Autism in Girls Can Hide Behind Social Cues

How is autism in girls unique? An expert shares insights.

In recent years, there’s been a rising awareness that autism in girls often presents differently compared to boys. 

Camouflaging is a key feature of autism in girls, according to 2021 medical research published in the National Institutes of Health. 

But as females mask their symptoms to fit in, they encounter unique challenges. “Autism masking” refers to how people with autism may strive to hide their symptoms of autism from others.

Girls with autism are at risk of delayed diagnosis, says Melissa Furman, clinical director at Total Spectrum, an autism therapy center.

“If a male client is engaging in hand-flapping behaviors, fingerpicking, lining up cars and trucks, spinning wheels, they’re going to be able to get diagnosed and started with applied behavior analysis (ABA) services right away,” Furman says. 

How does autism look different for girls?

Female clients may be masking their behaviors, says Furman. The diagnosis of autism might not be readily apparent.

Some signs of autism that doctors look for: 

  • Social challenges 
  • Limited eye contact
  • Sensory sensitivities
  • Fixation on particular interests 
  • Sleep disturbances
  • Challenges in emotional regulation

When a female client maintains eye contact, smiles and actively engages with the pediatrician, it becomes easy for the doctor to overlook masked symptoms. This can potentially lead to undiagnosed autism in girls who are skilled at masking. 

Total Spectrum Signs of Autism in Girls

According to Furman, when symptoms aren’t apparent by conventional standards, diagnosing autism becomes challenging, often resulting in delays or missed diagnoses. Consequently, delayed diagnosis translates to delayed treatment, further complicating the situation.

“If a female patient can’t receive access to those services then she might continue to mask autism behaviors,” she says.

Delayed diagnoses prevent early intervention

Additionally, if therapy is delayed, crucial skills in the child remain unaddressed. 

One skill that could be delayed is imitation, such as clapping hands and telling a client to copy that movement. 

The ability to imitate serves as a gateway to various other abilities, Furman says. For instance, a child might struggle to mimic classmates’ behaviors in school, hindering their social and academic development.

“Imitation is a skill that opens the door to a lot of other skills,” Furman says. “It might seem simple, to have a two-year-old copy me, but what happens if there’s a delay in teaching imitation? She might get into a school setting in kindergarten and not be able to copy her peers in her class, such as sitting at a table and raising her hand to ask a question.” 

It’s important that those in the field are collaborating so they’re aware this delayed diagnosis is happening and what to look for, Furman says. While pediatricians are experts in their field, they’re not experts in autism. 

How can services like Total Spectrum help?

Once the diagnosis is made, early intervention is vital with services like Total Spectrum, which leverages evidenced-based ABA therapy to personalize treatment.  

Using contemporary ABA therapy, Total Spectrum offers personalized treatments to focus on and treat individual behaviors. The ideal time to start therapy is between 18 months to 3 years old. 

Total Spectrum services can help your child: 

  • Build language and communication skills
  • Develop social skills
  • Increase tolerance for new experiences
  • Lessen meltdowns and tantrums
  • Succeed in school

Total Spectrum devotes an entire department of learned behavioral experts to conduct ongoing research regarding autism in girls and boys. 

“It’s life-changing,” Furman says of her work at Total Spectrum. “We do this because we are changing lives for the better for our clients. We want nothing more than for our clients to be successful and thriving in the community.” 


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