versa. At the moment, though, many girls are at a disadvantage due to late diagnoses or no diagnoses at all. The lack of an appropriate yardstick is the reason roughly 80% of ASD women are misdiagnosed. While they may be able to “fake-it,” there is still that disconnect from those around them which could possibly lead to anxiety, depression, and other mental issues. This is especially true for girls who are able to handle daily life and show no apparent signs of cognitive disabilities. For the time being, researchers and medical professionals need to tweak the criteria for an autism diagnosis to account for the girls that seem to fly under the radar.
Despite the lack of a causal link between gender and autism, studies have shown that hormonal differences between males and females may affect how autism expresses itself. The naturally occurring levels of estrogen and progesterone in females have been found to have “protective effects,” allowing ASD females to mask some of the symptoms. Another inference is that “males are just more vulnerable.” That is to say, their natural makeup makes them more susceptible to certain genetic mutations or variations that are linked to autism.
It’s important to note that these differences are not universal and that every individual with autism is unique. Parents and professionals have to be aware of the potential for underdiagnosis and misdiagnosis. It’s also important that parents become more alert when it comes to looking out for the signs of autism in their daughters. Spotting signs could be important for obtaining a diagnosis - which could be important for accessing extra support such as autism therapy. While many girls with autism may be able to make efforts to fit in, not getting that extra support could be stopping them from reaching their full potential.
You can learn about the signs of autism online in articles such as this one.
And if you wish to explain autism to kids, this blog from Serenity Kids will help.
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